WA State Umpires Assn/US Specialty Sports 9/19/2016

1/4/2016 web.usssa.com/sports/IC.asp?A=274030&6=181869 CERTIFICATE OF INSURANCE I Issue Date: 12/18/2015 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 be endorsed.If SUBROGATION IS WAIVED,subject to the terms and condistions 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: INSURERS AFFORDING COVERAGE EPIC Brokers INSURER A:Scottdale Insurance Company License No. OB29370 INSURER B:Scottdale Insurance Company P.O.Box 13847 INSURER D: INSURER D: Sacramento CA 95853 INSURER E: 888-880-3602 Insured: United States Specialty Sports Association 611 Line Drive Kissimmee, FL 34744 800-741-3014 Coverages: 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 ADDL SUBR Policy Policy LTR Type of Insurance INSD WVD Policy Number Effective Expiration Limits Date Date A Commercial General Liability y N KRS0000005907000 1/1/2016 1/1/2017 Each Occurrence$2,000,000 Occurence Basis Damage to Rented Premises(ea occ)$300,000 Med Exp(any one person)$Excluded General Aggregate$None Personal and Adv Injury$2,000,000 Products-Comp/OP Agg$2,000,000 Participant Legal Liability$2,000,000 B Excess Liability y N XKS0000005907100 1/1/2016 1/1/2017 Each Occurrence$1,000,000 Aggregate$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule may be attached if more space is required) Coverage indudes amateur play and practice in the insured sport for:City of Everett The Field/Facility Owner shown as the certificate holder shall be an additional insured but only with respects to liability caused by the negligent acts or omissions of the named insured and only with respects to losses resulting from amateur play and practice during USSSA sanctioned activities occurring between the coverage effective date listed below and the policy expiration date. Certificate Holder: I Coverage Effective Date: 1/1/2016 City of Everett CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE 802 Mukilteo Blvd DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Everett WA 92801 Certificate# USSSA-274030-181869t. Authorized Representatives: 11-f-1-14111 http://web.usssa.com/sports/IC.asp?A=274030&B=181869 2/2