PROOF OF INSURANCE (2025).......... (MMIDD/YYYYI
CERTIFICATE OF LIABILITY INSURANCE DATE 08P.&I2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOE S 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 INSUIRER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: It the certificate holder is an ADDITIONAL IN SURED, the policylies) must have ADDITIONAL IN SURED 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 rieu of such endorsement(s).
,PRODUCER CONTACT
RPS Bollinger
200 Jefferson Park NAME:
Whippany, NJ 07961 PHONE FAX
PHONE: 1-800446-5311 FAX: 973-921-8474 (AtC, No- Ext): 8041-"f,5311 (AIC, No.): 973-921 8 474
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E-MAIL
ADDRESS:
INSURERS NAIC 9
_LN.!ULT�RA SiKUSPoint America Insurance Company 3ST76
INSURED INSURER 8:
USA Softball. Inc. INSURERC:
2801 NE 50th Street
INSURER D:
01da11oma Cuv, OK 7'3111 . .. . .......
INSURER E:
WSURERF:
COVERAGES CERTIFICATE NUMBER:IR0202484088 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENTWITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED
OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN ISSUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
lNSR TYPE OF INSURANCE ADDL WEIR POLICY NUMBER POLICY EFF P6U—CYEXP LIMITS
LTR lN&R VVVD _(tMm IMMMMTM I
GENERAL LIABILITY X 9/1/2024 9/1/2025 EACI,, OCCUR,,rZ S3:00001X)
A 7), COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
CLAIMS -MADE FXJOCCUR PLH02GL00002121 M�EV,?SES (a oowrrffwe1
MEDE(PfArW0MMMMP- $10,ODO
Sexual Abuse & Moestation Liab per occurreftee: 31, PERWNAL&A9VAUUftY SLODO-DDO
Sexual use & Molestation Aggregate fimit: $2,00,000 CfF--QL AGGREGATE 35,000.ow
Participant & Legal Liability poor occurrence. $2.,0W.W0 PRODL�_,Ts - COMAUP AGG
GEN'L AGGREGATE LIMIT APPLIES PER: Participant & Legal Liability Aggregate lrmit' S2,00,=1
POLICY L] PRO- LOC
JECT F] Applies to non-pam6pants only
AUTOMOBILE LIABILITY Copmo%E-) Sh%CLE Um" (ra aowwx)
ANY AUTO Fyci:;�Ly UJURY lPe rpmws
ALL OWNED SCHEDULED U.XXXIN N11 U RY Mel WGRWI
AUTOS AUTOS PROPERTY DAMAGE
HIRED AUTOS NON -OWNED (Per wDbeM
—,AUTOS
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE
OCCUR 1-i rtAJAS AGGREGATE lo I A
I11,11_0R,ETEtJTJ0N 5,
WORKERS COMPENSATION YIN NIA srATUTE VTH_ 3
AND EMPLOYERS' UABILITY
ANY PROPFUEORIA111-101ECUTIVE E.L. EACH ACODS"JIT, $
aFFICERMEMEER —'-.? FP Di,. - EA EMPLOYEE $
(Mandatory in NH) EIL EM ME-1:4MMY113411
flyes, OeEcrlte uncer DES' -%PT' ON OF
OPERATIONS bebW
A Accident Insurance PHSA-BAMH-10537-241 9J1/2024 911f2025 AM00 rrwrm�e 57250.000
Full Excess
IS500
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 1014, Additional Remarks Schedule, if more space is required)
COVERAGE UNDER THIS POLICY SHALL APPLY TO THE INSURED ARISING OUT OF THE ADMINISTRATION, PLAY OR PRACTICE OF AMATEUR SOFTBALLIBASEBALL. BUT ONLY
FOR INCIDENTS INVOLVING BODILY INJURY. PERSONAL INJURY OR PROPERTY DAMAGE, CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED. THIS CERTIFICATE
IS ISSUED ON BEHALF OF: EL SEGUNDO GIRLS SOFTBALL
CERTIFICATE HOLDER CANCELLATION
Tlie, Cit,; Of Segundo, its offirets, offircials, employees, agents, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DA rE THEREOF„ NOTICE WILL BE DELIVERED IN
and volunteers ACCORDANCE WITH THE POLICY PROVISIONS.
350'Nhin St_
ElSegurido- CA 90245
AUTHORIZED REPRESENTATIVE
1988-22023ACORD CORPORATION All rights reserved
ACORD 25 (2016/03) The ACORD name and logo are registered madm of ACORD