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Home My WebLink AboutCertificate of InsuranceClient#: 21572 SEBASHAR ACORD. CERTIFICATE OF LIABILITY INSURANCE osl(M Zo srn 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. f the -certificate holder is an ADDITIONAL INSURED, the policy(les) must 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 f Edgewood Partners Insurance Center 27 School Street, Suite 404 Boston, MA 02108 617 398-55571 . s 415 356-3900 INC. No): LIMITS _ _..� _ _ r _ INSURER(S) AFFORDING COVERAGE NAIC A INSURER A: HCC Specialty Insurance Company INSURED I SEBASTIAN SHARKS YOUTH FOOTBALL AND CHEER ASSOCIATION POBOX 781832 INSURER B: AIG Insurance -Commercial Lines 061301201 INSURER C: Great American Ins Co.(IL) ROM _... 000,000 INSURER D: PERSONAL B ADV INJURY 1111,000,000 Sebastian, FL 32958 _ INSURER 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 CONTRACTOR 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. IN8R LTR _.__...._,..._.,.,_......... TYPE OF INSURANCE . ADDL I R ..N...... UB !!!+Q...._...__------ POLICY NUMBER ----- POLICY EFF MMiDD t__� POLICY EXP MMiO _ Dh►1'YY) LIMITS _ _..� _ _ r _ A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR 157003962 6/30/2015 061301201 EACH OCCURRENCE $11,000,000 ROM _... 000,000 MED EXP (Any one icon S PERSONAL B ADV INJURY 1111,000,000 GENERAL AGGREGATE 311000000 GENL AGGREGATE LIMIT APPLIES PER: i PRODUCTS - COMPIOP AGG $1,000:000 . PRO.POLICY LOC S AUTOMOSILEILIASILnY COMBINED SINGLE LIMIT L_...0-_ BODILY INJURY (Per person) $ ANY AUTO ALL _. AUTOS I D SCHEDULED AUTOS I NON -OWNED HIRED AUTOS AUTOS BODILY INJURY (Per accident) $ PRKRTYDAMAGE $ ra _.), S _ � 'OCCUR UMBRELLA UAB EACH OCCURRENCE - S AGGREGATE S EXCESS LIAR CLAIMS -MADE DEO ? RETENTIONS $ WORKERSCO)I[PENSATION AND EMPLOYeRS' LIABILITY Y f N ANY PROPRIETORIPARTNEWEXECUTIVEn OFFICEWMEMBER EXCLUDED? _ N 1 A _ _ . WC STATU- Ell IOELY E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE S (Mandatory In NH) l J Uyes desaft Under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S B A&H { SRG0009133720 6/30/2015 06/301201 SEE REMARKS C D&O j cPERATION$ EPP4915846 6130/2015 06/30/201 SEE REMARKS DESCRIPTION OF O I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, U mere space Is required) THE CERTIFICATE HOLDER is added as an additional Insured with respects to general liability coverage but only with respect to liability arising out of the operations of the named Insureds league. Sexual Abuse/ Molestation limits are as follows: $1,000,000 EACH OCCURRENCE 1$1,000,000 AGGREGATE THIS POLICY DOES NOT EXCLUDE CONCUSSIONS (See Attached'; Descriptions) City Of Sebastian 12�5 Main Street Sebastian, FL 32958 I ACORD 25 (2010105) 1 #S376151'/M376148 ! F SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ®1988 2010 ACORD CORPORATION. All rights reserved. of 2 The ACORD name and logo are registered marks of ACORD CMAR2 Client#: 21872 SEBASHAR ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDNYYY) 0610512015 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 pollcy(les) must 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 I Edgewood Partners Insurance Centers 27 School Street, Suite 404 Boston, MA 02106 617 398-5557! EMT N o��; 415 356-3900 ,� N, I INSURER(S) AFFORDING COVERAGE NAIC # INSUREtA: HCC Specialty Insurance Company INSURE ! SEBASTIAN SHARKS YOUTH FOOTBALL AND INSURER B: AIG Insurance -Commercial Lines 06130/2016 INSURER C. Great American Ins Co.(!L) i & RENTER 000000 CHEER ASSOCIATION PO�BOX 781832 Sebastian, FL 32958 ..___..___.____.._.__....__._._._____..._.._..._....._ INSURER 1); ..._ _ _ INSURER E • INSURER F • COVERAGES i 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 CONTRACTOR 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. TR OF INSURANCE -� AODL y.0 POLICY NUMBER MM QIYYYYI POMMLICY P /D � LIMITSLIMITSTYPE _._.___ ...__..._. A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 157003962 D613012015 06130/2016 EACH OCCURRENCE S1,000,000 i & RENTER 000000 CLAIMS -MADE OI OCCUR MED EXP (Any one person) S I PERSONAL A ADV INJURY 31,000,000 GENERAL AGGREGATE $1,000,000 _ GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG S 1,000 000 S �__.._.. POLICY r .1 AC LOC AUTOMOBILE LIABILITY INEgoodeD SINGLE LIMIT BODILY INJURY (Per person) S ANY AUTD BODILY INJURY (Per;;;w $ ALL OWNED SCHEDULED AUTOS AUTOS MON-OWNED KIREDA�ITOS AUTOS PROPERTY Q $ lPeracodyM $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LWB CLAtMS•MADE DED DRETENTIONS..S WORKERS COMPENSATION AND EMPLOYERS! UABILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y I N OFFICERIMEMBEREXCLUDED? � (Mandatory In NH) NIA __.____.._.__.__ _ . _ WC STATLI- OTH- 1QRy.LIMIIS E3... ff_._ i E.L. EACH ACCIDENT S , I E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT S Kyes describe under DESCRIPTION OF OPERATIONS below B ABH _ SRGO009133720 6/3012015 06/301201 SEE REMARKS C D&O EPP4915846 613012015 06/30/201 SEE REMARKS DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Addltlonal Remarks Schedule. It more space Is required) THE CERTIFICATE HOLDER is added as an additional insured with respects to general liability coverage but only with respect to liability arising out of the operations of the named insureds league. Sexual Abuse / Molestation limits are as follows: $1,000,000 EACH OCCURRENCE 1$1,000,000 AGGREGATE THIS POLICY'DOES NOT EXCLUDE CONCUSSIONS (See Attached Descriptions) I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Sebastian Sharks youth football THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN and Cheer Assoc. ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 781732 Se, bastlan, FL 32958 AUTHORIZED REPRESENTATIVE j ®1988 2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 of 2 The ACORD name and logo are registered marks of ACORD #S3761541M376148 CMAR2 CERTIFICATE OF INSURANCE ISSUE DATE (MM/ DD/ YY) 06/30/2010 12:01:00 AM ET PRODUCER .SADLER COMPANY, INC. P.O. BOX 5866 COLUMBIA, SOUTH CAROLINA 29250 -5866 (800) 622 -7370 Email: ayf®sad/ersports.com THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURED AMERICAN YOUTH FOOTBALL, INC. AND AMERICAN YOUTH CHEER AS MEMBERS OF ERS RISK PURCHASING GROUP ASSOC., INC. Sebastin Sharks Youth Football and Cheerleading Assoc c/ o Michael Lanam PMB 132 13537 US 1 Sebastian, FL 32958 COMPANIES AFFORDING COVERAGE COMPANY LETTER A NATIONAL CASUALTY COMPANY COMPANY LETTER B ACE AMERICAN INSURANCE COMPANY COMPANY LETTER C COVERAGES THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDTION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE SSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDTiONS OF SUCH POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE POLICY EXPIRATION DATE LIMIT OF COVERAGE A General Liability Commercial General Liability D Claims made la Occur D Owners It contractors Prot. KR00000001024100 12:01AM ET 06/30/2010 12:01AM ET 06/30/2011 General Aggregate NONE Products- Comp/ Ops Aggregate $2,000,000 Personal Advertising Injury 51,000,000 Each Occurrence 51,000,000 Rented to you limit $300,000 Medical Expenses (Any one person) $5,000 Participant Legal Liability 51,000,000 B PartcipantAcctdent PTPN01882922 12:01AM ET 06/30/2010 12:01AM ET 06/30/2011 Excess Medical 5100,000 Deductible $100 DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES RESTRICTIONS /SPECIAL ITEMS COVERED SPORTS: Tackle Football Ages 9 Under, Tackle Footbal Ages 12 Under, Tackle Football Ages 15 Under, Flag Football Ages 5 -17, Cheer Dance Step Squads Class 1 (no charge), NOTE: The Participant Accident policy, If included above, is not a part of the ERS Risk Purchasing Group Association. Inc. CERTIFICATE HOLDER CANCELLATION EVIDENCE OF COVERAGE SL39 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR UABIUTY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE (company A) .e_ AUTHORIZED REPRESENTATIVE (company B) 7 Sadler Sports: AYF Insurance Plan This certificate replaces any other previously issued certificate(s). 1 -92