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HomeMy WebLinkAboutChallenger Sports Corp - Soccer Camp 2021SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 5/21/2021 Twin Lakes Insurance Agency PO Box 970 Lees Summit MO 64063 Carrie McArthur 816-251-3316 816-525-4049 carrie@twinlakesins.com Scottsdale Insurance Company 41297 CHALSPO-01 National Continental InsuranceChallengerSportsCorp 8263 Flint Street Lenexa KS 66214 AmTrust Financial Group 146682737 A X 1,000,000 X 300,000 5,000 1,000,000 5,000,000 Y KKS0008740700 3/1/2021 3/1/2022 1,000,000 B 1,000,000 X X X CKS52340411 1/21/2021 1/21/2022 A X 5,000,000 X XKS0000008740800 3/1/2021 3/1/2022 5,000,000 C XTWC39636413/1/2021 3/1/2022 1,000,000 1,000,000 1,000,000 A Sexual Abuse/Molestation KKS0008740700 3/1/2021 3/1/2022 LIMIT 1,000,000 CERTIFICATE HOLDER IS NAMED AN ADDITIONAL INSURED WITH RESPECT TO THEIR INTEREST IN THE LIABILITY ARISING FROM THE OPERATIONS OF THE NAMED INSURED CITY OF PASCO IS NAMED AN ADDITIONAL INSURED WITH RESPECT TO THEIR INTEREST IN THE LIABILITY ARISING FROM THE OPERATIONS OF THE NAMED INSURED Program:International Soccer Camp Dates:July 26th -30th Pasco Parks &Recreation 525 N Third Ave,1st Floor Pasco WA 99301 ENDORSEMENTNO. ATTACHEDTO AND FORMINGA PARTOF POLICY NUMBER ENDORSEMENTEFFECTIVE DATE (12:01 A.M. STANDARDTIME)NAMEDINSURED AGENTNO. KRS-GL-56(7-18)Page1of2 THISENDORSEMENTCHANGESTHEPOLICY. PLEASEREADITCAREFULLY. ADDITIONALINSUREDSOWNERSAND/ORLESSORSOFPREMISES, SPONSORSORCO-PROMOTERS Thisinsurance modifies insurance providedunder the following: COMMERCIALGENERALLIABILITYCOVERAGEPART LIQUORLIABILITYCOVERAGEPART A. SECTIONII—WHOISANINSURED is amended to include asan additional insured any per- son(s) or organization(s) of the types indicated by an “x” in any boxes shown below, but only withrespecttoliabilityfor“bodilyinjury,”“propertydamage”or“personalandadvertisinginjury” caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1.In theperformance of your ongoingoperations; or 2.In connection with your premises owned byor rented to you. However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. Withrespect toanadditional insuredowner and/or lessor of premises, thisinsurancedoes not applyto: a.An“occurrence” or offensewhichtakesplacewhileyouarenotatenant inpossession of thesubject premises. b.“Bodily injury” or “propertydamage” arising out of: (1)Structural alterations, new construction or demolition operations performed by or onbehalf of theowner and/or lessor of premises; (2)Anydesign defect or structural maintenance of the premises; or (3)Anypremises defect. B.With respect to the insurance afforded to these additional insureds, the following is added to SECTIONIII—LIMITSOFINSURANCE: If coverageprovidedtothe additional insured isrequiredby acontract or agreement, themost we will pay onbehalf of the additional insured is theamount of insurance: 1.Required by the contract or agreement; or 2.Availableunder theapplicableLimits of InsuranceshownintheDeclarations; whichever is less. 0000 KKS0000008740700 03/01/21 CHALLENGER SPORTS CORP. (SEE KRS-SP-1) KRS-GL-56(7-18)Page2of2 This endorsement shall not increasethe applicableLimits of Insurance shown in theDeclarations. ScheduleofAdditionalInsureds: Owners and/or Lessors of the premises leased, rented or loanedto you Sponsors Co-Promoters Any individual person(s) or organization(s) listedbelow: AUTHORIZEDREPRESENTATIVE DATE X X X X Coaches, Officials, and Volunteers while performing their duties for the insured. SEE UTS-3g Form ENDORSEMENTNO. ATTACHEDTO AND FORMINGA PARTOF POLICY NUMBER ENDORSEMENTEFFECTIVE DATE (12:01 A.M. STANDARDTIME)NAMEDINSURED AGENTNO. KRS-GL-115(3-13) Page1of5 THISENDORSEMENTCHANGESTHEPOLICY. PLEASEREADITCAREFULLY. COMMERCIALGENERALLIABILITYBROADENINGENDORSEMENT Thisendorsement modifies insurance provided under the following: COMMERCIALGENERALLIABILITYCOVERAGEFORM The following is a summaryof the Limits of Insurance and coverage provided by thisendorsement. These coveragesapply separatelyto each of your premises described inthe Declarations. If you purchase additional limits for anyof these coverages at a specified location, the limits shown below will apply in excessof the insurance purchased separately. We will not pay more under this endorsement than the Limitsof Insurance shown belowunder the Summary of Additional Coverages. SummaryofAdditionalCoverages LIMITSOFINSURANCE SUBJECTSOFINSURANCE $300,000 per occurrence Damage to Premises Rented to You $ 25,000 EmergencyReal Estate Consultant Fee $ 25,000 Identity Theft Exposure $ 50,000 KeyIndividual Replacement Cost $ 2,500 LeaseCancellation Moving Expense $ 2,500 Supplementary Payments—Bail Bonds $ 500 per day Supplementary Payments—Lossof Earnings $ 25,000 Temporary MeetingSpace $ 25,000 TerrorismTravel Reimbursement $ 25,000 WorkplaceViolenceCounseling I.TheCommercial General LiabilityCoveragePart is amendedas follows: A.The following replaces SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTYDAMAGELIABILITY,2.Exclusions,a.: a. ExpectedorIntendedInjury “Bodily injury” or “property damage” expected or intended from the standpoint of the in- sured. This exclusion does not applyto “bodilyinjury” or “propertydamage” resulting from the use of reasonable forcetoprotect persons or property. 0000 KKS0000008740700 03/01/21 CHALLENGER SPORTS CORP. (SEE KRS-SP-1) KRS-GL-115(3-13) Page2of5 B.The following replaces SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTYDAMAGELIABILITY,2.Exclusions,g.(2): (2)Awatercraft you do not own that is: (a)Lessthan fifty-eight (58) feet long; and (b)Not beingusedtocarrypersons or property for acharge; C.The following replaces SECTION I—COVERAGES, COVERAGE BPERSONAL AND ADVER- TISINGINJURYLIABILITY,2.Exclusions,b.and c.: b.Material PublishedWithKnowledge of Falsity “Personal and advertising injury” arising out of publication of material, including, but not limited to, oral, written, televised, videotaped or electronically transmitted publication of material, if doneat thedirection of theinsured withknowledge of its falsity; c.Material Published Prior To Policy Period “Personal and advertising injury” arising out of publication of material, including, but not limited to, oral, written, televised, videotaped or electronically transmitted publication of material, whose first publicationtook place before the beginning of the policyperiod; D.Thefollowingreplaces SUPPLEMENTARYPAYMENTS—COVERAGESA.and B.,1.b. andd.: b.Up to $2,500 for the cost of bail bonds required because of accidents or traffic law viola- tions arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. Wedo not have to furnishthese bonds. d.All reasonable expenses incurred by the insured at our request to assist us in the investi- gation or defense of the claim or “suit,” including actual loss of earnings up to $500 a day because of time off fromwork. E.Thefollowingreplaces SECTIONII—WHOISANINSURED,3.a.: a.Coverage under this provision is afforded only until the one hundred eightieth (180 th) day after you acquire or form the organization or the end of the policy period, whichever is earlier. F.The following are added to SECTION IV—COMMERCIAL GENERAL LIABILITY CONDI- TIONS,2. DutiesInTheEventofOccurrence,Offense,ClaimorSuit: e.Knowledge of the “occurrence,” offense, claim or “suit” by the agent, servant, or “em- ployee” of an insured shall not in itself constitute your knowledge unless one of your officers, manager or partners has received notice of the “occurrence,” offense, claim or “suit.” f.Failure by the agent, servant or “employee” of an insured (other than an officer, manager or partner) to notify us of an “occurrence” shall not constitute a failure to comply with Items a.and b.of thiscondition. G.Thefollowing areadded to SECTIONIV—COMMERCIALGENERALLIABILITYCONDITIONS: 10. UnintentionalErrororOmission Anyunintentional error or omission in the description of or failure to completely describe, any premises or operations intended to be covered by this Coverage Part will not invalidate or affect coverage for those premises or operations. However, you must report such error or omission tousas soon as practicableafter its discovery. 11. WaiverofRightofRecovery We waive all rights of recovery when you have agreed to waive your rights of recovery when required by a written contract. However, this provision only applies if the written contract was executed prior tothe date of the “occurrence.” KRS-GL-115(3-13) Page3of5 H.Thefollowingreplaces SECTIONV—DEFINITIONS,3.and14: 3.“Bodily Injury” means bodily injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright, humiliation, emotional distress or death resulting frombodilyinjury, sicknessor disease. 14.“Personal and advertising injury” means injury, including consequential “bodily injury,” arising out of oneor more of thefollowing offenses: a.False arrest, detention or imprisonment; b.Maliciousprosecution or abuse of process; c.The wrongful eviction from, wrongful entry into, or invasion of the right of private occu- pancyof a room, dwelling or premises that a person occupies, committed byor on behalf of itsowner, landlordor lessor; d.Any publication of material including, but not limited to oral, written, televised, videotaped or electronically transmitted publication of material that slanders or libels a person or organization or disparagesa person’s or organization’s goods, products or services; e.Any publication of material, including but not limited to oral, written, televised, videotaped or electronically transmitted publication of material that violates a person’s right of privacy; f.Theuse of another’s advertising idea in your “advertisement”; or g.Infringingupon another’scopyright, trade dressor slogan inyour “advertisement.” I. BroadenedCoverage—DamagetoPremisesRentedtoYou 1.The word fire is replaced with the phrase fire, lightning, explosion, smokeandleaksfrom sprinklers whereit appearsin: a. SECTION1,CoverageA.,2.Exclusions,j.DamagetoProperty; b. SECTION1,CoverageA.,2.Exclusions,lastparagraph; c. SECTIONIII,LimitsofInsurance,Item6.;or d. SECTIONIV,Conditions, 4.OtherInsurance,Itemb.(1)(a)(ii). 2.The limit of Insurance applicable to Damage to Premises Rented to You is $300,000 unless a higher limit isspecified on the Declarations. II.Thefollowing are AdditionalCoverages: EmergencyRealEstateConsultantFee($25,000Aggregate) We will reimburse you up to $25,000 in any one policy year for any realtor’s fee or real estate consultant’s fee required by the Named Insured’s need to relocate due to the imminent danger of loss of lifeor harmtooccupantsof the NamedInsured’spremisesscheduled on the Declarations. IdentityTheftExpense (1) Coverage We will pay for reimbursement of anypresent director or officer of the Named Insured for expenses incurred as the direct result of any “Identity Theft” occurring, discovered and reported during the policy period. (2) LimitofInsurance We will pay up to $25,000 as a Limit of Insurance under this Additional Coverage— IdentityTheftExpense. (3)“Identity Theft” means the act of knowingly transferring or using, without lawful authoriza- tion, the identity of any officer or director of the Named Insured with the intent to commit, or to aid or abet another to commit, any unlawful activity that constitutes a violation of federal lawor a felonyunder any applicable stateor local law. KRS-GL-115(3-13) Page4of5 (4)“Identity Theft Expenses” means: (a)Costs of notarizing documents required by financial institution or similar creditors as testamentstofraud. (b)Costs for certified mail to lawenforcement agencies, credit agencies, financial institu- tionsor similar creditors. (c)Loan application fees for re-applying for loan(s) when the original application is re- jectedsolely because of incorrect credit information. KeyIndividualReplacementExpenses We will pay up to $50,000 as a Limit of Insurance per policy year under this Additional Cover- age—Key Individual Replacement Expenses for expenses incurred by the Named Insured to replace the Chief Executive Officer or Executive Director if that officer or director suffers an injury during thepolicy period whichresultsinthelossof life during thepolicy period. “KeyIndividual Replacement Expenses” means: (1)Costs of advertising the employment position opening; (2)Travel, lodging, meal and entertainment expenses incurred in interviewing job applicants for theemployment position opening; and (3)Miscellaneous extra expenses incurred in finding, interviewing and negotiating with the job applicants, including, but not limited to, overtime pay, costs to verify the background and references of the applicants and legal expenses incurred to draw up employment contracts. LeaseCancellationMovingExpenses We will reimburse the Named Insured up to $2,500 for moving expensesincurred when moving is made necessary by the cancellation of a lease at premises occupied by the Named Insured and described in the Declarations. TemporaryMeetingSpace We will reimburse you up to $25,000 as a Limit of Insurance in any one policy year under this Additional Coverage—Temporary Meeting Space for expenses incurred due to the temporaryun- availabilityof the Named Insured’s primary office space due to the failure of a climate control sys- tem, or leakage of a hot water heater during the policy period. Expenses will be reimbursed only for the rental of temporary meeting space required for meeting with parties who are not insured under this Policy. No deductible applies to this Additional Coverage—Temporary Meeting Space. TerrorismTravelReimbursement We will reimburse you up to $25,000 as a Limit of Insurance in any one policy year for “Emer- gency Travel Expenses” incurred by a director or officer of the Named Insured due to the occur- renceof a“Certified Act of Terrorism.” “Emergency Travel Expenses” are additional travel expenses incurred to re-schedule comparable transport due to the cancellation of scheduled transport withinforty-eight (48) hoursof a “Certified Act of Terrorism.” “Certified Act of Terrorism” means an act that iscertified bythe Secretaryof the Treasury, in con- currence with the Secretary of State and the Attorney General of the United States, to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria contained in that Act for a“CertifiedAct of Terrorism” includethe following: a.the act resulted in aggregatelossesin excessof $5million; and b.the act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian popula- tion of the United States or to influence the Policy or affect the conduct of the United States Government bycoercion. KRS-GL-115(3-13) Page5of5 WorkplaceViolenceCounseling We will reimburse you up to $25,000 as a Limit of Insurance in any one policy year under this Additional Coverage—Workplace Violence Counseling for expenses you incur for the coun- seling of employees of the Named Insured when that counseling is necessary due to an incident of “Workplace Violence.” “Workplace Violence” means the intentional use of, or threat to use deadly force by any person with the intent to cause harm and that results in bodily injury or death of a person while on the Named Insured’spremises. AUTHORIZEDREPRESENTATIVE DATE