Loading...
PROOF OF INSURANCE (2026 - 2026)CERTIFICATE OF LIABILITY INSURANCE /2025 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 INSURERS), 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 onthis certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Mass Merchandising K&K Insurance Group Inc. PHON' 9-800-426-2889 1rFAX 260 459-5105 .._._ P.O. Box 2338 (A/c No, Ext) (A/c No): Fort Wayne, IN 46801-2338 E-MAILADDRESs Info@sportsinsurance-kk.com .PRODUCER CUSTOMER ID: INSURER(S) AFFORDINGR _..................m, ........... COVERAGE NAIC # INsuRED: 2001864683 CP# 3886 Specialty Insurance .6.8. 3 INSURER A: AIG S � Company 26883 RK Sports LLC INSURER B DBA: Sportball INSURER C: 1379 W Park Western Dr INSURER D: Los Angeles, CA 90732 INSURER E: A Member of the Sports, Leisure & Entertainment RPG INSURER F: OVERAGES �.. ...... ......0 RTIF1I ATE NUMBER: 2000673537 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY X 9YAPG0001334486101 06/05/25 06/05/26 EACH OCCURRENCE �RRENCE $2,000 000 CU ..'.d -. ......._ CLAIMS -MADE X I OCCUR 12:01AM 12:01 AM (E Occurrence) T6 RENTED PFiEMisEs $1 000 0011 0 � M (Ea Occurrence) VIED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: XITITITAT , GENERAL AGGREGATE $5 000,000, _......—MAB®pTY G -.._. .. $2,000,000 POLICY [:]PROJECT [� LOC pR0®ES IONALOL mmITITmmmmIT OTHER: LEGAL LIAB TO PARTICIPANTS $2,000,000 A AUTOMOBILE LIABILITY 9YAPG0001334486101 06/05/25 06/05/26 COMBINED SINGLE u...iT (Ea $2,000,000 12:01 AM 12:01 AM accdent) ANY AUTO BODILY INJURY (Per person) OWNED AUTOS SCHEDULED BODILY INJURY (Per accident) ONLY AUTOS HIRED AUTOS ''.. NON -OWNED PROPERTY DAMAGE(Per accident) X ONLY �_X IAUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB l CLAIMS -MADE AGGREGATE m..m..... .. ._ - .,,,... ..-,.........._. ...,....... .._. DED RETENTION _. . WORKERS COMPENSATION NIA PER STATUTE OTHER AND EMPLOYERS' LIABILITY YIN E,L. EACH ACCIDENT ANY PROPRIETOR/PARTNER/ EXECUTIVE ) E Lmm DEA ISSE EMPL EA Hmmmmmmmm OFFICER/MEMBER EXCLUDED? { OYEE (Mandatory in NH) If yes, describe under E,L. DISEASE— POLICY LIMIT DESCRIPTION OF OPERATIONS below A MEDICAL PAYMENTS FOR PARTICIPANTS 9YAPG0001334486101 06/05/25 06/05/26 PRIMARY MEDICAL 12:01 AM 12:01 AM EXCESS MEDICAL $25,000 DESCRIPTION OF OPERATIONS ! LOCATIONS I' VEHICLES QACORO 101, Adtitdlar W Remarks Schedule, may be attached if more space is required).. Sport(s): Motor Skills Development Age(s): 12 & Under The City of El Segundo, its elected and appointed officials, employees, and volunteers are added as an additional insured, but only for liability caused, in whole or in part, by the acts or omissions of the named insured Sexual Misconduct Liability - $250,000 each "Insured Event" limit/ $1,000,000 aggregate Effective: 06/06/25 Primary and Noncontributory is added via form PRIG 4288 CERTIFICATE HOLDER CANCELLATION City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 350 Main Street EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH El Segundo, CA 90254 THE POLICY PROVISIONS. Owner/Manager/Lessor of Premises AUTHORIZED REPRESENTATIVE V lUdd-LUI0 At..VKL/ UVKrVKA 11Vrv. ran ngms reaerveU.. Coverage is only extended to U.S. events and activities. ** NOTICE TO TEXAS INSUREDS: The Insurer for the purchasing group may not be subject to all the insurance laws and regulations of the State of Texas. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 9YAPG0001334486101 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE ................. Name Of Additional Insured Person(s) Or Organization(s) The City of El Segundo, its elected and appointed officials, employees, and volunteers 350 Main Street El Segundo, CA 90254 Named Insured: RK Sports LLC DBA: Sportball CP# 3886 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; 2. If coverage provided to the additional insured whichever is less. is required by a contract or agreement, the This endorsement shall not increase the applicable insurance afforded to such additional insured will Limits of Insurance shown in the Declarations. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2 " DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 06/23/2025 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 Next First Insurance Agency, Inc. PHONE (855) 222 5919 I FAX No PO Box 60787 (Alq„.No._EaEIt i J _........ .. Palo Alto, CA 94306 ADDRESS. support@nextlnsurance.c11 om INSURED RK Sports LLC DBA Sportball 1379 W Park Western Dr PMB 160 San Pedro, CA 90732 INSURERA: National Specialty Insurance Company 122608 INSURER B INSURER C INSURER D INSURER E COVERAGES CERTIFICATE NUMBER: 189469738 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. IN ®„ ADDL S`'UBRI ®,,, ,,_.......POLICY EFI=,..i,. ,POLICY"EXP �„, LTR TYPE OF INSURANCE POLICY NUMBER MMIDO/YYYY MMIDDIYYYY I LIMITS r COMMERCIAL GENERAL LIABILITY j EACH OCCURRENCE $ � CjAMAG�'YC9_KtENY�Cl CLAIMS -MADE I OCCUR ME EIXPS(Any one personc e) $ n) $ t ` PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ POq pCyr p,,p:C PRODUCTS - COMP/OP AGG I $ jECT..AAM.m n is OTHER COMBINED SINGLE LIMI1 ' $ AUTOMOBILE LIABILITY JL:a aerideeit,'1„ , mn .. ," .._ . ANY AUTO I BODIL11 Y INJURY (Per person) $ OWNED SCHEDULED ,•m,� B AUTOS ONLY i AUTOS i - PODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY r_jp r1ac denf)AMADE $ i i $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB ] I CLAIMS MADE � AGGREGATE $ DED RETENTION $ J J $ 1 WORKERS COMPENSATION X 'STATUTE 01 H ) ANYP OPRI TOR/PARTNE EXECUTIVE YIN ,E:L. EACH ACCIDENT A OFFICER/MEMBEREXCLUDED? NIA X NXTKTDWYPT-00-WC 06/06/2025 ,06/06/2026 $1,000 000 00 (Mandatory in NH) - I E.L. DISEASE_ EA_E_M_ PLOYEE $ 1 000 000 00 ;If yes, describe underff E..L DISEASE POLICY ;DESCRIPTION OF OPERATIONS below 1 ' ICY LIMIT - $1,000,000.00 I i t_... ' DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The Certrf sate Holder is City of Ell Se undo, NEXT will endeavor to provide Ihtfi is Cercato Holder with writteo notir_e of cancellation 10 clays in advtance for any of the following pollc)es: Workers Cornpensation. A'+ aiver of Subrogadon applies art favor of this Certificate Holder, on the followng policies: Workers Compensation All Certificate Holder privileges apply only if required by written agreement between the Certlfic�at'e Holder and the insured, and are subject to policy ker ms and condltlons. CERTIFICATE HOLDER CANCELLATION City of El Segundo LIVE CERTIFICATE 350 Main St " SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE El Segundo, CA 90245 x THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN r " ACCORDANCE WITH THE POLICY PROVISIONS. CI M*1 AUTHORIZED REPRESENTATIVE R or scan to view @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD