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CERTIFICATE OF LIABILITY INSURANCE (1000) KEYSSPO-01CSALAMONE DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/13/2019 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). CONTACT PRODUCER NAME: PHONEFAX Johnson, Kendall & Johnson, Inc. (215) 968-4741(215) 968-0973 (A/C, No, Ext):(A/C, No): 109 Pheasant Run E-MAIL info@jkj.com Newtown, PA 18940 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # Philadelphia Insurance Company INSURER A : INSURED BrickStreet Insurance12372 INSURER B : Keystone Sports and Entertainment LLC, Pennsylvania INSURER C : Professional Soccer LLC t/a Philadelphia Union INSURER D : 2501 Seaport Drive, Suite 500 Chester, PA 19013-2249 INSURER E : INSURER F : COVERAGESCERTIFICATE 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. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) 1,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 100,000 CLAIMS-MADEOCCUR X PHPK20048447/1/20197/1/2020 $ PREMISES (Ea occurrence) X 5,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 3,000,000 X POLICYLOC PRODUCTS - COMP/OP AGG$ JECT OTHER:$ COMBINED SINGLE LIMIT 1,000,000 A AUTOMOBILE LIABILITY $ (Ea accident) X ANY AUTO PHPK20048447/1/20197/1/2020 BODILY INJURY (Per person)$ X OWNEDSCHEDULED AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ PROPERTY DAMAGE HIREDNON-OWNED XX (Per accident)$ AUTOS ONLYAUTOS ONLY $ 10,000,000 A XX UMBRELLA LIABOCCUR EACH OCCURRENCE$ PHUB6835867/1/20197/1/2020 10,000,000 EXCESS LIABCLAIMS-MADE AGGREGATE$ 10,000 X DEDRETENTION$ $ PEROTH- WORKERS COMPENSATION B STATUTEER AND EMPLOYERS' LIABILITY Y / N WCA40200096/20/20196/20/2020 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Clearwater is Additional Insured and coverage is Primary & Non-Contributory with respects to the operations of the Named Insured where required by written contract for General and Auto Liability. Waiver of Subrogation is provided for Workers Compensation. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater - Parks & Recreation Department ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: Kevin Dunbar PO Box 4748 AUTHORIZED REPRESENTATIVE Clearwater 33758-4748 ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD