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CERTIFICATE OF LIABILITY INSURANCE (7) CERTIFICATE OF LIABILITY INSURANCE DATE 10/13/18/13/18 ) PRODUCER CERTIFICATE#: 3091201-2019-1 309 12 Keystone Risk Managers, LLC 1995 Point Township Drive Northumberland, PA 17867 INSURERS AFFORDING COVERAGE: ADDITIONAL NAMED INSURED: INSURER A: Lexington Insurance Company CLEARWATER LL INSURER B: National Union Fire Insurance Company of Peter Mcguff (Non-Liability) Pittsburgh, PA 1504 seabreeze st CLEARWATER, FL 33756 INSURER C: AIG Specialty Insurance 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 OR 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. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR NAMED TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YYYY) DATE(MM/DD/YYYY) LIMITS INSRD GENERAL LIABILITY EACH OCCURRENCE $1'000'000 X 011225826 01/01/2019 01/01/2020 A X ^ OCCURRENCE GENERAL AGGREGATE $2'000'000 Property INCL PARTICIPANTS Pro Deductible:$250 X p Y Dama PRODUCTS/COMP OPS $1,000,000 a 9 AGGREGATE Sexual Abuse $1000000 X SEXUAL ABUSE OCCURRENCE Sexual Abuse $2,000,000 AGGREGATE MEDICAL PAYMENTS Any One Person A X DIRECTORS&OFFICERS 019329346 01/01/2019 01/01/2020 EACH LOSS $1,000,000 AGGREGATE $1,000,000 C X CYBER LIABILITY COVERAGE 19326190 01/01/2019 01/01/2020 LIMIT OF LIABILITY $100,000 PER LEAGUEAGGREGATE S&P SECURITY AND PRIVACY LIABILITY $100,000 PER LEAGUE SUBLIMIT OF LIABILITY RETROACTIVE DATE CONTINUITY DATE INSURANCE $1,000 PER LEAGUE RETENTION POLICY INCEPTION POLICY INCEPTION REGULATORY ACTION SUBLIMIT OF $100,000 PER LEAGUE SUBLIMIT OF LIABILITY LIABILITY $1,000 PER LEAGUE RETENTION EM EVENT MANAGEMENT INSURANCE $100,000 PER LEAGUE SUBLIMIT OF LIABILITY NOT APPLICABLE POLICY INCEPTION $1,000 PER LEAGUE RETENTION A X CRIME COVERAGE 011408726 01/01/2019 01/01/2020 EACH LOSS $35,000 Crime Deductible:$250 Property/$1,000 Money AGGREGATE NONE As in Master Policy: As in Master Policy B X SPORTS EXCESS ACCIDENT SRG9105434 01/01/2019 01/01/2020 Med. Max.$100,000 Excess Deductible $50 "X"INDICATES COVERAGES SELECTED FOR ADDITIONAL NAMED INSURED ADDITIONAL INSURED Who is an Insured(SECTION II)of the General Liability policy is amended to include as an insured the person or organization shown in the schedule,but only with respect 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 additional exclusions: 1.Structural alterations,new construction,maintenance,repair or demolition operations performed by or on behalf of the person or organization designated in the Schedule and/or performed by the above named Little League;and 2. That part of the ball field or other premises not being used by the above named Little League. NAME AND ADDRESS OF PERSON OR ORGANIZATION: 1.City of Clearwater INSURED CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE Little League Baseball Risk Purchasing Group, Incorporated WITH THE POLICY PROVI S. 539 U.S. RT. 15 Highway South Williamsport, PA 17702 AUTHORIZED kEPRESENTATIVE IMPORTANT DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. CERTIFICATE OF LIABILITY INSURANCE DATE 10/13/18/13/18 ) PRODUCER CERTIFICATE#: 3091201-2019-1 309 12 Keystone Risk Managers, LLC 1995 Point Township Drive Northumberland, PA 17867 INSURERS AFFORDING COVERAGE: ADDITIONAL NAMED INSURED: INSURER A: Lexington Insurance Company CLEARWATER LL INSURER B: National Union Fire Insurance Company of Peter Mcguff (Non-Liability) Pittsburgh, PA 1504 seabreeze st CLEARWATER, FL 33756 INSURER C: AIG Specialty Insurance 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 OR 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. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR NAMED TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YYYY) DATE(MM/DD/YYYY) LIMITS INSRD GENERAL LIABILITY EACH OCCURRENCE $1'000'000 X 011225826 01/01/2019 01/01/2020 A X ^ OCCURRENCE GENERAL AGGREGATE $2'000'000 Property INCL PARTICIPANTS Pro Deductible:$250 X p Y Dama PRODUCTS/COMP OPS $1,000,000 a 9 AGGREGATE Sexual Abuse $1000000 X SEXUAL ABUSE OCCURRENCE Sexual Abuse $2,000,000 AGGREGATE MEDICAL PAYMENTS Any One Person A X DIRECTORS&OFFICERS 019329346 01/01/2019 01/01/2020 EACH LOSS $1,000,000 AGGREGATE $1,000,000 O X CYBER LIABILITY COVERAGE 19326190 01/01/2019 01/01/2020 LIMIT OF LIABILITY $100,000 PER LEAGUEAGGREGATE S&P SECURITY AND PRIVACY LIABILITY $100,000 PER LEAGUE SUBLIMIT OF LIABILITY RETROACTIVE DATE CONTINUITY DATE INSURANCE $1,000 PER LEAGUE RETENTION POLICY INCEPTION POLICY INCEPTION REGULATORY ACTION SUBLIMIT OF $100,000 PER LEAGUE SUBLIMIT OF LIABILITY LIABILITY $1,000 PER LEAGUE RETENTION EM EVENT MANAGEMENT INSURANCE $100,000 PER LEAGUE SUBLIMIT OF LIABILITY NOT APPLICABLE POLICY INCEPTION $1,000 PER LEAGUE RETENTION A X CRIME COVERAGE 011408726 01/01/2019 01/01/2020 EACH LOSS $35,000 Crime Deductible:$250 Property/$1,000 Money AGGREGATE NONE As in Master Policy: As in Master Policy B X SPORTS EXCESS ACCIDENT SRG9105434 01/01/2019 01/01/2020 Med. Max.$100,000 Excess Deductible $50 "X"INDICATES COVERAGES SELECTED FOR ADDITIONAL NAMED INSURED ADDITIONAL INSURED Who is an Insured(SECTION II)of the General Liability policy is amended to include as an insured the person or organization shown in the schedule,but only with respect 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 additional exclusions: 1.Structural alterations,new construction,maintenance,repair or demolition operations performed by or on behalf of the person or organization designated in the Schedule and/or performed by the above named Little League;and 2. That part 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 Clearwater P.O. box 4748 Clearwater, FL 33758 INSURED CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE Little League Baseball Risk Purchasing Group, Incorporated WITH THE POLICY PROVI S. 539 U.S. RT. 15 Highway South Williamsport, PA 17702 AUTHORIZED kEPRESENTATIVE IMPORTANT DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 710/13/2018 E(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 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 ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT David Irwin NAME: Keystone Risk Managers, LLC (PA/CNNo Ext: (570)473-2150 FAX No: (570)473-2151 1995 Point Township Drive E-MAIL ADDRESS: Dlrwin@Keystoneinsgrp.com INSURER(S)AFFORDING COVERAGE NAIC# Northumberland PA 17867 INSURERA: Lexington Insurance Company 19437 INSURED INSURER B: AIG Specialty Insurance Company 26883 Little League Baseball Risk Purchasing Group, Incorporated INSURERC: CLEARWATER LL INSURER D: 1504 seabreeze st INSURER E: CLEARWATER FL 33756 INSURER F: 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 SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MWDD/YYY MWDD/YYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE � OCCUR PREMISES Ea occurrDence $ 300,000 MED EXP(Any one person) $ Excluded A X 011225826 01/01/2019 01/01/2020 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 1,000,000 JECT X OTHER: Per League SEXUAL ABUSE OCC/AGG $ 1 M/$2M AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVEF—] E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Certificate Holder is named as Additional Insured per form CG 2026(04/13) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS. P.O. box 4748 AUTHORIZED REPRES TIVE Clearwater FL 33758 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 01 1225826 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 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 PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): City of Clearwater P.O. box 4748 Clearwater, FL 33758 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III— Limits Of Insurance: with respect to liability for "bodily injury", "property If coverage provided to the additional insured is damage or personal and advertising injury required by a contract or agreement, the most we caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the omissions or the acts or omissions of those acting amount of insurance: on your behalf: 1. Required by the contract or agreement; or 1. In the performance of your ongoing operations; or 2. Available under the applicable Limits of 2. In connection with your premises owned by or Insurance shown in the Declarations; rented to you. whichever is less. However: This endorsement shall not increase the 1. The insurance afforded to such additional applicable Limits of Insurance shown in the insured only applies to the extent permitted by Declarations. law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1