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PROOF OF INSURANCE (2023) CLOSED
SOCC-91 ,a►coR CERTIFICATE OF LIABILITY INSURANCE DATEIMM/DD/YYYY) 11 /02/2022 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 riahts to the certificate holder in lieu of such endorsement(s). PRODUCER RPS Bollinger Sports & Leisure PO Box 1322 Morristown, NJ 07960 David Campanello INSURED Itners Edge Sports Training North Lake Pleasant Park.. reoria, AZ 85383 C: HIV.. t. XYw\ 1 hl= 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, POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXCLUSIONS AND CONDITIONS OF SUCH PO� ....""" _ INSR ADDL. SUBRI POLICY EFF POLICY EXP TYPE OF INSURANCE o POLICY NUMBER LIMITS A X COMMERCIAL GENERAL LIABILITY 1 000,000 $,.... ...PROkung] _I CLAIMS -MADE [ Xµ) OCCUR X X 3502AK011830.2 11/05/2022 11/05/2023 DAMAGE TO $ 100,000 .....,,.. X Incl Participants MEDEXP�oneperson? $ 5,000 A "X .Sexual e/Mol Abus .... $1MILL1$2MILL 11/O5/2022 11/O5/2023 PERSQNAL.&ADV....— ... _ INJURY $ 1,000,000 GEN'L AQCREGA.;fE. LIMIT APPLIES PER: GENERAL AGGREGATE $..... 3,000 000 POLICY JEaT 7 LOC PRODUCTS COMP/OPAGG $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMONEO SIDLE LIMI L ANY TO - BODILY INJURY fPerpersonl "8 .......... OWNEDSCHEDULED .. AUTOpS ONLY AUTOS qq AUTOS ALQITQ N PROPERT�Y' OAMAGE Per ONLY ��..____ �'Y acrdan, ... . $ UMBRELLA LIAB OCCUR EACH OCCURRENCE ..-- EXCESS LIAB CLAIMS -MADE .......w '�..._..... _RETENTION GGREGATE A ..... ».._ . $$, ...... ........... ..- DED $ � WORKERS COMPENSAT10N AND EMPLOYERS' LIABILITY y PER OTH I S?AT.uTE _ .. _.FR � .................... 'YIN ANY PROPRIETOR/PARTNER/EXECUTIVE �� N / A E L EACH Af OIQFINT '' $ C.SF'FICER1M .MBER EXCLUDED? ( andator n NH) S I If describe under E L DISEASE EAEMPLQYEE ''.., as, RIPTI N F QPER.AT,ONS below E DIS - PQ IQY IMIT A Accident Insurance 102AH025250-15 _EA 11/05/2022 11/05/2023'Med Max: 25,000' Full Excess I Ded: 500 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is Included as an additional insured. Coverage Its rovided under these policies Only for sponsored/supervised activities of Waiver Subrogation he named insured for Which a premium has been paid. of applies. This Insurance Is primary and non -Contributory With any other insurance. The City of El Segundo, its officers, officials, employees agents and volunteers 350 Main St El Segundo, CA 90245 ACORD 25 (2016/03) CITYELS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD