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ACaRO� CERTIFICATE OF LIABILITY INSURANCE 11/17/2016 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 REPRESENTATIVBDR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.A statementon this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Bollinger, Inc. PHONE (A/C, FAX (A/C, 150 JFK Parkway No. Ext): 800 -526 -1379 No): 973 - 921 -2876 ShortHills, NJ 07078 -5000 EMAIL ADDRESS: Phone: 800- 446 -5311 Fax: 973- 921 -8236 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Markel Insurance Company 38970 Amateur Softball Association and Members of the JO INSURER B: 01/01/17 CA - Southern California ASA Individual Registrat $2, 000, 000 A Philip Gutierrez INSURER C: P C Box 5028 INSURER D: Oceanside, CA 92 051 INSURER E: COVERAGES CERTIFICATE NUMBER: 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 ADDS SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR VND GENERAL LIABILITY 3602AH230069 12/01/15 01/01/17 EACH OCCURRENCE $2, 000, 000 A V COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 3 0 0 0 0 0 CLAIMS MADE �/ OCCUR PREMISES (Ea occurence) , M ED EXP (Any one person) $10 , 0 0 0 W * Nan- participants only PERSONAL & ADV INJURY $2 , 000 , 000 A V Participant Liability Sexual Abuse & Molestation Liad per occurrence: $2,000,000 GENERAL AGGREGATE $ 5 , 0 0 0 , 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: Sexual Abuse & Molestation Aggregate limit: $2,000,000 POLICY PROJECT LOC PRODUCTS - COMPIOP AGG $ 2 , 0 0 0 , 0 0 0 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) FI ALL OWNED AUTOS BODILY INJURY $ I I SCHEDULED AUTOS IPPROVE) (Per person) HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) $ 1 PROPERTY DAMAGE $ F-1 (Per accident) UMBRELLA EACH OCCURRENCE LIAB OCCUR AGGREGATE EXCESS CLAIMS MADE LIAB $ $ DIED RETENTION $ $ WORKERS COMPENSATION AND WC STATUTORY '-I OTHER EMPLOYER'S LIABILITY Y/N LIMITS J ANY PROPRIETOR/PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF E.L. DISEASE - POLICY LIMIT $ OPERATIONS below OTHER 4102AH220317 12/01/15 01/01/17 Med Max. $250,000 52 -Week Benefit A Accident Medical Full Period. Deductible may apply y pp y Excess DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) COVERAGE UNDER THIS POLICY SHALL APPLY TO LIABILITY OF THE INSURED ARISING OUT OF THE ADMINISTRATION, PLAY OR PRACTICE OF AMATEUR SOFTBALL/BASEBALL, BUT ONLY FOR INCIDENTS INVOLVING BODILY INJURY OR PROPERTY DAMAGE. CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED. THIS CERTIFICATE IS ISSUED ON BEHALF OF: OC illusion CERTIFICATE HOLDER CANCELLATION The City of Riverside, its officers, employees and SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED agents are named as additional insured BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 3900 Main Street AUTHORIZED REPRESENTATIVE Riverside, CA 92522 ACORD 25 (2010!05) @ 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD