CERTIFICATE OF LIABILITY INSURANCE (5) CERTIFICATE OF LIABILITY INSURANCE DATE
Keystone Risk managers,LLC CERTIFICATE#
1.995 Point Township Drive
Northumberland,PA 1,7867
POOFFICHA NX FD N�"VRED: INSURERS AFFORDING COVERAGE,
INSURER A EXINGTON INSURANCE OMPAK
TIL C
...........--.....................
L INSURER B: NATIONAL UNION FIRE INSURANCE
(Non-[jahlfity) COMPANY OF PITTSBURGH,PA
INSURER C: AIG SPECIALTY
FINSURANCE 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 DR 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ONSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLMYEXPMATI N LIMITS
LTA INSM DATE MMMDNYYY DATE FAWDONYYY
GENERAL.LIABILITY
OCCURRENCE a 4 11_ 0 If 'GENERAL AGGA EGATE
X INCL.PARTICIPANTS
____,t!qp2!!tP!nage Deductible:$250 A G C AF.C A E
ALA
X SEXUALABUSE
SFXUAL ABUSE
.... ANYQNZ
MEDICAL PAYMENTS
... ....
ROIL—.—
EACH LOSS $1,000 000
DIRECTORS OFFICERS ..........
AGGREGATE $1,000,000
$35,000
EACH LOSS
I
CRIME COVERAGE .......
Crime Deductible.$250 Property/S1.000 Money AGGREGATE
NONE
A,�,t Maste,Poky As in Master
B SPORTS EXCESS ACCIDENT Mw,=,61 DO,)DO Policy Excess
1, 1, _7"0 J.
Dad,S50
"X"INDICATES COVERAGE SELECTED FOR ADDITIONAL NAMED INSURED
ADDITIONAL INSURED
Who is an insured{SECTION 11)of the GenoralUablity policy Is amended to Include as an Insured the person or organization Shown in the schedule,but Only with respect to
fabilily arising Out Of the above named Unfle League's maintenanoe or use of ball fields,or other premises loaned,donated,or rentrA to;that Little League by such person or
orgairizationsand subject to the following addifionat exclusions:
1. Structural alterations,new construction,maintenance.,ropatf or demolition operation's performed by or on behalf of the person or orgaNzalion designated in the Schedule unless
performed by the above named Little League and
E. That part of the ball field or other premises roi being used by the above named Little League
NAME AND ADDRESS OF PERSON OR ORGANIZATION:
INSURE.D CANCELLATION
SHOULD ANY OF THE ABOVE UESCRIOLD POLUES TO 1 H ABOVE NAMED LITTLE LE-AGUE'BE CANCELED SUCRE,THE
Little League Baseball Risk Purchasing Group,Inc. EXPIRATION DATIF THERFOIF,THE,ISSUINC�nNSURER OR THFIR REPRE55NTAIRVE WILL MAIL SO DAYS WRITTEN NOTICE
TO THE D-$IGNATED PERSON On OrIGANIZATION AT TH10��
,,K�"ADDRESS TO US,
539 U�.S.RT IS HIGHWAY
South Williamsport, PA IT702
AUTI10MZEDRrPnESENTATFV�