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CERTIFICATE OF LIABILITY INSURANCE (2) ACORO® CERTIFICATE OF LIABILITY INSURANCE 04/14/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUINGINSURER(S),AUTHORIZED REPRESENTATIV®R PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsementA statementon this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Bollinger, Inc. PHONE(A/C, FAX(A/C, 101 JFK Parkway No.Ext): 800-526-1379 No): 97 3-921-2876 ShortHills, NJ 07078-5000 EMAILADDRESS: Phone: 800-526-1379 Fax: 973-921-2876 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Markel Insurance Company 38970 Amateur Softball Association and Members of the JO INSURER B: FL - Florida ASA Individual Registration Program Carlton Benton INSURER C: 1843 Bedivere INSURER D: Lakeland, FL 33813 INSURER E: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR TYPE OF INSURANCE ADDL suaR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR —D GENERAL LIABILITY 3602AH230069 09/01/14 09/01/15 EACH OCCURRENCE $2,000,000 A Q COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED ❑❑CLAIMS MADE FVJOCCUR PREMISES(Ea occurence) $300,000 "Non-participants only MED EXP(Any one person) $10,000 A ❑V Participant Liability General Aggregate PERSONAL&ADV INJURY $2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: applies per Team GENERAL AGGREGATE $5,000,000 ❑POLICY ❑PROJECT ❑LOC PRODUCTS-COMP/OP AGG $2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ❑ANY AUTO (Ea accident) E]ALL OWNED AUTOS _ BODILY INJURY $ SCHEDULED AUTOS (Per person) ❑HIRED AUTOS BODILY INJURY F1 NON-OWNED AUTOS (Per accident) $ El❑ PROPERTY DAMAGE $ (Per accident) ❑UMBRELLA ( OCCUR EACH OCCURRENCE LIAB AGGREGATE ❑EXCESS ❑CLAIMS MADE $ LIAR ❑DED FI RETENTION $ $ WORKERS COMPENSATION AND WC STATUTORY OTHER EMPLOYER'S LIABILITY Y/N LIMITS ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ OTHER 4102AH220317 09/01/14 09/01/15 Med Max. $250,000 52-Week Benefit A Accident Medical Full Period. Deductible may apply Excess y pp y DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) COVERAGE UNDER THIS POLICY SHALL APPLY TO LIABILITY OF THE INSURED ARISING OUT OF THE ADMINISTRATION, PLAY OR PRACTICE OF AMATEUR SOFTBALL/BASEBALL, BUT ONLY FOR INCIDENTS INVOLVING BODILY INJURY OR PROPERTY DAMAGE. CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED. THIS CERTIFICATE IS ISSUED ON BEHALF OF: Clearwater Bullets 18U CERTIFICATE HOLDER CANCELLATION City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 112 S. Osceola Avenue AUTHORIZED REPRESENTATIVE X `_�/} ""r Clearwater, FL 33756 I/•1��� �'/ ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD