Skyhawks Sports Academy 11/19/2021

A�Rt�® CERTIFICATE OF LIABILITY INSURANCE DATE(MtA/DDIYYYY) I 03/31/2021 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 poiicy(tes)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 _ Roach, Howard, Smith and Barton NAME: Jo Watson 8750 N. Central Expressway PHONE FAX Suite 500 rA/C No.Ex0: (972) 744-2772 INC,No);(972) 744-2872 E-MAIL Dallas TX 75231 ADDRESS: Jwatsonorhsb.com INSURER(S)AFFORDING COVERAGE NAIC t! INSURERA:Vantapro Specialty Insurance C 44768 INSURED INSURERB:Allied World Insurance Company 22730 Skyhawks Sports Academy, LLC INSURER C:Chubb Indemnity Co 12777 1826 E. Sprague Avenue INSURER D: Spokane WA 99202 INSURERS: INSURER F: COVERAGES CERTIFICATE NUMBER:Cart ID 51695 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. NOTWTHSTANDING 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 ADDL SUER LTR TYPE OFINSURANCE INRD WVD POLICY NUMBER AMU; (MM%DD/YYYY) LIMITS A X COMMERCIALGENERALLIABILITY EACHOCCURRENCE S 1,000,000 CLAIMS-MADE I X I OCCUR 5075218902 03/31/2021 03/31/2022 PPREMISES(EaEocjrr ncel $ 300,000 _ MEDEXP(Any one person) S 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X I POLICY I IJEC I (LOG PRODUCTS-COMP/OPAGG $ 3,000,000 ((OTHER: Abuse/Molestation $ 1,000,000 AUTOMOEILELIA9a1TY A ANY AUTO (EaaAaccIdeD SINGLE LIMIT S 1,000,000 5079003402 03/31/2021 03/31/2022 BODILY INJURY(Per person) S OWNED SCHEDULED A171"OS ONLY _ AUTOS BODILY INJURY(Per accident) $ X HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY X AUTOS ONLY (Per accident) $ S B X UMBRELLA LIAe X OCCUR 5078027302 03/31/2021 03/31/2022 EACHOCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DEO RETENTION S WORKERS COMPENSATION P S C AND EMPLOVERS'LIABILITY ,//N 71754023 03/31/2021 03/31/2022 x STATUTE ERH ANYPROPRIETOR/PARTN ERJEXEC UTIVE OFFICERIMEMBEREXCLUDED7 I NI N/q E.LEACHACCIDENT $ 1,OOD,000 (Mandatory In NH) If yes,describe under EL.DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 $ $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) General and auto liability policies include blanket automatic additional insured endorsement or provision that provides additional insured status to any person or organization the Named Insured is required by written contract to add as an additional insured. General Liability policy includes Primary and Non-Contributory status in favor of Additional Insureds when there is a written contract or agreement requiring such status. General and workers compensation/employers liability policies include blanket automatic waiver of subrogation endorsement or provision that provides this feature to any person or organization the Named Insured is required by written contract to provide a waiver of subrogation. 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, its officers, agents and employee ACCORDANCE WITH THE POLICY PROVISIONS. 8811 Airport Road AUTHORIZED REPRESENTATIVE Easels Park Athletic Office Everett WA 98204 .C- tax{ ©19 8----8'"'-----2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1