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2017-037C10
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2017-037C10
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Last modified
10/25/2017 4:56:51 PM
Creation date
10/25/2017 4:56:50 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
03/21/2017
Control Number
2017-037C10
Agenda Item Number
8.C.
Entity Name
Willis Sports Association, Inc
Subject
Grant contract for Fun at Bat
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ACO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) <br /> 03/21/2017 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> NAME: <br /> American Specialty Insurance&Risk Services,Inc. PH NN Ext): 260-969-5203 FAX <br /> No): 260-969-4729 <br /> dba A S Insurance&Risk Services Agency E-MAIADDRESS: <br /> 7609 W.Jefferson Blvd.,Suite 100 INSURER(S)AFFORDING COVERAGE NAIC <br /> Fort Wayne IN 46804 INSURER A: Arch Insurance Company 11150 <br /> INSURED INSURER B: <br /> Office of the Commissioner of Baseball-Events INSURER C: <br /> 245 Park Avenue,34th Floor INSURER D: <br /> INSURER E: <br /> New York NY 10167 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 1001390625 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> GE TO <br /> CLAIMS-MADE n OCCUR PRREM SES(EaENTED occurrence) $ 1,000,000 <br /> MED EXP(Any one person) $ Excluded <br /> A Y SSCGL0001300 02/01/2017 02/01/2018 PERSONAL SADV INJURY _$ 1,000,000 <br /> GE 1.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $ 5,000,000 <br /> POLICY PEa LOC PRODUCTS-COMP/OP AGG $ 5,000,000 <br /> X OTHER: EVENT $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY _ AUTOS ONLY (Per accident) <br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 <br /> A X EXCESSLIAB CLAIMS-MADE N N SSFXS0000900 02/01/2017 02/01/2018 AGGREGATE $ 1,000,000 <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION • PER OTH- <br /> AND EMPLOYERS'UABILITY Y/N STATUTE ER <br /> ANYPROPRIETOR/PARTNER/EXECUTIVEN/A E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLU DE D1 <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) <br /> -The Certificate Holder is only an Additional Insured with respect to liability caused by the negligent acts or omissions of the Named Insured,but only with <br /> respect to the VERO BEACH RBI from March 10,2017 through January 31,2018. <br /> -Coverage available under Aegis Security Insurance Company policy#7311704970 is on file with the policyholder.Policy effective date:February 1,2017/ <br /> Policy expiration date:February 1,2018.Excess Accident Medical Expense Benefit:$10,000,subject to$250 deductible.Accidental Death&Dismemberment <br /> Principle Sum:$10,000. <br /> CERTIFICATE HOLDER CANCELLATION <br /> Indian River County Commissioners <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 1801 27th Street <br /> AUTHORIZED REPRESENTATIVE <br /> Vero Beach FL 32960 <br /> I <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />
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