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CERTIFICATE OF INSURANCE AGENCY: Entertainment & Sports Insurance eXperts (ESIX) 5660 New Northside Drive, Suite 640 Atlanta, Georgia 30328 Phone:678-324-3300 Fax:678-324-3303 DATE: 1 /5/2010 CERTIFICATE NUMBER: 20100105005739 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. NAMED INSURED: INSURERS AFFORDING COVERAGE: USA Water Ski Lake Owasso Safe Boating Association INSURER A: Philadelphia lndemnity Ins. Co. 1251 Holy Cow Road 460 W Horseshoe Dr Polk City, Florida 33868 Shoreview, Minnesota 55126-3001 INSURER B: Philadelphia lndemnity Ins. Co. POLICY/COVERAGE INFORMATION: 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS TYPE OF INSURANCE: POLICY NUMBER(S): EFFECTIVE: EXPIRES: LIMITS: A GENERAL LIABILITY X COMMERCIAL GENERAL PHPK509478 1/1/2010 1/1/2011 GENERAL AGGREGATE (Applies Per Event) $2,000,000 LIABILITY EACH OCCURRENCE $1,000,000 X Occurrence DAMAGE TO RENTED PREMISES (Each Occ.) $1,000,000 X Participant Legal Liability MED EXP (Any one person) EXCLUDED PERSONAL & ADV INJURY $1,000,000 PRODUCTS-COMP/OP AGG $2,000,000 B UMBRELLA/EXCESS LIABILITY X Occurrence PHUB293258 1/1/2010 1/1/2011 AGGREGATE (Applies Per Event) X SIR EACH OCCURRENCE RETENTION/DEDUCTIBLE $4,000,000 $4,000,000 $10,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS: The certificate holder is an Additional Insured with respect to liability arising out of the negligence of the Named Insured as per the folloiwng endorsement: Additional Insured - Certificate Holders (Form PI-AM-002). Coverage only applies with respect to tournaments, practices, exhibitions, clinics and related activities sanctioned and approved by USA Water Ski, Inc. CERTIFICATE HOLDER: City of Roseville 2660 Civic Center Drive Roseville, Minnesota 55113 NOTICE OF CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE: r