CERTIFICATE OF LIABILITY INSURANCE (2) CERTIFICATE OF LIB BIL. ,Y INSURANCE NTE
Keystone Risk Managers,LLC I CERTIFICATE#
1995 Point Township Drive
Northumberland,PA 17867 INSURERS AFFORDING COVERAGE:
ADDITIONAL NAMED INSURED!
CLEARWATER LL. INSURER A: LEXINGTON INSURANCE COMPANY
JDI-V� J NURrIi-ly
CAY DR, STE _1 INSURER B: NATIONAL UNION FIRE INSURANCE
(Non-Liability) COMPANY OF PITTSBURGH,PA
CL E AR WA I E R R, 33760
CHARTIS SPECIALTY
INSURER C: INSURANCE COMPANY
COVERAGES
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.AGGREGATE LIMITS SHOWN ll.41AY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
INSA ADD'L UMBER I S
LT14 INSRD TYPE OF INSURANCE I POLICY IN DATE MWDDNYYY 1 DATE MM(OD/YYYY
GENERAL LIABILITY i C),Q fx, 0
I Z.g GENERAL AGGREGATE!.
XIOCCURRENCE '22 2:0 f.,
210 14., 1
X 0 58 PROCIUCTSiCOMP 0 a
X INCL.PARTICIPANTS Property Damage Deductible:$250 AGGREGATE xt i C
--SEXUALABUSE
1
OCCURRENCE 1�11'_� C
X SEXUALABUSE SEXUALABUSE
AGGREGATE C'C
ANY ONE
MEDICAL PAYMENTS PERSON
EACH LOSS $1,000,000
DIRECTORS&OFFICERS
8119,'i 6� d1 P. 20 1 E,
AGGREGATE $1,000,000
EACH LOSS $35,000
4 Q t-3'rl 1 4 fD J.
CRIME COVERAGE
Crime Deductible:$250 Property/$1,000 Money AGGREGATE NONE
As in Master Policy i As in Master
B SPORTS EXCESS ACCIDENT Med.Max.$100.060 Policy Excess
Y R%'W�9 1 G 5 1 qn 4 10 1 zu C 2Q 1, Ded.$5U
"X"INDICATES COVERAGE SELECTED FOR ADDITIONAL NAMED INSURED
ADDITIONAL INSURED
Who is an insured(SECTION 11)of the General Liability policy is amended to include as an insured the person or organization shown in the schedule, but only with respect to
liability arising out of the above named Little League's maintenance or use of ball fields,or Other premises loaned,donated,or rented to that Little League by such person or
organizations and subject to the following additional exclusions:
1. Structural alterations,new construction,maintenance,repair or demolition operations performed by or on behalf of the person or organization designated in the Schedule unless
performed by the above named Little League and
2. That part of the ball field or other premises not being used by the above named Little League
NAME AND ADDRESS OF PERSON OR ORGANIZATION:
J:; t'T'Y OF l!"1NAL-I A�_S C,01UNTY
INSURED CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIE�,�T
6 TTHE ABOVE NAMED LITTLE LEAGUE BE CANCELED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER 0 �SENTATIVE WILL MAIL.30 DAYS WRITTEN NOTICE
Little League Baseball Risk Purchasing Group,Inc. TO THE DESIGNATED PERSON OR ORGANIZATION AT THEIR LAST KN I DO I RESS TO US
539 U.S.RT.15 HIGHWAY
Z
South Williamsport, PA 17702 AUTHORIZED
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