Underdog Sports Leagues 11/27/2018

ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MWODMlW) 4/13/2018 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 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 Cari Maciolek, ACSR NAME: Bell Anderson Agency, Inc. �Nt EXU. (425)291-5200 AXNQI,(425)291-5100 600 SW 39th St, Suite 200 ADORE55.carim@bell–anderson.com INSURER(S)AFFORDING COVERAGE NAIL 9 Renton WA 98057 INSURERA:Philadelphia Indemnity Insurance ; 18058 INSUREDINSURER B QBE Insurance Corporation 39217 Seattle Sports Leagues, Inc. INSURER C: DBA: Underdog Sports Leagues; DBA: FunCorp INSURER D: 426 Yale Ave N INSURER E: Seattle WA 98109 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1841328622 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 UE TYPE OF INSURANCE ADDL SR POLICY EFF POLICY EXP LIMBS LTR !NMWVD POLICY NUMBER (MMIDDIYYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X OCCUR PAMAGE TO RENTED $ 100,000 X Participant Legal Liab. PBPK1805160 4/17/2018 4/17/2019 MEDEXP(Anyoneperson) $ 5,000 PERSONAL 8,ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 3,000,000 X POLICY I I JECT LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT $ 1,000,000 _1E4 accident) _ A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS PBPK1805160 4/17/2018 4/17/2019 BODILY INJURY(Per accident) $NON-OWNED PROPERTY DAMAGE _ X HIRED AUTOS X AUTOS (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS UAB i CLAIMS-MADE AGGREGATE $ DED RETENTIONS I $ — WORKERS COMPENSATION PEROTH- AND EMPLOYERS'LIABIUTY Y/N STATUTE 1 ER – ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N I A A (Mandatory In NH) PBPK1805160 4/17/2018 4/17/2019 EL DISEASE-EA EMPLOYEE $ 1,000,000 If yes.describe undw (WA StopGa DESCRIPTION OF OPERATIONS below PI Et DISEASE-POLICY LIMIT $ 1,000,000 Accident Medical tlf5A4725A 4/17/2018 4/17/2019 Limit: $25,000 I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) City of Everett, its officers, agents, and employees are additional insured per the attached endorsement #CG2011 0413. CERTIFICATE HOLDER CANCELLATION crettenmier@ci.everett.wa. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2930 Wetmore Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Everett, WA 98201-4067 AUTHORIZED REPRESENTATIVE Jason Webb/CEM c-�.-�"`'' —J - ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 romanr I