CERTIFICATE OF LIABILITY INSURANCE (2)
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Nov 12 04 03J28p
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Ellen Hl!!'nr~
WINI'HNI..:l INNINI..:l
801-683 -8218
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OP 10 E DATli: (~'oOrNvY)
n:srC:-3 11 15: 04
IS CERTIFIC~ IS ISSUED ~ A MATTe OF INFORMATIO
ONLY AND CONFI:RS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOes 1II0T AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
A.~Q8t'-
CERTIFICATE OF LIABILITY INSURANCE
THe POllCICS OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABove FOR THE POLICY peRll~;lO lNQI(:A.Teo. NOTWlrHSTA,..C1Nl3
Atf( RfCluIReMfN'T. TERM OR coNDITION OF ANY CONTRACT OR OlliER [)OC\.IMENl' WITH RESPECT TO WHICH THIS CERTIFICATE MAyae ISSU60 OR
MAY PERTAIN. THE INSURANCE AFFOfU$O BY THE POUCIES Ds,;eAIB!D HEReIN IS ~UEIJ~ TO ALL itie TERII/IS. IOXCI.UOlON~ ANDCONOlnONG QF SUCH
POUCII!l!l. AGCAE~TE U,..TS !JI1OW'" MA.Y HAW Bfil;Jll ~l;OUCI;D 5Y PAID c::lMI\S.
, -~.mri:J:!OYIYE pol.lcv E "', ~ u. ._ ,~___. - ----
LTR INSR T'tPf' IV e 1'OLIO'f NUMBER DOI'fyi DATI; UMIT&
! gEm'1Yd- LlollBILITY F;^e~ OCC\JRRF.NCE $).,000,000
AI ~ OOMloICRClAL GCNl::~L LlADIUTY '1!BD 11/12/04 11/3;2/06 -P1\1\1llm:"ro"Rcm:u s .so ,000
,F>Rl::III!l::;,CS,(L.~ occumn",,)
::=J CLAIM!> M"'~. ~ OC~f.\ ~ ."
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X Athletic I ~~AONAL & AOIIINJUR\I $1,000,000
, . , . .. ~. ,"-""-
. i Cc~KALAQQH~OAT~ "~_;Z,!, ~_o,_O,,~[)~ 0_
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I 131011I'1. ,.r;GHl',GATF I,IMI'!' JlPI"LIP.:5 PER: PRODUCTS - COMPIOP AGO . 1,000,1)00
!xl POLII;T r--I ~~T I -, I U1C I
, AUTOMOBILe LIAIlIUTY ! COIllIlINI.:O SINGLE LIMIT
I 'I-- I ,
ANY...lITO I (C~ a.x:ido:nl)
- , . " ' . .,,- ~.., ...... ..-.. ,I' , ......".
ALL OWNFD Aum!'! I DO~Y INJURY
I" I I $
~Hr=OI.lI Fin "t.rTO!': ! (Ptor penon)
...-- I
HIRED /lllITOS , OOOlly IN.JUKY
.., $
NO...'OWNED AUTOS , (l"8l'lICIOlclClnl}
......- I .., ... , , '.' . .. "
- ._......M". ... . , , .. .....-.-..... PROPF.RTY DAMAGe $
("'llI'~o;jC(oontl
GARAGE 1I6GlILITY A\JTO ONLY, t:A ACCIDCNT I
:==i ANY "lITO ; -.......-...
, OTHF,f! "HAN r:^ Aee I
i AU''O ONl 't~ AC(.I $
. -
I;IICl:!ltIllUlIIBRELIA UAIiIILm" I I bAeM OCCUR:MENCC $
i-I OCCUR ' I"'l Cl^'M5"'/\/JF. . ". , . ,
I I\GGR~ClI\Tt ,
I ... ....-...---
_..._,,--- $
R OEDUC'n~1;i i $
Rl:!TI:NnON $ S
WOR1(ERS CQMPetll/MllON JoND I Iro~Y':G;&U__L:A.W
EMP'~t:l'tl!!R.lI' LIABILITY I 1-----
A~ PROPRIGroIWA~r;;:R/Q(E'CUTJVi;; . E;:,L, r,;ACH ^CCII;lF,iNT $
OFRCl!:RIMtM~ EXCLUDED? I l:1,L D\::.1:;ASl: - ~. ~~rY?",!,:1 i
~rrt~t&C~~~"Or.s ""'- . -.. , . ...... ~ ~. " I. ".
D, L DlSCASC - POLICY LIMIT $
OTjoIER
B Acoido~~.1/Ye~~ TeD 11/1.2/04 I 11/12/05 Pll!~ Pe;rso 10,000
i Ded Pe;z:;lSo 100.00
OIUlCHlf'nON Q~ QI"EHA1lONSI LOCATIONS 1 VEtllaLl!SJ EXCWSIONS AODal BY INDOft8El\fEtfT I sptClAl, PflQIIIIlONS
Add.i t:i<>full ins'Uz:ed; City of Cle.~ Wat:e;r, PO Box 4'749 Cle3r Water. !';r.. 33758
Oescription of Benefits: Acei&:nt:a1 Dc~th. Di.sroembermen't , or 1.0ss of Sight
$2,500; ADcidcnt:ll ~di.ca1. Expc:ultl! Benefit FulJ. 'E.xcesal Max Benef;i.t I'Cr
ecvered po)!'l!lon $10,000 wI benefit iIDlQ'l.U1 t lOO~ of uauAl & CustomaJY Chll.:t'ge;
Oeductible per person $100.00
f'RQOUCEN
~zicaD SpO%ts Insurance ~%p
Michael Henry
53841 Popla. AVWlue., Sw..tocl 204
Memphis TN 3811~
Y.bon~:901-683-8321 Fax:901-683-0391
I,;iuqeo'. .,.,...., . ... ........._ft.~---
The Winning Inning, Inc.
Rangy C;. Hol~and
PO ;wox 15953
clearwate~ rL 33166
COV~RAGfS
CERTIFICATE HOLDER
INSURERS AFfORDING COVERAGE
NAIC#
IN!IU~ Po:
INSlJRl;R a'
JN$VHE:~ c:
Amerid4Jl ~ tern.at:i Vel Co
QBE IDsul:~" c;~!lY.... _ ,_..
INI!lIJRCR D:
IN$uREf.C E;
CANC~L.LAnON
FOR INF SHOULtI ANY OP 1lI~ ABOVE DE'SCAIDUII PP~'CIf;8 CIO CANeElLEO BEFORE THE &XPlRATlolII
DATE THl1:REO~. THIlI!lSUING IWSlJ~GR WI~L. ,"N~lOAVO~ TO MAlL. ~~__ DAYS WRfTTION
NOTICE TO Tlo4lil CliRTIFICAiE HOLDER HAMeD TO THE< LI>PT.IlUT "AlLURE 10 00 so SHALL
IMPOSE 110091.10411011I OR LIABILITY Of MY KIND UI'O" Tl'Il! INBUftE!R.1I AGENTS OR
REPRE~ENTATlYl!!I.
AuTHORIZeO Fl,EPRI!8I!NTATIVE
JI1C)c Russell stadium
800 Ph1l1ios Pr~Ye
Clearwa~r FL33165
Miehael'R. HCIID