Skyhawks Sports Academy 11/27/2018

• ACCPRO /Y® CERTIFICATE OF LIABILITY INSURANCE DATE o9/zo/zo16 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: Jo Watson Roach, Howard, Smith and Barton PHONE 8750 N. Central Expressway, Suite 500 (A/CC.No.Ext): (972) 231-1300 (NC,No):(972) 231-1368 E-MAIL Watson@rhsb.corn Dallas TX 75231 ADDRESS: 7 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Chubb Indemnity Co 12777 INSURED INSURER B:Philadelphia Indemnity 18058 Skyhawks Sports Academy LLC INSURER C: 9425 N. Nevada St., Suite 210 INSURER D: Spokane WA 99218 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:Cart ID 42510 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. ILTR TYPE OF INSURANCE NSD SWVD POLICY NUMBER UBR POLICY EFF POLICY EXP LIMITS (MMIDD/YYYY) {MM/DD/YYYY) B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PHPK1866344 09/23/2018 09/23/2019 PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ Excluded PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000_ X POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: Abuse/Molestation $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) B ANY AUTO PHPK1866344 09/23/2018 09/23/2019 BODILYINJURY(Perperson) $ OWNEDX SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED. NON-OWNED PROPERTY DAMAGE X AUTOS ONLY AUTOS ONLY (Per accident) $ _ $ B X UMBRELLALIAB X OCCUR PHU8643163 09/23/2018 09/23/2019 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$WOR $ A AND EMPLOYERTIONS' PEY/N 71754023 03/31/2018 03/31/2019 X STATUTE EERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED7 N (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General liability and Automobile liability policies include a blanket automatic additional insured endorsement or provision that provides additional insured status to the certificate holder when required by written contract or agreement. General liability and Automobile liability policies contains a special endorsement or provision with "primary additional insured" wording. General liability, Automobile Liability and workers compensation policies include a blanket automatic waiver of subrogation endorsement or provision that provides this feature only when there is a written contract between named insured and certificate holder that requires it. Certificate Holder is Additional Insured as respects General Liability for Ongoing Operations of the Named Insured per form PI-GL-005 (07 12) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Everett, its officers, agents and employee 8811 Airport Road AUTHORIZED REPRESENTATIVE Kasch Park Athletic Office �� ( � Everett WA 98204 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1