Loading...
CERTIFICATE OF INSURANCE (6) CERTIFICATE OF INS URA NCE issue Date: 1/10/2017 THIS CERTIFICATE IS ISSUED AS A MATTBR.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 ISSUING INSURER(s),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE.GERTIFICATE HOLDER. Important,If the certificate hoiden is an ADQITIdNAL 1NSUREDr the pol.icy(ies)must be endorsed,If SUBROGATION IS WAIVED,subject to the terms and condistions of the policy;certain pblicies may require an end.i rsernent.A statement on this certificate does not confer rights to the certificate Holder in lieu of such endorsernerit(slieu Producer: INSURERS AFFORDING COVERAGE .EPIC Brokers iNSURER..A:National Casualty.Company License No-0129370 INSURER B:National Casualty Company P.O.Box: 13847 INSURER C;Nationwide Life Insurance Company Sacramento CA 95853 INSURER a 888-880-3602 INSURER E: Insured: United States Specialty Spurts Association 5:11 Line.Dri vice Kissimmee, 1~L 34744 8Q0-741-3014 Coverages: 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.documentwith respect to which this certificate maybe issued or may pertain,the insurance afforded by the policies described herein is subject to all the terms,exclusions and conditions of such policies..Lirrlits shown may have been redUCed by paid claims. :INSR A�DL SUBR. Policy Policy i LTA Type of insurance 1 50 VV11D Policy Number Effective Expiration Limits { Date date A Commercial General Liability y I\ KRO00000a6630200 111120.17 1/1/2018 cecl�C)cCtfrrcrycc sa]Of1,c7U0 E C]C UrenCe Basis Damage to i me d Prrnfisestea occ)K300.o( Hied Exp[any one.person)$!-:e]utled General Aggregate$Node Personal aF�d A&Injury S2,WO,060 t'roducts-ComplOP.Agg S2.pOp;OOCf 111 Participan[regal Liabilitv.S2,Or ODO $ Excess Liability y N XK.0000QO06630500 1/112017 9111201$ fsaciF C7rcurrCnee Sl.oa],rloa A ggrcAalc.S I.,f)OD;[1Utt. C Participant Accil ent SPX00000278.70900 111!2017 111/2018: AD&D$None 116pliary Mcdic,'%l S Nonc y l;xcess;4ledieal$€OO,OCICI Weekly InderoniryS None DESCRIPTION OF pPERgT1QAf$1 LOCATIONS 1 V!~}3ICLE5.(ACORD 161,Addiitio"al Remarks Schedule may be attached If more space is required) Coverage includes amateur Play and practice in th.e.insured sport for:Clearwater Lady Bombers-Barb-or 04 USA 12-U- 017-9176i305258T [ - Certificate holder shalfbe are additional"insured but only with respect to liability caused by the negligent acts or omissions of the named insured and only with respect to losses resulting from the team Y league listed and occurring between the coverage effective date listed below and the policy expiratlon date,'g50MO Dedvotibfe for excess medical Certificate Holder. Cnv.erdge Ettective`Date-, 1/10/2017 9:48M PtIM Clean water Lady Bombers.- Barber 04 CANCELLATION Angela McEvoy SHOULD ANY OFTHE.ABOVE DESCRIBED POLICIES BE CANCELLED. 1628 Short Birch.Ln BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE.DELIVERED TriniV FL:3465 IN ACCORDANCE WITH THE POLICY PROVISIONS. Certificate# USSSA-305551 Authorized Representatives, CERTIFICATE OF INS UIZANCE Issue Dale: 111012017 THIS CERTIFICATE IS ISSUED AS A MATrER.O>"INFORMATION ONLY AND CONFERS:NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTI.FICATE DOES NOT AFFIRMATIVELY OR NEGAT AMEND,EXTEND OR ALTER THE COVERAGE AFFORCED 13Y THE POLICIES BELOW: THIS CERTIFICATE OF INSURANCE DOES NOT CONSTrrUTE A CONTRACT BETWEEN THE ISSUING lHSLIRER(s),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. Important:If the certifcate holder is an ADDITIONAL INSURED,the policy{ies)#-oust be endorsed.If SUBROGATION IS VIIAIVED,subject to the terms and cnndistions.of the policy,cartain policies may require an endemernenL A statement on this certificate does not canferrights#o the.certificate holder in lira of such endorsement(s). Produce]-* INSURERS AFFORDING COVERAGE EPIC Brokers INSURER A:National Casualty Company :License No.OB29370 INSURER B-National Casualty Company P.O.Box 13847 iNSURER C; Sacramento CA 95853 INSURER 0.,. INSURER E.- 888-880-3602 Insured: United Status Specialty Sports Association 611 Lime Drive Kissirnnice,FL,34744 $0p-741-3014 Coverages. This is to certify that the.polidies of insurance listed below have been Issued to the insured named above for the policy period indicated,Notwithstanding any requirement;term,.or condition.of any contract orother document with respect to which this certificate ma.y be issued or may.pertain,the.insurance afforded by the policies described herein is subject to aII the.terms,exclusions and conditions of s..uch poiicfes.Limits shown may have been reduced by paid claims, tNSR A©l7L SLfBR Policy Policy LTR TYPO of Insurance I.NS� VvVS� Policy:Numiser Effective Expiration Limits Cate Date . A Commercial.General Liability Y KRfl00i30QU6fi302170.. 1111 017 111!2018 Faeh Oc�urrrac�S?:aan,ono Occurence.Basis Damage to Ranrd I'NCmises(ea occ)-200,000. Med Fxg(any one pawn)$Exdj)ded General A ggregair S Nme ! 1?ersonal and Adv Injury S2,4Dp,(IC>(}. { 1'roduiis C:ofnp/OPAgg S2.0WCM PiriciPani Lcgat Liability S2mo 000 I3 Excess Liability Y N XK00000006631 31 1111201.7 111!2018 f:ach.accursenceSi..U[1(},000 Aggrrgste SI.OUf],CXxS DESCRIPTION OF OPERATIONS I LOCATIONS]VEHICLES(ACORD 101,Additional Remarks Schedule may be attached if more.space is requiredy Coverage:includes amateur play and practice in the insured sport for:Clearwater Lady Bombers-Barber 04 USAES 12U-L2017-917 9900625fi Certificate holder shall be an additlori6i insured but only with respect to liability caused by the negligent acts or orriissions of.the.named insured.and only with respect to lasses resulting from the team 1 League listed and occurring between the coverage effective date listed below and the policy expiration date, Certificate Molder. Co'crage Effective Date: II10/2017 9:48.00 PM. City of Clearwater CANCELLATION SHOULD ANY OF THE ASOVE.DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED. PQ Eox 474$ 1 IN ACCORDANCE inrlTH THE POLICY PROV#SIONS. Clearwater FL 33758 Certificate it LISSSA-305651-21829! Authorized Representatives:ves: A� CERTIFICATE OF LIABILITY INSURANCE 1/sil2017 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 CERTIFICA`f£ OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS},.AUTHORIZED REPRESIENTATiVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the polig(les).must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain Policies may require an endofsemenL A statement on this certificate does.not.confer rights to the eartificate holder in lieu of such endorsoment(s). PRODUCER CONTACT NAME: Westpoint: Insurance Group, :Ltd. PHONE (800)318-7709 RAC N.I!(70B)636-3915 $920 W.. 111th St E-MAIL INSURE 5 AFFORoING COVERAGE NAIC 9 Chicago Ridge IL 60415 INSURE RA L-HO UStOn Casualtv Com an INSURED iNsUREksAxis Global INSURER c- National Softball Association INISURER D: P.O. Box 7 INSURER£, Niaholasville KY 4.0340 1 INSURER F:: COVERAGES CERTIFICATE NUMBER:Ci•17131.09756 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEP!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.SH.OWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR SUOR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE WVD POLICY HUMSER MWD DnYM (MMIDDrYYM LIMITS A GENERALWABILITY 7/7006175 1/01/2017 1:101/2018 EACH OCCURRENCE S 3',000,000 X COMMERCIAL GENERRL f IA9ILITY PREMISE n occiurenae S 300,.000 CLAIMS-MADE a]OCCUR X MED EXP(Any one person) $. 5,000 PERSONAL&ADV INJURY S' 3,000,000 GENERAL AGGREGATE S 4,00.0,000 GEN'LAGGREGATE.LIMITAPP LIES PER: PRODUCTS-COM06PAGO .E' 3,000,000 POLICY PRO- F71 Jrr-T LOC PARTICIPANT LEGAL LIAR $ 1,000,000 AUTOMOBILE LIABILITY .COMBINED SINGLE LIMfT (ES acdiddnL ANY AUTO sbD1LY INJURY[Per Person] S ALL OWNED SCHEL].JLEI] BODILY INJURY Peraccidvnt 5 AUTOS AUTOS t H OED AUTOS NON-OWNED PROPERTY DAMAGE .$. AUTOS Par dent 5' UMBRELLA LIAR OCCUR. EACH OCCURRENCE 5 EXCESS LIAR. HCLAWS-MADE AGGREGATE .S DEC I I RETENTIONS 5 WORKERS COMPENSATION INC STATU-.I OT;- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIFJfECUTIVE E,LEACH ACCIDENT �. OFFICERIMEMBER EXCLUDED? ❑ NIA (Mandatory In NH) E.L.DISEASE-EA S M PLOYEZ S If yes,describe under DESCRIPTION OF OPERATIONS Dolow EL DISEASE-POLICY LIMIT S $ Excess Accident Med cal R.PO-50299-214 1lai/xDi7 1/01/Ula S250DedQcthle 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS.I VEHICLES {Attach ACORD iui,Additional Remarks Schedule,If more space Is requlred€ Zffectisre_07./31/17-01/01118 The certificate holder is named as additional:. insured with respects to the NSA sanctioned activites of: Clearwater Lady Bombers (Boldiga) Please note - NSA Sanctioned Leagues must adhere to the rules and regulations of the N.S.A. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE TH>=RI=oFI NOTICE WILL BE DELIVERED IN ACCORDANCE WrTH:THE POLICY PROVISIONS. City of Clearwater Attn Risk: Management .Q. ]SOX 4748 AUTHORIZED REPRESENTATIVE Clearwater, FL 33758 Terri T..omasik/AMIs ACORD 25(2.010105) C 1988-201 D.ACORO CORPORATION. All rights reserved. INS[12Sr�m1x.FYi i Tha Ar_rIPF)nsmo and Ir A ore rarricf.o 01 mantra Af Arewp l