USTA Pacific Northwest 12/3/2019

A CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 10/17/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Arthur J. Gallagher Risk Management Services, Inc. PHONE 973-635-1800 FAX Nol:973-921-2876 200 Jefferson Park (A/C.No.Ext): Whippany NJ 07981 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:National Surety Corporation 21881 INSURED UNITSTA-54 INSURER B:The American Insurance Company 21857 United States Tennis Association Pacific Northwest INSURER c:Fireman's Fund Insurance Company 21873 9746 SW Nimbus Avenue INSURER D:Aegis Security Insurance 33898 Beaverton OR 97008 INSURERS:RSUI Indemnity Company 22314 INSURER F: COVERAGES CERTIFICATE NUMBER:1012401462 REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP/YLIMITS LTR INSR WVD POLICY NUMBER (MM/DDYYYI (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY Y Y XXC80514599 12/31/2018 12/31/2019 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $1,000,000 X Participant Liab MED EXP(Any one person) $10,000 X Abuse&Molestat PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- JECT 1 LOC PRODUCTS-COMP/OP AGG $1,000,000 X OTHER: EVENT Participant Agg $1,000,000 B AUTOMOBILE LIABILITY XXA80336881 12/31/2018 12/31/2019 COMBINaccidEent)DSINGLELIMIT $1,000,000 (Ea _ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) _ _ $ C UMBRELLA LIAB X OCCUR XAE49082431 12/31/2018 12/31/2019 EACH OCCURRENCE $10,000,000 E NHA085173 12/31/2018 12/31/2019 - X EXCESS LIAB ,CLAIMS-MADE AGGREGATE $10,000,000 DED RETENTION$ - $ WORKERS COMPENSATION PER E AND EMPLOYERS'LIABILITY Y I N STATUTE ERH ANYPROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Accident/Medical FR0346 12/31/2018 12/31/2019 AD&D $25,000 Participants Accident Med Excess $25,000 Benefit Period 52 Weeks DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) USTA Tennis events,programs and tournaments Dates:12/31/2018-12/31/2019 Location:City of Everett facilities City of Everett is named as an additional insured with respect to the negligence of the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Everett, ACCORDANCE WITH THE POLICY PROVISIONS. its officers, agents and employees 802 Mukilteo Blvd AUTHORIZED REPRESENTATIVE Everett WA 98201 I '17—‘-'i 1144 (.71---- ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD