CERTIFICATE OF INSURANCE
KSB
CERTIFICATE OF INSURANCE
1131166
ISSUE DAlE (MMIDDIYY)
5/03/05
PRODUCER
K & K Insurance Group, Inc.
1712 Magnavox Way
P.O. Box 2338
Fort Wayne, In 46801
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
INSURED
ESF, INC.
D/B/A SUMMER CAMPS/PHILLIES BASEBALL ACA
750 E, HAVERFORDROAD
BRYN MAWR, PA 19010
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
LETTER
GREAT AMERICAN ASSURANCE ,COMPA
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 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.
CO, TYPE OF INSURANCE POliCY EFFECTIVE POLICY EXPIRATION
lTR POLICY NUMBER IoATE (MINDDIVY) DATE (MINDOIYY) LIMITS (in thousands)
General liability 12:01AM 12:01AM General Aggregate $ 2000
~ I&J Commercial General liability PAC0558448900 5/12/04 11/12/05 Producls.ComplOps Aggregate $ 2000
o Claims Made 6LjOccur, Personal & AdvertiSing Injury $ 1000
DOwner's & contractors Proto Each Occurrence $ 1000
0 Fire Damage (Anv one fire) $ 300
Medical Expense (Any one person) $ 'i
Participant Legal Liability. .., .' $ N/A
Automobile Liability 12:01AM 12:01AM Combined
A o Any auto PAC0558448900 5/12/04 11/12/05 Single $ 1000
Limit
B All owned autos Bodily
Scheduled autos Injury $
(ner ~........,
IX] Hired autos Bodily
Ii] NofH)Wned autos Inju;r.......AAnI, $
'';''r '
o Garage liability Property
0 Damage $
-- &aess-liabHity - ---- .-- 12:01AM - - - Each
- --- 12:01AM Aggregate
A 0 EXC0558449000 5/12/04 11/12/05 Occurrence
o Other than Umbrella form $ 3000 $ 3000
Workers' Compensation Statutory
and $ Each Accident
Employers' Liability $ Disease-Policy Urn"
$ Disease-Eadl Employee
AD&D $
Participant Prfmarv Medical $
Accident Excess Medical $
WeeklY Indemnity $ X
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESJRESTRICTIONS/SPECIAlITEMS
CERTIFICATE HOLDER IS NAMED ADDITIONAL INSURED AS RESPECTS TO THE OPERATIONS
OF THE NAMED INSURED GENERAL LIABILITY CG2024
CERTIFICATE HOLDER
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CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE
CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE
ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS
WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO
THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE
NO OBLIGATION OR lIABILITY OF ANY KlN9 UPON THE
COMPANY, ITS AGENTS OR REPRESENTATIV~" /l
_AIJfHO~IZED REPRESENTATI~_::~K_~ ,/1
/ cJ____)
1-92
CITY OF CLEARWATER
CLEARWATER, FL
SL39