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PROOF OF INSURANCE (2025)AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03/22/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Acrisure, LLC 370 OLD COUNTRY RD STE 200 CONTACT NAME: (A//CC,NNo, Ext): (516) 746-4141 FAX No): E-MAIL ADDRESS: lemert@acrisure.com; mcorry@whitmoregroup.com; arcia whitmore rou Yg @ g P•com; cbiviano@whitmoregroup.com GARDEN CITY, NY 11530-1702 INSURERS) AFFORDING COVERAGE NAIC # INSURERA: Great American Insurance Company 16691 INSURED SPORTS AND RECREATION PROVIDERS ASSOCIATION (PURCHASING GROUP) AND INSURERB : ITS PARTICIPATING MEMBERS: Grace Marie Maxwell dba Athletic Grace Dance Studio INSURERC : INSURERD : 113 West Grand ave El Segundo, CA 90245 INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER: GAP124665 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR wVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE PREMISES (Ea RENTED occurrence $30Q000 CLAIMS -MADE OCCUR MED EXP (Any one person) $10,000 A X HOST LIQUOR LIABILITY INCLUDED X PAC 4725036 01/ 12:00 AM 12AM 04/01/2025 12:01 AM PERSONAL & ADV INJURY $1,000,000 X INCLUDES ATHLETIC PARTICIPANTS GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY JECRO- X P T LOC AUTOMOBILE A LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) ANY AUTO ALL OWNED SCHEDULED BODILYINJURY(Per AUTOS AUTOS accident HIREDAUTO NON -OWNED AUTOS PROPERTY DAMAGE Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAB I CLAIMS -MADE DED RETENTION $ A Professional Liability X PAC 4725036 04/01/2024 12:00 AM 04/01/2025 12:01 AM EACH OCCURRENCE AGGREGATE LIMIT $1,000,000 $1,000,000 A Abuse and Molestation X PAC 4725036 04/01/2024 12:00 AM 04/01/2025 12:01 AM EACH OCCURRENCE GENERAL AGGREGATE $100,000 $300,000 AD&D AGGREGATE $500,000 A Accident/Medical Coverage BSR-F162220-00 04/01/2024 12:00 AM 04/01/2025 12:01 AM AD&D MAXIMUM MEDICAL $100,000 $100,000 DEDUCTIBLE $100 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Dance Studio - Ballet/Pointe, Ballroom, Tap, Jazz, Zumba (R), Cultural/Heritage Style Dancing, Modern. Locations: 113 West Grand ave - El Segundo, CA 90245 The Certificate Holder is added as an additional insured but only with respect to liability arising out of the named insured during the policy period. Scheduled Activities Exclusion Applies -Please Refer to Named Insured Member Certificate of Coverage CERTIFICATE HOLDER CANCELLATION The City of El Segundo 300 Main st El Segundo, CA 90245 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Ac risA.we,, LLG ACORD 25 (2016/03) @ 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD