Loading...
HomeMy WebLinkAboutAMERICAN BICYCLE ASSOCIATION DBA USA BMX - INSURANCE CERTIFICATEClient#: 1067930 AMERIBICI ACORDT,. CERTIFICATE OF LIABILITY INSURANCE DATE 2/20/ /DD Y2015 YYY) /20/ 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 HOLDfR. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must 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 USI Insurance Services LLC-CL 2201 E. Camelback Rd Suite 220A Phoenix, AZ 85016 602 279-5800 S•CT PHONE 602-279-5800 No Est): A/C No): 602-279-5899 ADDRESS: phxCertificate.Request@usl.biz INSURER(S) AFFORDING COVERAGE NAICN INSURER A: Philadelphia Indemnity Insuranc 118058 INSURED American Bicycle Association dba: USA BMX INSURER B: INSURER C: P.O. Box 718 INSURER D : Chandler, AZ 85244 INSURER E: INSURER F : 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 CONTRACTOR 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 REDUyC�EFD BY PAID CLAIMS. LTR TYPE OF INSURANCE INISR ADDL BFI WV POLICY NUMBER MMMIDDDW MW DnYYP LIMITS A GENERAL LIABILITY PHPK1296554 3/01/2015 03/01/2016 EACHOCCURRENCEs1 000000 X COMMERCIAL GENERAL LIABILITY ' CLAIMS -MADE I X I OCCUR PREMISEB aEONccurrDence $100000 MED EXP (Any one person) $Excluded PERSONAL &ADV INJURY $1,000000 X Ded:$0 GENERALAGGREGATE $5 00O 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $1 000 000 X POLICY PRO- LOC Abuse/Molest $1 000,ON A AUTOMOBILE LIABILITY PHPK1296554 3/01/2015 03/01/201 COMBINED SINGLE LIMIT Me accident 1,o00,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ $ A X' UMBRELLA LIAS X OCCUR PHUB490332 3/01/2015 03/01/201 EACHOCCURRENCE 0000 $400 AGGREGATE $4 000 OOO EXCESS LIAR CLAIMS -MADE DED X'. RETENTION $$10,000 $ WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ - -- (Mandatory In NIQ H yas, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMB $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder and any other entities listed below are listed as additional insured under the General Liability on a primary & Non Contributory Basis including waiver of subrogation with respect to the American Bicycle Association/USA BMX sanctioned events/competitions/practices and other operations conducted by American Bicycle Association/USA BMX track operators on behalf of the American Bicycle Association/USA BMX. RE: Epic BMX #1352 City of Fort Collins C/O John Stephen 215 N. Mason Fort Collins, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE le,14 /v, oe64_ ACORD 25 (2010105) 1 of 1 #S14369907/M14368698 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CXTJD