HomeMy WebLinkAboutStar S CrudupPREP CERTIFICATE OF LIABILITY INSURANCE DATE.MMIDDrYYYY)
031 U6r2024
THIS CERTIFICATE D AS A MATTER OF INFORMATIONL N ERS NO RIGHTS UPON THE CERTIFICATE HOLDER. T I
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.
19FURTA certificate holder Is an ADBITIONAL INgURE15, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. I
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 endorsements .
PRODUCER
CONTAUT NAME: MM - Sports InstrurLtDrs
K&K Insurance Group, Inc.
1712 Magnavox Way
Fort Wayne, IN 46804
PHONE
xt Arc No E: 1-800 426-2889 Arc No): 1-2ti0 459 5105
info s ortsinsurance-kk.com
ADDRESS: @ P
CUSTOMER ID
INSURER(S) AFFORDING COVERAGE
NAIC 0
INSURED
INSURER A: AIG Specialty Insurance Company
26883
Star S Crudup
INSURER B:
807 Comstock Cir
Nampa, 10 83651
INSURER C:
INSURER D:
A Member of the Sports, Leisure & Entertainment RPG
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: U00061988 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 LTR
TYPE OF INSURANCE
ADDLISUBRI WsD
WVD
POLICY NUMBER
MMIDDYYV)
POLICY EXP
(MMIODNYYYI
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
X.
9YAPG0001334486600
03/2512024
C V2SCO25
EACH OCCURRENCE
$1,000,000
CLAIMS' ❑X OCCUR
MADE
1201! AM EDT
12:01 AM
PREMISES Ea OcCurrqnCei
$1,000,000
MED EXP (Any one person)
$5.000
PERSONAL d ADV INJURY
$1.000,000
GENERAL AGGREGATE
S5,000,000
GEML
AGGREGATE LIMITAPPLIESPER
PRODUCTS -COMPrOPAGG
S1,000,000
POLICY ❑ JECT ❑ LOC
PROFESSIONAL LIABILITY
$1,000,000
LEGAL LIABILITY TO
PARTICIPANTS
$1,000,000
OTHER:
FI). BY
AUTOMOBILE LIABILITY
71711, [HISIN
INGLE LIMIT
Ea accident
BODILY INJURY (Per person)
ANY AUTO
OWNED AUTOS SCHEDULED
ONLY AUTOS
f]
LI
MAR
AR 1
et
i 2024
BODILY INJURY (Per acadeni)
HIRED NON -OWNED
PRO MAGE
AUTOS ONLY AUTOS ONLY
Per accident
NOT PROVIDED WHILE IN HAWAII
UMBRELIAL" OCCUR
EACH OCCURRENCE
EXCESS LIAR HCLAIMS-MADE
AGGREGATE
DED RETENTION
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
N1A
STATUTE OTHER
ANY PROPRIETORIPARTNERI Y 1 N
E.L. EACH ACCIDENT
EXECUTIVE OFFICEWMEMBER
EXCLUDED? (Mandatory in NH)
E.L. DISEASE -EA EMPLOYEE
E.L. DISEASE -POLICY LIMIT
It yes. describe under DESCRIPTION
OF OPERATIONS below
MEDICAL PAYMENTS FOR PARTICIPANTS
PRIMARY MEDICAL
EXCESS MEDICAL
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Instructor of: Cheerleading
Sports instruction conducted at locations that are NOT owned or operated by the instructor
The Certificate holder is added as an additional insured, but only for liability caused, in whole or in part, by the acts or omissions of the named insured.
I.CK I IrR.A I C nULUCK L ANI:CLLA I IUN
City of Caldwell SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
411 Blaine St PO BOX 1179 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Caldwell, ID 83606 ACCORDANCE WITH THE POLICY PROVISIONS.
Owner/Manager Lessor of Premises AUTHORIZED REPRESENTATIVE
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 1 exas
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