INSURANCE CERTIFICATE
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. : ISSUE DATE IMM/DD/YYI
1 C E R T I F' I CAT E 0 f I + U RAN C E I: ;-; . ,:
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PRODUCER :THIS CERTIFICATE IS ISSUED AS A ~ATTER OF' INFORMATION ONLY AND CONfERS
~- :NO RIGHTS UPON THE CERTIF'ICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
r~i~~Bl~o~l~~~~dce Agency i~~:~~~-~~-~~:~~-:~~-~~~~~~~~-:~~~~~~~-~~-:~~-~~~~~~~~_~~~~_____________
P.O. Box 455 : COMPANIES AfFORDING CO~ERAGE
l8~4yi;l6~141~ts, VA 23834 ;CDMPANy--------TRAHSAMERICA-INSURANCE-COMPAKy---------------------------
,---------------------------------------------------------iLETTER A
: INSURED :CORPaR,-----------------------------------------------------------------
: : LEiTER B
: UNITED STATES SLO-PITCH SOFTBALL ASSOCIATION :rDRPaRY-----------------------------------------------------------------
: INC. (USSSA). UNITED STATES SLO-PITCH snfTBALL :LETTEH C
: HALL OF fAME'FOUNDATION, INC., ET. AL. - :CORPaR,-----------------------------------------------------------------
i P.O. BOX 2047 :LETTER D
: PETERSBURG, ~A. 23804 :rDRP.RY-----------------------------------------------------------------
: : LETTER E
:' COVERAGES "=="'==="==,="'===,=,===""==="'=,="'=,=="===,"="=="'===,===,=,==========="===""===="=,="'=,""'==="
: 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 AHY REQUIREMENT TERM OR CONDITION OF' ANY CONTACT DR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
: CERTIFICAtE MAY BE ISSUED DR MAY PERTAINl tHE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
: EXCLUSIONS AND CONDITIONS OF' SUCH POLICI.S. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
lCO : l POLICY : POLICY i
:LTR: TYPE OF' INSURANCE POLICY NUMBER :EFFECTIVE :EXPIRATION: LIMITS
: : I l DA.TE 1 DATE :
:---t--------------------------------f----------------------f----------t----------f------------------------------------------------
: : GENER~L LIABILITY: ::: GENERAL AGGREGATE :; NONE
: A : : SSP 35042062 : 04/13/93 : 01/01/94 :-PRDDUCTS:rORP7DP~-aCGRECaTE----T~----I-n~~Unu-
: : [Xl COMMERCIAL GENERAL LIABILITY: :: :-PER~OmTaDmm:rm;IRJllRI--n---Tn~ UUU-
.: : [] CLAIMS ~ADE [Xl OCCUR. : :: :-..rJrDrrtJRREHrE'---------------rr---n~'unu-
: : [ ] OWNER'S . CONTR~CTOR' S PROT.: ::: -PIRn.fmCE-Un--oiie--tlreT-----rr------,U'UUU-
: : [ ] : ::: -~Enrran!PER5Haii--oiie--ersoiiTrr-------,'nun-
i---f----:::::::::::::::::::::::::::-f----------------------t---------------------t-------------------~-----~------t----------:----
: : AUTOMOBILE LIABILITY: :: COMBINED SINGLE :
: l f :: LIMIT :$
: ~ [ ] ANY AUTO: :: ___n__n_______nn_nnnnn_t-n--------nn
: : [ ] ALL !JIlNED AUTOS: : BODILY INJURY :
: : [ ] SCHEDULED AUTOS: : IPer I,erson) :;
: : [ 1 HIRED AUTOS: :--------------------------------+-----------,---
: : [ ] NON-OWNED AUTOS: : BODILY INJURY
; : [ ] GAR~GE LIABILITY : IPer a""i,lent) :;
1 [ ] :--------------------------------f---------------
: : PROPE:RTY DAMAGE ~
I : : t: :$
i---f---~----~-----------------------+----------------------f----------f----------t--------------------------------t---------------
: : EXCESS LIABILITY : ::: EACH OCCURENCE : $
: i [ ]Umbrella Form : i: ~-~CGRECATE---------------------;r-------------
: : [ ]Gther Than Umbrella Form : i; ~-------------------------------r--------------
l---f--------------------------------t----------------------f----------t----------t--------------------------------f---------------
: : WORKER'S COMPENSATION : ::: : STATUTORY LIMITS :
: : AND : :: :'EilrnrCrDERT------------------rr-------------
:: EMPLOYERS' LIABILITY : :: :-DBEa~F-PDmn!m---------rr-------------
: : : ::: -nrSEaSE-:-..rnI'll'LDYEE"-------n--------------
l---+--------------------------------f----------------------f----------t----------t------------------------------------------------
: iDTHER : :: i
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i DESCRIPTION OF OPERATIONS/LOCATIONSjVEHICLES/SPECIAL ITEMS
: FIELD OWNER LISTED BELOW IS NAMED AS ADDITIONAL INSURED IN ACCORDANCE
WITH ATTACHED ENDORSEMENT CG 2011.
,
,
:' CERTIfICATE HOLDER ="==,="'==~"'==="'====="'==="'== CANCELLATION """"'==="'====""=""=,="'=,=="=~=""==""===,
: R E eEl V ED: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
: City of Clearoater : EXPIRATION DATE THEREOF~ THE ISSUING COMPANY WILL ENDEA~DR TO
: P.O. Box 4748 : MAIL 30 DAYS WRITTEN nOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
: Clearoater, FI. 34618 APR 2 6 1993 : LEFTf BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION DR
: : LIAB LITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OF REPRESENTATIVES.
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CL 247
(1-85)
POUCY NUMBER: SSP-3S1142C62
THIS ENDORSEMENT CHANGES THE POUCY, PLEASE READ IT CAREFULL.Y,
CG2C 1111 85
ADDITIOr.:A!. INSURED-MANAGERS OR LESSORS OF PREMISES
This endorsement modifies insurance provided undor the following:
COMMERCIAL GENERAl. L.IABIUTY COVERAGE PART
SCHEDULE
1. Designation of Premisos (ParI Leased 10 You): AS REQUESTED AND ENDORSED
2. Name of Person or Organization (Additionat Insured);
AS REQUESTED AND ENDORSED
3. Additional Premium: INCLUDED
(If no entry appears above. the information required to. completed this endorsement will be shown in the Declarations
as applicable to this endorsement.)
'.
. .
WHO IS AN INSURED (Section II) is amended to include as an insured the person QI'. organization shown in the .
Schedule but only with respect to liability arising out of the owner$hip, maintenance or Uli8 of that part of the
premises leased to you and shown in the Schedule and subject to the following additioi1aJ exc/u$ions:
This insurance does not apply to;
1. Any .occurrence' which takes place after you cease to be a tenant in that premises.
2. Structural alterations. new construction Dr demolition operations perfOIi'ned by or on behalf of the pgrson or
organization shown in the Schedule.