CERTIFICATE OF INSURANCE
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I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NOu---
I RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND
. OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. .
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I COMPANIES AFFORDING COVERAGE
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I COMPANY A
i LETTER
RODUCER
LINGER
._ . JFK PARKWAY
SHORT HILLS. NJ 07078
TELEPHONE: 1-800-526-1379
MARKEL INSURANCE COMPANY
:ODE
SUB-CODE
j COMPANY B
I LETTER
i COMPANY C
'LETTER
I
I C~ANY D
LETTER
i COMPANY E
i LETTER
~SURED
REGISTERED TEAMS OF THE AMATEUR
SOFTBALLASSOC~TIONOFAME~CA
Clearwater Lady Bombers SB LG
Lynda Estes
4345 Ridgemoor Drive North
Palm Harbor. FL 34685
:;OVERAGES .,
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAIlED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWffiISTANDING 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POlICIES. LIIITS SHOWN. MAY HAVE BEEN REDUCED BY PAID ClAIMS.
TYPE 0
_."_.____n_"" I POUCY EFFECTIve -~-"-
i POLICY EXPIRATION
F tNSURANCE i POLICY NUMBER LIMITS
i DATE(MMIDDIYY) DATE (MMlDDIYY)
ILlTY I ,
3602AH230069 .SEE EFFECTIVE 01101107 GENERAL AGGREGATE $5 000.000
IAL GENERAL LIABIUTY I DATES BELOW PRODUCT5-COMPIOPS AGGREGATE $2 000 000
MADE ~OCCUR. I I PERSONAL & ADVERT\SING INJURY $2 000.000
ANT LIABILITY I EACH OCCURRENCE i $2 Ooo~l!l!,_
Number of Teams: 6 I FIRE DAMAGE (Anyone fire) $300 000
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6. iGENERAL LIAB
!Xl COMMERC
rTlClAlMS
A. ! X J PARTICIP
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I GENERAL AGG~EGATE APPLIES ~ER TEAM i MEDICAL EXPENSES (Any one peISOIl) i $5.000 .
IMPORTANT:'TEAMS MUST BECURRENTL Y REGISTERED WITH ASA TO BE ELIGIBLE FOR COVERAGE. (Non-participan~ QO/y)'
E FECTIVE DATE I TEAM NAME
1/1/2006 Clearwaler Lady Bombers 10U
1/112006 . Clearwaler Lady Bombers 16U
EFF TIVE ATE I TEAM NAME
1/1/2006 Clearwater Lady Bombers 12U
1/1/2006 Clearwater Lady Bombers 16u Gold
EFFEC V DATE I TEAM NAME
1/112006 Clearwater Lady Bombers 16U
1/112006 Clearwater Lady Bombers 14u
Important Note _ If Waiver and Release Plan purchased, signed forms must be kept byTeamlLeague for a minimum of three years.
COVERAGE UNDER THIS POLICY SHALL APPLY TO LIABILITY OF THE INSURED TEAM/LEAGUE LISTED ABOVE ARISING OUT OF THE ADMINISTRATION, PLAY OR
PRACTICE OF AMATEUR SOFTBALlJ8ASEBALL, BUT ONLY FOR INCIDENTS INVOLVING BOOILY INJURY, PERSONAL INJURY OR PROPERTY DAMAGE. THE
CERTIFICATE HOLDER BELOW IS NAMED AS AN ADDITIONAL INSURED TO THIS POLICY (SEE ENDORSEMENT PAGE ATTACHED).
.. ..___"..,:_.~--.,__._____..___~v_-:_~_..__.__---::__~.--:---:-________--~--~---,.-~..,.-~-.-:------:-----c-----,-.~-----:-~~~----~'-.~---~--:--:-:c-..-...
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I ! AUTHORIZED REPRESENTATIVE 7Jp~
. ._.... _.._____~____---__-"-.--....,.---.Ll--- - ---~ ----- -------- ~-~~..,.--
ACORD CORPORATION 1988
CANCEllATION
, I
;. .! SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
, EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL~
., 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 KIND UPON
i i THE COMPANY,ITS AGENTS OR REPRESENTATIVES.
: !
CERTIFICATE HOLDER
City Of Clearwater
..... ~,1
ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION FOR
AMATEUR SOFTBALL ASSOCIATION OF AMERICA ACTIVITIES
-his endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
!~moolnsu~ ,
As shown on the attached Certificate of Insurance I
I
! Policy Number i Policy Period ! Endorsement Effective Date 1
I 3602AH230069 I 01/01/06 - 01/01/07 I As shown on the attached Certificate oflnsurance :
: Issu=;~~':~!~_~,!~NEE CO~~~~______ I AUth:Zoo_~_~~rese~tative~. ~iii'.. :
(The above infonnation is required only when this endorsement is prepared after the policy is issued.) ~
SCHEDULE
Name of Person or Organization:
As shown on the attached Certificate of Insurance
A. The following is added to Section II-WHO IS AN INSURED:
The person or organization shown in the above SCHEDULE but only with respect to liability arising out
of the organization, promotion, administration and conduct of amateur softball/baseball activities,
including games, practices, tournaments, and fund-raising activities, under the rules of the Amateur
Softball Association of America, provided:
a. That if the person or organization is designated as a Team, the person or organization so designated
shall be deemed to include team members, managers, coaches, assistants, batboys, registered
scorekeepers, sponsors, any other individual participating in the official functions of the team, and if
so indicated, a Field Owner, but only for liability arising out of the designated Team's amateur
softballlbaseball activities covered under this policy;
b. That if the person or organization is designated as a League, the interest of the League shall not be
included unless all teams in the League purchase this insurance. .
When the interest of the League is so included, the person or organization designated as a League
shall be deemed to include all teams in the league and team members, managers, coaches,
assistants, batboys, registered scorekeepers, sponsors, any other individual participating in the
official functions of the League or of any such teams, and if so indicated, a Field Owner, but only for
liability arising out of the designated League's amateur softballlbaseball activities covered under this
policy;
All other terms and conditions of this policy remain unchanged.
1959GL 10 00
Indudes copyrighted malerial of Insurance Services Office. Inc. with its permission.
Copyright, Insurance Services Office. Inc.
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