PRACTICE THIRD PARTY CERTIFICATE OF INSURANCE AMATEUR ATHLETIC UNION OF THE US INC PRACTICE THIRD PARTY CERTIFICATE OF INSURANCE
AMATEUR ATHLETIC UNION OF THE U.S.,INC.
CERTIFICATE HOLDER City of Clearwater Parks and Recreation
COVERAGE DATES:
100 South Myrtle Avenue
Clearwater,FL 33756 01/01/2017-8/31/2017
This certificate is issued as a matter of information only and confers no rights upon the certificate holder.Thi's.'rti icak dge��not affirmatively or
negatively amend,extend or alter the coverage afforded by the policies below. This certificate of insurangoes iit ns itute a contract between the
issuin insurers ,authorized re resentative or producer,and the certificate holder.
PRODUCER INSURED M TIFICATE ID: 71,CFL6793
Foy Insurance Amateur Athletic Union of the U.S.,Inc. / / CLUB CODE: W W EB34
64 Portsmouth Ave Walt Disney World Resort /0I, I zinf'{yettz'fXaL� ��1ub
PO Box 1030 P.O.Box 10000 �� 1670 dV�rn SffedT �/
Exeter,NH e
03833-1030 Lake Buena Vista,FL 32830-100 �
(407)934-7200
t1�&�YZER(S)AFI� �PIYiG
Company A United State Fire Insurance Compa�yy'TAIC#i2111
i6 T r d�
Company B Everest National Insurance Compan nTR r ers to Company A or B.
COVERAGES- This is to certify/tklatthdPdlacy ies)of msttpafYeye hStCbelbhap f9een i ueJ to the insured named above for the policy period indicated.
Notwithstanding any requirement«tern o�c60ditapil o �y cb}tCI kp ot)3er}ouPmetf�llh re§peh t6Kvhich this certif cate may be issued or may pertain,the insurance
afforded by the policy harem is s{ �det t9 all t 0tins-,kvlu 7t s end co, n ch policy(ies),limits shown may have been reduced by paid claims.
r
INSR TYPE qF /PC COW"ftAC4EF FOERAG COVE RAS LIMITS
LTR INSu .. N�g ji f�AFE(nIDf/1)Pf Y) i�I)A E N J✓XT �
Accident 01/2®�T)2'01�A % C ideP4�ldyiical � 50,000
A Participant ] � 4 9/O1/2(t16 12 AM 9/'
Acd �nt LT9ed41 a �i�mmberment 10,000
• Excess 1/2017 12 O1 e3}f'Per Club 9,000,000
Liability � 1 �� Paicj AgatePerClub 9,000,000
.
General SIB 0 7�s
• �) � ( A' 9��U fJ1'�12�O1,�l�q[. Each Occurrence Limit 1,000,000
Liability / �� i �/ f General Aggregate Limit Per Club 3,000,000
sd//� Participant Legal Liability 1,000,000
Personal and Advertising Injury Limit 1,000,000
Products-Completed Operations Aggregate 3,000,000
e'
Fire Damage to premises Rented to You
.�� (Any One Premises) 1,000,000
' p Medical Expenses Limit(Any One Person) 5,000
Sexual Abuse Liability 1,000,000
gay ' Sexual Abuse Aggregate 2,000,000
ADDITIONAL INFORMATI I /SPECIAL EMS
I
Coverage applies to Blazm R venz Tfar�liC ub >�cen§V7RL/6793 Practice,Blazin Ravenz Track Club from
II
01/01/2017 through 08/31/200fd t,e osr netleriEi''d/or liabilities of the AAU Club(s)or registered members. For said club to have coverage,all membership
requirements in the AAU must be 17iet �
The Certificate holder shall be an AdditY� Insured,but only with respect to the operations of the Named Insured,subject to the provisions and limitations of
the policy(ies),attached CG 20 26 0413 applies.
CANCELLATION—Should any of the above described policies be cancelled before the expiration date thereof,notice will be delivered in accordance with
the policy provisions. But,failure to mail such notices shall impose no obligation for liability of any kind upon the insurer,its agents or representatives.
REVOCATION OF MEMBERSHIP-will result in cancellation of coverage.
FACILITY OWNER SHOULD VERIFY THIS CERTIFICATE.
Go to www.aausports.org,Resources,Insurance Certificates, Print/View Certificates
Certificate No.20176041 F3]
Authorized Representative inscertfaciliry.ipt
POLICY NUMBER:SI8ML00176-161 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED-DESIGNATED PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE
r
SCHEDULE yid
Name of Person or Organization: City of Cleary� tor
100 Souty Iyrticvxfe
ClearwaxeriFL'� TSfi°
r
/r
Event: Practice,Blazin Ravenz Track Club
Date: 01/01/2017 through 08/31/2017
THE ABOVE PERSON jI OGN1 PLO I �QDI �NA�)Ti� ��AS REQUIRED BY WRITTEN CONTRACT.
Ir %
endorsement#20176041
(If no entry appears abo �;��i}�fpracs Yfjdird to cbplpte tlus etiorseefik1 b slfdu ln �io l �claratigns a pplicable to
this endorsement.) ��� / r✓� "
A. Section II-Wh"is Al}Insprod'„s a0Vff4,ed tQ inc1uoc ag,aid adliT41 is ers ations(s)shown in the
i
Schedule,but only with fespvct to Yia(Y4i�y r `bpd y inl -� pop rty ama or� o a acid dvertising injury"caused,in
whole or in part,by your acts of 0111111"� n4pf thp4,Ia&t ng on, qtr ialf
1. In the performance ot� Qiti itpeY ti6P§�'or
2. In connection with your
rijClss pv�ned {�° d to ° „ 1
However: ° r�ri ��r «d'
1. The Insurance a�1o1�� to such adpa pri fnsu �(aly pal es to th �ztent permitted by law;and
2. If coverage p�wv cd to tic addition(1-tu i re(1lurpd bjJa contract or agreement,the insurance afforded to such
additional insured will not 1p� to ler th n i t h� pu aft eQiYired by the contract or agreement to provide for such
additional insured.
l �
B. With Respect to the insur 'ce nsureds,the following is added to Section III-Limits Of
Insurance: , ; p/
If Coverage providedztorti e &�jitip aY�p ut d 1 required by a contract or agreement,the most we will pay on behalf of the
additional insured is the Amos t of i fice:
1. Required by the coritta60�f or agrement;or
2. Available under the appi able Limits of Insurance shown in the Declarations;whichever is less.
This Endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
CG 20 26 0413 Copyright,Insurance Services Office,Inc.,1984 Page I of I