2022/01/22 Young Champions Recreation Programs, Inc.--^\ -ACORLI oarE l5t/oo.YYYY)
7t20t2022
THIS CERTIFICATE IS ISSUED AS A MATTEN OF INFOHIIATION ONLY AND CONFERS NO FIGHTS UPON THE CERTIFICATE HOLDER. ITIIS
CERTINCATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENO, EXTEND OF ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSUBANCE OOES NOT CONSNTUTE A CONTBACT BETWEEN THE ISSUING INSUREB(S), AUTHORIZED
REPBESENTATIVE OR PRODUCEN, AND THE CENTIFICATE HOLOEN.
IMPORTANT: ll the cartllicale holder ls an ADOITIONAL INSURED, the pollcy(ies) must have ADDITIONAL lNSURED provislons or be endorsed
thl! certlllcate doea not confer dg hts to th6 cortlllcate holder ln llou ol ruch endor3emcnl{3).
PA@UCER
Arthur J. Gallaghor & Co.
lnsurance Brokers of CA lnc. LIC # 0726293
18201 Von Karman. Suite 200
lrvin€ CA 92612
ArthurJ Gallagher & Company
949-349-9800 949"349-S962
INSUBEB(5) AFFOFDINC COVEFAGE
INSUEEF a: Phrl hra lndemnr lnsurance Co 18058
tisunED
Young Champrons Recreation Programs, lnc.
and Champion Youth Outreach Programs, lnc
322 Oak Placo, Ste B
Braa CA 92821
t auBEBB, Sonthel lnEuranco Company Ltd 11000
!-rguBEuq: PhilalqP}ra lnd6mnity lnsur€ncr CoEPqly _
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IXSUEEF E:
18058
COVERAGES
CERTIFICATE HOLDER
CEHTIFICATE NUMBER : 5759s5652 R N NUMBER:
CANCELLANON
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO TO THE INSURED NAMED AAOVE FOR THE POLICY PERIOO
INDICATED NOTWTHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CEBTIFICATE MAY AE ISSUEO OR MAY PERTAIN, THE INSUFANCE AFFORDEO BY THE POLICIES DESCRIAEO HEREIN IS SUAJECT TO ALL THE TEBMS.
EXOLUSIONS AND CONOIIIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED 8Y PAIO CLAIIUSrNsF rypE oF rirsuBANcE 'ir?"t Yff poucy NUi EER r&?ts8ltTu ,i&$Bhil'"r IlrTTS
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RE Projcct Nama Elevation Church 26250 Bradl6y Rd Mcnitoc CA 92566
City of Menifee, its officers, offlcials, omployees, desi
Attn Tina Chrupcala
gnsted Volunteers & agents sorvrng as rndependent
contract in the role of city ot agency otficials
29844 Haun Rd..
Menifee CA 92586
SfIOULO ANY OF THE ABOVE OESCFIBEO POUCIES BE CANCELLED BEFORE
THE EIPIRATIOTI OA'E THEBEOf. I{OTlcE WILL BE OELIVERED I}{
ACCOBDANCE }VIT}I THE POLICY PBOVISIOT{S.
AUTHOFIZED FEPBESE IATIVE
O 198&2015 ACORD CORPOFATION. Allrlghts relsrvod.
Tho ACOFO nlmo and logo aro reglstorrd marks ol ACORD
2'or 3 2s5O
ACOED 25 (2016/03)
CERTIFICATE OF LIABILITY INSURANCE
r SUBROGATION lS WA|VEO, sublect to tho t6rm3 rnd condltlon3 of the pollcy, cenaln pollcles may requlrc an endorlemont, A stalement on
I
P( )t.t( t)'# PNPK2427636
Pr-AS-010 (04/04)
THIS ENDORSEMENT CHANGESTHE POLICY. PLEASE READ IT CAREFULLY
ADDITIONAL INSURED: OWNERS AND / OR LESSORS OF PREMISES,
LESSORS OF LEASED EQUIPMENT, SPONSORS OR CO.
PROMOTERS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
This policy is amended to include as an additiona lnsured any person or organization of lhe types
designated beiow, but on y with rospect to liability arising out of your operations:
1 . Ownors and / or lossors of the premisos loas6d, rsnted. or loaned to you, subject to the following
additional exclusions:
a This insurance applies only to an "@currence- which takes place while you are a tenant in the
premises;
b. This insurance does not apply to'bodily injury'or "properly damage" resulting from slructural
alterations. new construction or demolition operations performed by or on behalf of the owner and
/ or lessor of the premises;
This insurance does not apply to liability of the owners and / or lessors for "bodily injury'' or
"property damage" arising out of any design defect or struclural maintenance of the premises or
loss caused by a premises defect.
With respect to any additional insured includgd under this policy, lhis insurance does not apply to the
sole negligenc€ of such additional insured.
2. Lessor of Leased Equipment, but only with respect to liability for "bodily injury', "property damage" or
''personal and advertrsing iniury" caused, in whole or in part, by your marntenance, operatron or use of
equipment leased to you by such person(s) or organization(s) subjoct to the following additional
exclusions:
a This insurance does not apply to any "occunenc6" which takas place after the equipmant lease
expires.
3. Sponsors
4. Co-Promoters
c
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