CERTIFICATE OF INSURANCE (2) Page 1 of 1
CERTIFICATE OF INSURANCE
Issue
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
James C Jenkins Ins Srvc Concd CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
License NO. 0545478 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES BELOW.
P.O.Box 5668
-oncord CA 94524
388-880-3602 INSURERS AFFORDING COVERAGE
insured: INSURER A: National Casualty Company
United States Specialty Sports Association INSURER B:
311 Line Drive INSURER C:
Kissimmee, FL 34744 INSURER D:
300-741-3014 INSURER E:
OVERAGES
The policies of insurance listed below have been issued to the insured named above for the policy period indicated. Not withstanding any
requirement,term,or condition of any contract or other document with respect to which this certificate may be issued or may pertain,the
nsurance 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.
"TR Type of Insurance Policy Number Policy Policy Limits
Effective Date Expiration Date
A General Liability KR00000002273500 1/1/2012 1/1/2013 Each Occurrence $2,000,000
Commercial General Liability Damage to Rented Premises(ea occ) $1,000,000
Occurrence Basis Med Exp(any one person) $ Excluded
General Aggregate $ None
Personal and Adv Injury $2,000,000
Products-Comp/OPAgg $2,000,000
Participant Legal Liability $2,000,000
Description of operations/vehicles/exclusions added by endorsements/special provisions:
overage includes amateur play and practice in the insured sport for: City of Clear-water/ Lady Bombers
The Field/Facility Owner shown as the certificate holder shall be an additional insured but only with respects to liability
-aused by the negligent acts or omissions of the named insured and only with respects to losses resulting from amateur
Slay and practice during USSSA sanctioned activities occurring between the coverage effective date listed below and the
3olicy expiration date.
-ertificate Holder: Coverage Effective Date:
Cancellation: Should any of the above described policies be
City of Clear-water r/ Lady Bombers cancelled before the expiration date thereof, the issuing insurer
Tony Crat will endeavor to mail 30 days written notice to the certificate
holder named to the left, under Certificate Holder, but failure to do
12C CIIkrt fret so shall impose no obligation or liability of any kind upon the
Clear-water FL 33733 insurer, its agents or represenatives.
Dertificate# UA-134337 Authorized Represenatives: ,
ittp://www.usssa.com/sports/IC.asp?Seqno=OA8AE707-383B-40B6-BF2E-2EEDD3C8A7FO&Cert=O 4/19/2012