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2013-03-06 P & R Packet
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2013-03-06 P & R Packet
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3/4/2013 12:55:29 PM
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DATE: 5116=12 <br /> CERTIFICATE OF INSURANCE <br /> CERTIFICATE NUMBER: 20120516082775 <br /> AGENCY: <br /> Entertainment S Sports Insurance eXperts (ESI() THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br /> 5660 New Northeide Drive, Suite 640 NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT <br /> Atlanta Georgia 30328 AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Ptwm:678 -324 -3300 Fax: 678,U4-3303 <br /> NAMED INSURED: INSURERS AFFORDING COVERAGE: <br /> USA Water Ski Bald Eagle Water Ski Show Inc INSURER A. ktdemnity Ins. Co. <br /> 1251 Holy Cow Road 8521 WNte Oak Rd <br /> Polk City, Florida 33868 Lino Lakes, Minnesota 55038 INSURER B: Phladelphia Indemnity Ins. Co. <br /> POUCY/COVERAGE INFORMATION: <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br /> REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE <br /> INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS <br /> SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INS TYPE OF INSURANCE: POLICY NUMBER(S): EFFECTIVE: I EXPIRES: Lw111T8: <br /> A GENERAL LIABILITY <br /> X COMMERCIAL GENERAL PHPK808058 1/1/2012 1/1/2013 GENERAL AGGREGATE (Applies Per Event) $2,000,000 <br /> LIABILITY 12:01 AM 12:01 AM <br /> — EACH OCCURRENCE $1,000,000 <br /> X Ocaurenoft DAMAGE TO RENTED PREMISES (Each Occ.) $1,000,000 <br /> X Participant Legal Liability MEDICAL EXPENSE (Arty one person) EXCLUDED <br /> PERSONAL NL ADV INJURY $1,000,000 <br /> PRODUCTS - COMP /OP AGG $2,000,000 <br /> B UMBRELLA/EXCESS LIABILITY <br /> X Occurrence PHUB368206 1/1/2012 1/1/2013 AGGREGATE (Apples Per Event) $4,000,000 <br /> 12:01 AM 12:01 AM <br /> X SIR EACH OCCURRENCE $4,000,000 <br /> RETENTIONIDEDUCTIBLE $10,000 <br /> DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS: <br /> Coverage only applies whh rasped to toumments, practices, exhibitions, clinics and related activities sanctioned and approved by USA Water Ski, Inc. <br /> (CERTIFICATE HOLDER: NOTICE OF CANCELLATION: <br /> City of Centerville Should any of the above described pokies be cancelled before the expiration date thereof, <br /> 1680 Maid Street notice w8 be delivered in ecowdwics wNh the poky provisions. <br /> Centervwa, Minnesota 55038 AUTHORIZED REPRESENTATIVE: <br />
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