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Home My WebLink AboutInsurance Certificates - Skydive Named Insured: Individual Members of the United States Parachute Association Company: Starr Indemnity & Liability Company Policy Number: 10006460365-01 Effective Date: 12:01 AM March 1, 2020 Expiration Date: 12:01 AM March 1, 2021 This Certificate does not amend, extend or otherwise alter the terms and conditions of the policies referred to herein Membership Jump Coverage at a USPA Drop Zone Limits of Liability Single Limit Bodily Injury and Property Damage Liability: $ 50,000 Per Occurrence $1,000,000 Aggregate Event Location: Sebastian, FL Additional Insured only as Respects Operations of the named insured: Sebastian Municipal Airport City of Sebastian with whom we agree, if possible, to notify 30 days before date of cancellation if policy should be cancelled, but the Company shall not be liable in any way for failure to give such notice. Kimmel Aviation Insurance Agency, Inc. 442 Airport Road Greenwood, MS 38930 Authorized Representative Certificate of Insurance Named Insured: The Individual Members of the United States Parachute Association Company: Mitsui Sumitomo Insurance USA Inc. Policy Number: ACME -18-00219-03 Effective Date: 12:01 AM March 1, 2019 Expiration Date: 12:01 AM March 1, 2020 This Certificate does not amend, extend or otherwise alter the terms and conditions of the policies referred to herein Membership Jumo Coverace at a USPA Drop Zone Limits of Liability Combined Single Limit Bodily Injury and Property Damage Liability: $ 50,000 Per Occurrence $1,000,000 Aggregate Location: Sebastian, FL Additional Insured only as Respects Operations of the named Insured: Sebastian Municipal Airport City of Sebastian with whom we agree, if possible, to notify 30 days before date of cancellation if policy should be cancelled, but the Company shall not be liable in any way for failure to give such notice. Insurance Technologies & Programs A Division of Air Capital Insurance, LLC P.O. Box 148 Wichita, KS 67202 C=� Authorized Signature Certificate of Insurance Named Insured: The Individual Members of the United States Parachute Association Company: StarNet Insurance Company Policy Number: BA -13 -03 -00004 Effective Date: 12:01 AM March 1, 2013 Expiration Date: 12:01 AM March 1, 2014 This Certificate does not amend, extend or otherwise after the terms and conditions of the policies referred to herein Membership Jump Coverage at a USPA Drop Zone Limits of Liability Combined Single Limit Bodily Injury and Property Damage Liability: $ 50,000 per Occurrence $1,000,000 Aggregate Location: Sebastian, FL Additional Insured only as Respects Operations of the named insured: Sebastian Municipal Airport! City of Sebastian with whom we agree, if possible, to notify 34 days before date of cancellation if policy should be cancelled, but the Company shall not be liable in any way for failure to give such notice. Insurance Technologies di Programs 'V)�i (:� '� �Q t A Division of Air Capital Insurance, LLC Authorized Signature P.O. Box 148 Wichita, KS 67202 CERTIFICATE OF INSURANCE This certiFicate is given �s a matter oi' information only and confers no righis up�n the certificatt holder. Date: May 12, 2011 This is to certify to: Ci#y of Sebastian and Indian River County Policy No. TA055440A Coverage's General Aggregate Limit Each Occutrcnce Limit that the policy listtd below es issued to the fotlowing for the period indicated by Lloyd's Underwriiers: Skydive Sebastian Sebastian, Florida PREMiSE LIABILITY INSURANCE Policy Period; from May 9, 2011 to May 9, 2012 Limits of Liabilitv a 1,OOQ,Q00 AB�Sate S 1,000,000 REMARKS Certificate Holder included as an additional insured with respect to above caverages 5tandard Skydiving Exclusion applies with respect to the certificate holder Nothwithatanding any requiremert, term or condition of any contract or other docurnerrt with rospect to which this certificate may be issued or rntry pertain, the inseuanct afforded by the policy described herein is subject to all the terrns, exclusions and conditions of such policy. This certificate dces noi amend, exttnd or otherwise alter the coverage's afforded by the poiicy described herein. Limits may have been reduced by paid claims. By: ' � Certificate No. � Certificate Effective Date: M�y 12, 2011 AVIAT1pN W5URANCE REPRESENTATiVES, INC. 8975 VANNS TAVERN ROAD GATt�tESViLLE, GEORGIA 30566 (678) 947-17E0 FAX: (678) 947-1T$1 f • ,,..•�-� SKYDI-4 OP ID: DB A��"�� DATE (MMIDDIYYYY) �,____- CERTIFICATE OF LIABILITY INSURANCE 03/14/12 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 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 816-525-2125 NAMEACT Deb Brotherton, AINS, CLCS 608 S WkTh �d St eet Agency 816-525-4049 ac No EXi : 816-251-3317 a� Na : 816-525-4049 Lee's Summit, MO 64os3 E-MAIL DebraB TwinLakesins.com Mark A. Smith. CIC AD�RESS: INSURED Skydive Sebastian of South Florida 400 W. Airport Drive Sebastian, FL 32958 INSURER A; Scottsdale Insurance Company INSURER B : INSURER C : INSURER D : INSURER E : NAIC # 297 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 7ypE OF INSURANCE A POLICY NUMBER M� DY/YYYY MM DD/YYYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ �,OOO,OOO i� X COMMERCIAL GENERAL LIABILITY CPS1464911 10/26/11 10/26/i2 pREMISES Ea occurrence $ ��,0�0 CLAIMS-MADE � OCCUR MED EXP (Any one person) $ $,�� PERSONAL 8 ADV INJURY s EXCLUDED GENERALAGGREGATE $ Z�OOO�OOO GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s EXCLUDED POIICY PR� LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ NON-OWNED Per accident HIREDAUTOS AUTOS $ UMBRELLA LIAB QCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y� N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N � A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 107, Additional Remarks Schedule, if more space is required) BUILDING OR PREMI3E OFFICE LIASILITY COVERAGE I3 LIMITED TO 400 W. AIRPORT DR. SEBA3TIAN, FL. 32958 CERTIFICATE HOLDER CANCELLATION CITYSEB SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Sebastian ACCORDANCE WITH THE POLICY PROVISIONS. 1225 Main St. Sebastian, FL 32958 AUTHORIZED REPRESENTATIVE -��'r c�%r.�c.. �O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ....... c~-:-~: ;,~.~-~: ...: :':~ ~ ~--~'~? :: ..... astian, ~1. 32958 COMPANIES AFFOROING COVE~GE Skydive Sebastian of Florida Inc. 400 w. Airport Dr. Sebastian, FL. 32958 Sphere Drake South =0.~ C 95NM80034306 1/20/95 1/20/96 1 Mil 1 Mil ~ditional Insureds: City of Sebastian and Price ~3RO 25°$ '' :'~r~.'~' u:?"-::TM · ....... !::*' :. ' -OA~'CORPOI~ATIGN,A;:~G~ SEBASTIAN INSURANCE 4075890731 P. 02 ... >: %' y~ t.. .l . z' .'.. ^~,/I~'/e ~"g n' ~ 1 :.•~'h~,,'~;.;I;~•.:. i~r,.~,.`''~~'~.; ~ %'. ~ ir~•.. `.'~• ~ ~ ~ ISSUED TE (MM/DO/Y ~ .:?~:%" A Y), :a ~C~tMi~ ~`•::. •, •;{ .j;' ye'~1"~ ..,' i~ ~ f .;J ~ : : ~ . • ;l'11 PgouucEa THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Sebastian Insurance CONFERS NO RIGHTS UPON THE CERTIFICATE HOLpER. THIS CERTIFICATE 734 S Fl i t DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE . em ng S . POLICIES BELOW. Sebastian, Fl. 32958 COMPANIES AFFORDING COVERAGE ~E,M'~Pq Y A Sphere Drake COMPANY B INSURED LETTEq Skydive Sebastian of South ea Y C ~ ° M Florida Inc. E r r ~ . 400 W. Airport Dr. °~E^ "Yp Sebastian, FL. 32958 R COMPANY E LETTER „ ,, CiOVEF~IAQE.4 , , ..•. •' ~ •. '~ ' '''~~' ~~~~~Y ".'.~~ III' rl ~~1, 1~~:~~" ni' ..'t t' „1 ,. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED B ELOW RAVE 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. CO TYPE OF INSURANCE POLICY NUM6Efl TR - POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS QENERAL LIABILITY 6EN6RgL AGGREGATE $ ~ M 1.1 A X COMMERCIAL GENERAL LIABILITY g 5NM 8 0 0 3 4 3 0 6 1/ 2 0/ 9 5 1/ 2 0/ 9 6 PRODUCTS•COMP/OP AGG. s CLAIMS MAO•_ OCCUR. PERSONAL 6 ADV. INJURY S UWNER'S & CONTRACTOR'S PROT, EACH OCCURRENCE $ ~ M l I ~ FIRE DAMAGE (Any one lire) S MED. EXPENSE (Any one person) LS AUTOM061LE LIABILITY BINED SINGLE ANY AUTO `M T S ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS $ (Par Parson) HiAED AUTOS 60DILY INJ RY S NON-OWN60 AU703 ( ) Per aecldem GApAOE LIABILITY .. PROPERTY OAMAQE & . EXCES9 LIABILITY . EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE 5 OTHER THAN UMBRELLA FORM _.. . WORKER'S COMPENSATION ~~ 6TATUTORY LIMITS EACH ACCIDENT 3 AND DISEABE-POLICY LIMIT 8 EMPLOYER' LIABILITY DISEASE-EACH EMPLOYEE 9; • •_. OTHER ~•~ -~~•~~ f~ DE9CRlPT10N OF OPERATIONS/LOCATtONS/YEHICLES/SPECIAL ITGMS 1 _ _ __ _ CERTIFICATE HOLaER ,~ M- ~ ~ CANCELLATION JAddi tional Insureds : SHOULD ANY OF THE ABOvE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Sebastian EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO 4 and 3 ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE MAIL Clay Price LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 1 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUT IZED gEPRE ENTATIENTATIVE 1 ACORD zs-S P/90) '• ~ ;'.;_;•:!°'. C;'"~' ~ a'' ` ''• •• ~ . •: `:' :'<~• •• ;:. ` ®ACOBa COFtPOR'ATIdN.:'~9905