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CERTIFICATE OF INS URANCE 01.10-03 <br />Phis is issued as a matter of information only and confers no rights upon the certificate holder. This <br />certificate does not amend, extend or alter the coverages afforded by the policy below. <br />Phis is to certify that the policy of insurance listed below has b to the insured named below for <br />:lie Policy period indicated, notwithstanding any requirement, term or condition of any contract or other <br />document with respect to which this certificate maybe issued or may pertain, the insurance afforded by <br />:lie policy described herein is subject to all the berms, exclusions and conditions of such policy. <br />insured: Producer: <br />USA WATER SKI <br />AND 1TS 11S MEMBER CLUBS, COACHES <br />AND OFFI CAA <br />1251. HOLY COW ROAD <br />PoLK CITY, FL 33868 <br />Sullivan &Strauss Ageucyjnc. <br />one Hallow Lane <br />Lake Success, NY 1. 1042 <br />Tel: 800 - 225 -65b0 Fax: 516 -365-3615 <br />Policy r1r: D064LOO498 <br />Effective Date; <br />3 200.3' <br />Ins. Co.: U.S. Fidelity &Guaranty <br />expiration Date: <br />� Janu-ary f, zoos <br />TYPE OF INSURANCE <br />LIIV.IITS (ire thousands) <br />Commercial General Liability <br />General Aggregate <br />$53000 <br />(Occurrence Fonn) <br />Each Occurrence <br />$ 13,000 <br />Products /Completed Ops <br />Aggregate <br />S Y,000 <br />Fire Damage Le gal Liability <br />Any one fire <br />$ 50 <br />Medical Expense <br />Any one person <br />$ 5 <br />Paiticipant Legal Liability <br />Included <br />REMARKS. <br />The Certincate Holder(s) shah be an Additional Insured, but only with respect to the <br />operations of the Named insured and only in accordance with the provisions and limitations <br />of endorsement AG 4007- .11/97 Additional Insured - Sponsor.. <br />OWNED WATERCRAFT LIABILITY EXCLUDED <br />Certificate Holder: CANCEUA ION <br />Additional Insured 410-00012 ShoWd the above policy be cance lcd bdore <br />the date of expiration, ffio issuing company will <br />ALL CLUBS AFFILLATED WITH USA endeavor to mail 30 days vnittea notice to the <br />WATERS KI ASSOCIATION & AlSffIUCAN WATER lamed certificate holder, but fails to mail such <br />ASSOCIATION. notice shall impose ne obligation or liability of any <br />00000 kind upon ffic company, its agents or representatives. <br />Authon'zcd Represcntatl vc: <br />�. Jim <br />