2023 Summer Outdoor Yoga ClassesSummer Outdoor Yoga Classes Schedule — Nikki Steinert — 402-312-9262
All classes to be held at Black Elk-Neihardt Park
Saturday, June 3d 10-11am
Saturday, June 10th 10-11am
Saturday, June 17th 10-11am
Saturday, June 24th 10-11am
Saturday, July 8th 10-11am
Saturday, July 15th 10-11am
Saturday, July 22nd 10-11am
Saturday, July 291h 10-11am
Saturday, August 5th 10-11am
Saturday, August 12th 10-11am
Saturday, August 191h 10-11am
Saturday, August 26th 10-11am
AG URO CERTIFICATE OF LIABILITY INSURANCEI '% """'
�....� 04/06/2023
Insurance Plus 866-756-5636
Arthur J. Gallagher Risk Management Services, Inc.
8430 Enterprise Circle, Suite 200
Lakewood Ranch, FL 34202
INSURED
Nicole L Steinert
730 N 16th St
Blair, NE 68008
nnVFRAnPA
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING
NAIC #
21199
Lines Insurance
Report all claims via e-mail at sarasota.bsd.operations@ajg.com
Ins. # 561456 INSURER B:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTAN DING
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSRADD'LI - - POLICY EFFECTIVE POLICY EXPIRATION
LTR 14,TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YYYY I LIMITS
GENERAL LIABILITY
r EACH OCCURRENCE
$ 2,000,000
-X COMMERCIAL GENERAL LIABILITY
02/28/202302/28/2023 ' DAMAGE TO RENTED
02/28/2024 �EMIsEs (Ea ogcurre _
$100,000
I
CLAIMS MADE x
#PLP0066026-01MED EXP (Any one person)
$ NIA
A
I PERSONAL &ADV INJURY
$ 2,000,000
XGENERAL
AGGREGATE
I
$ 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS COMPIOP AGG
$ 2.000,000
X POLICY I PRO LOC
JFQT
BUS, PERS, PROP, AGG I DED
$1,000/ $250
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$
j ANY AUTO
(Ea accident)
ALL OWNED AUTOS
1
E BODILY INJURY
$
SCHEDULED AUTOS
i
' (Per person)
HIRED AUTOS
i
BODILY INJURY
$
NON -OWNED AUTOS
(Por accident)
j I
PROPERTY DAMAGE
$
¢ (Per accident)
I GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
_ ;ANY AUTO_
EA THAN _EA ACC
$
AUTO ONLY; AGG
$
I EXCESS I UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR 1 CLAIMS MADE
AGGREGATE
$
DEDUCTIBLE
j
±
$
1 RETENTION $
I
$
WORKERS COMPENSATION
I WC STATU-OTH-
(_TORY LIMITS ER
AND EMPLOYERS' LIABILITY YIN
_i
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L, EACH ACCIDENT
OFFICER/MEMBER EXCLUDED?
I
(
(Mandatory In NH)
EL. DISEASE - EA EMPLOYE
$
If yes, describe under
5 ECI O 10 low
EL, DISEASE - POLICY LIMIT
$
A OTHER professional Liability
#PLP0066026-01 ( 2,000,aggre00 per occurrence 1$3,000,000 annual
ate
02/28/2023 102/28/2024
4
I I I
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Holder named below is listed as an Additional Insured for the General Liability policy.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Blair DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
218 S 16th St NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL
Blair, NE 68008 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE —
ACORD 25 (2009101) OO 19UH-2009 ACORD CORPORATION. All rights reserves.
INS025(200901) The ACORD name and logo are registered marks of ACORD
Yoga Liability Waiver
In any physical activity, risk of serious injury is possible. Yoga and other activity is no substitute for
medical diagnosis and/or treatment. The student assumes the risk of yoga or other activity and releases
the teacher, Nicole Steinert, and the City of Blair from any liability claims.
I am participating in classes or workshops with Nicole Steinert. I am aware of the physical risks involved
with exercise and understand it is my personal responsibility to consult with my doctor regarding my
participation. I have no medical conditions, that I am aware of, which would prevent me from taking
part in classes or workshops, and I assume responsibility for any risk or injury I may sustain as a result of
my participation. I have read the above release and waiver of liability and understand its contents. I
understand that it is my responsibility to find a pace that suits me. I agree to the terms and conditions
stated above.
Printed Name:
Signature:
Email: (optional)
Phone: (optional)
Date:
Please contact me for future classes and workshop offerings: Yes(_) No (_)
Preferred contact method: Email (_) Phone (Texts) (_)