HomeMy WebLinkAboutNATIONAL ASSOCIATION OF SPORTS OFFICIALS (NASO) - INSURANCE CERTIFICATEDocuSign Envelope ID: 436A4BD3-1028-4D18-98A2-0670012C9F05
AXIS8000(08/14) CERTIFICATE OF INSURANCE 09/16/2014
PRODUCER
American .Specialty Insurance & Risk .Services, Inc.
142 North Main Street
Roanoke Indiana 46783
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.
INSURED
INSURERS AFFORDING COVERAGE
National Association of Sports Officials (NASD)
INS. A: AXIS Insurance Company
2017 Lathrop Avenue
INS. B:
Racine, VVI 53405
INS. C:
SEAN GROGAN
120 WHITNEY COURT
WINDSOR, CO 80550
CERT NUMBER: 1000987606
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOT WITHSTANDING ANY
REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT 1MTH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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.
INS
LTR
POLICY
TYPE
POLICY NUMBER
POLICY
EFFECTIVE
POLICY
EXPIRATION
LIMITS
A
GL
AXGLG4100089-11
04/27/2014
12:01 a.m.
04/27/2015
12:01 a.m.
General Aggregate - Per Official
2,000,000
Products -Completed Operations Aggregate
2,000,000
Personal and AdvertisingIn'u
1,000,000
Each Occurrence
1,000,000
Damage to Premises Rented o You (Any One Premises
300 000
Medical Expense Limit (Any One Person
Excluded
A
XS
AXXS03100311-11
04/27/2014
12:01 a.m.
04/27/2015
12:01 a.m.
Each Occurrence
2,000,000
General Aggregate
2,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
- Other Named Insured (conrd):but only while acting in their rapacity as officials during sports events organized by a recognized sanctioning body, such as local Park Department or any
formal organized association, and while assigning, acating as a board member or committee member of an officials associaiton, and while attending seminars, conferences, and similar
_ meetings designed to improve their officiating knowledge and skills.
The Certificateholder is only an additional insured with respect to liability caused by the negligence of the Named Insured as per Form AX IS1003- Additional Insured - Certificateholders,
effective April 27, 2014.
- Other Named Insured:National Association of Sports Officials(NASO) & NASO-member officials, including officials enrolled by associations, contracted with NASO for which a premium
has been paid under this policy,
ADDITIONAL INSURED CANCELLATION
CITY OF FORT COLLINS
413 S. Bryan Ave.
Fort Collins, CO 80521
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES
BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
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