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CERTIFICATE OF LIABILITY INSURANCE (4) DATE /Y (MM/DDYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 01/05/2024 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 NAME: American Specialty Insurance&Risk Services, Inc. HONE FAX No,Ext): A/C,No E-MAIL ADDRESS: 7609 W.Jefferson Blvd.,Suite 100 INSURER(S)AFFORDING COVERAGE NAIC# Fort Wayne IN 46804 INSURERA: Arch Insurance Company 11150 INSURED INSURER B: National Horseshoe Pitchers Association INSURERC: P.O. Box 205 INSURER D: INSURER E: Drexel MO 64742 INSURER F: COVERAGES CERTIFICATE NUMBER: 1002200158 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 MM/DD MM/DD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADENTED OCCUR PREM SESOEa occurrrence $ 1,000,000 MED EXP(Any one person) $ Excluded A Y SBCGL0442306 12/31/2023 12/31/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000 X POLICY❑ PRO- ❑ JECT LOC PRODUCTS-COMP/OPAGG $ 5,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 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 X OCCUR EACH OCCURRENCE $ 1,000,000 A X EXCESS LAB CLAIMS-MADE SBFXS0057106 12/31/2023 12/31/2024 AGGREGATE $ 1,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVEF—] E.L.EACH ACCIDENT $ OFFICE R/M EMBER 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) -Coverage applies to the following:CLEARWATER HORSESHOE CLUB, FLORIDA CHARTER, 1326 S MARTIN LUTHER KING JR AVE,CLEARWATER, FL 33756. -Named Insured(continued): National Horseshoe Pitchers Foundation; National Horseshoe Pitchers Association(NHPA)Member Charters, Leagues and Teams but only with respect to NHPA sanctioned events CERTIFICATE HOLDER CANCELLATION CITY OF CLEARWATER, FL ATTN: PARKS&RECREATION ATHLETIC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE COORDINATOR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O. BOX 4748 AUTHORIZED REPRESENTATIVE -�---y Clearwater FL 33758 J ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC#: AC"J?" ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED American Specialty Insurance&Risk Services, Inc. National Horseshoe Pitchers Association POLICY NUMBER P.O. Box 205 SBCGL0442306 CARRIER NAIC CODE Drexel, MO 64742 Arch Insurance Company 11150 EFFECTIVE DATE: 12/31/2023 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE-Certificate#1002200158 -The Certificate Holder shall be an Additional Insured, but only with respect to the operations of the Named Insured,and subject to the provisions and limitations of Form CG 2026 Additional Insured-Designated Person or Organization, but only with respect to NHPA SANCTION ED EVENTS. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD