CERTIFICATE OF LIABILITY INSURANCE (3) CERTIFICATE OF LIABILITY INSURANCE
DATE 12/18/15
Keystone Risk Managers,LLC CERTIFICATE#
0912,1, 1—1
1995 Point lownship Drive
Northumberland,PA 17867 3 09 12
AD'DaQf0%i NAMED N SLRED INSURERS AFFORDING COVERAGE:
fNSURERA] EXINGTONINSURANCE COMPANY
M;,i'f T WF',RN]Et,47
052
ASHL,AND FERRACE INSURER& NATIONAL UNION FIRE INSURANCE
C 16.,L,.4'FC w A T E F"� r'", 3"'3761.. (Non-Liability) COMPANY OF PrrTSBURGH,PA
INSURER C: AIG SPECIALTY
INSURANCE COMPANY
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE lNSURED 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 08 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,
NSA ADD'L Y EFFECTIVE
LTR M$RO TYPE OF INSURANCE POLICY NUMBER POLIC POLICY 6 RAT�(;W
DATE MWDONYYY DATE MK`DDNYYY LIMITS
GENERAL LIABILITY EA — -_
X OCCURRENCE zwoccuaflf'zi $1,, 605 1 000
rl� X Y 410 16 1 /21./2017 _GDERAL AGOAEGATE $R1 0001 000
INCL.PARTICIPANTS Tj1Dp UMPOPS
±q2anrua, �De�d�Ulble:�1250
9 000 1 0 00
X SEXUALABU$E
000 0()
$21 0001 000
WEDICAL PAYMENTS —AWONf-
X DIRECTORS&OFFICERS 193J()95S 1, EACH LOSS $1,000,000
AGGREGATE $1,000,000
CRIME COVERAGE 0 114007'17 1 1")1,6 1 0 1/,"20 17 EACH LOSS $35,000
J_r)1 11,la,iz_
Crime Deductible:$250 Property/$1,000 Money AGGREGATE NONE
SPORTS EXCESS ACCIDENT As on Mwmef Poky As in Master
Max,$100,0w Policy Excess
SR O 91 0 5 4134 1/in 1/20 1 1 /01 �2017 me"
"X"INDICATES COVERAGE SELECTED FOR ADDITIONAL NAMED INSURED
F.
Who ls;an Insured(SECTION"II)-.;ti§e Mneral Liability policy is amended to include as an insured the p7ror',or orgarttiXato-otti;hown in the schMt*j`i'e,'but only wit rasp t 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 addffiorfaf exclvslons,
1, Structural aftrations,new cons"ion,maintenance,repair or demiftlon 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 pail of the ball field or other premises not being used by the above named Little League
NAME AND ADDRESS OF PERSON OR ORGANIZATION:
CITY Of ("LEAR l4AT]EI? 22 PINELLAS COUNTY SCHOOL. 130ARD
INSURED CANCELLATION
SHOULD ANY OF THE ABOVE DESCMIDEP POLICIES TO TREASOVE NAMED LITTLE:LEAGUE BE CANCELED BEFORE THE
Little League Baseball Risk Purchasing Group,Inc. EXPIRATION DATE THEREOF,THE ISSUINfY INSUAEIFA OR THEIR ACPMESENTATWE WILL MAIL 30 DAYS WRITTEN NOTICE
TO T14E DESIGNATED PERSON OR ORGANIZATION AT THEIR KNO"ADD! RESS TO
539 U�S.FIT.15 HIGHWAY
South Williamsport,PA 17702
AUTHORIZED REFIRESENTAVVE