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AC0120® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 04/04/2019 <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(ies)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 PHOJo Watson <br /> Roach, Howard, Smith and Barton N: <br /> 8750 N. Central Expressway, Suite 500 (aC.No.ExtL (972) 231-1300 A/C,No): (972) 231-1368 <br /> jwatson@rhsb.com <br /> Dallas TX 75231 <br /> ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Vantapro Specialty Insurance Co 44768 <br /> INSURED INSURERB:Allied World Insurance Co 22730 <br /> Skyhawks Sports Academy LLC <br /> INSURER C:Chubb Indemnity Co 12777 <br /> 5360 Legacy Drive, Suite 150 INSURERD: <br /> Plano TX 75024 INSURERE: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:Cert ID 44339 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 NSD WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> AMAGERENTED <br /> CLAIMS-MADE X OCCUR 5075218900 03/31/2019 03/31/2020 PREMSESO(Eaocccurrence) $ 300,000 <br /> MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY_ $ 1,000,000 <br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 <br /> X POLICY PRO- <br /> JECT LOC PRODUCTS-COMP/OPAGG $ 3,000,000 <br /> OTHER: Abuse/Molestation $ 1,000,000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 <br /> (Ea accident) <br /> A X ANY AUTO 5079003400 03/31/2019 03/31/2020 BODILYINJURY(Perperson) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> X AUTOS ONLY R AUTOS ONLY (Per accident) <br /> B X UMBRELLALIAB X OCCUR 5078027300 03/31/2019 03/31/2020 EACH OCCURRENCE _ $ 5,000,000 _ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 <br /> DED RETENTION$WO $ <br /> C AND EMPLOYERS' <br /> YERS'LABILITOMPENSATION YIN 71754023 03/31/2019 03/31/2020 X PER <br /> ERH <br /> AND EMPLOYERS'LIABILITY <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBEREXCLUDED? N N/A <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> $ <br /> $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) <br /> General liability policy includes a blanket automatic additional insured endorsement or provision <br /> that provides additional insured status to the certificate holder when required by written <br /> contract or agreement. General liability policy contains a special endorsement or provision with <br /> "primary additional insured" wording. General liability and Workers Compensation policies include a <br /> blanket automatic waiver of subrogation endorsement or provision that provides this feature only <br /> when there is a written contract between named insured and certificate holder that requires it. <br /> CERTIFICATE HOLDER CANCELLATION • <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 /> City of Everett, its officers, agents and employee <br /> 8811 Airport Road AUTHORIZED REPRESENTATIVE <br /> Ranch Park Athletic Office <br /> Everett WA 98204 �,(� -1(4 <br /> -' <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br /> Page 1 of 1 <br />