HomeMy WebLinkAboutBSN SPORTS LLC - INSURANCE CERTIFICATEAGORO CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
07/31/2015
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.
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 statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
MARSH USA INC.
CONTACT
NAME:
CHASE TOWER
111 MONUMENT CIRCLE, SUITE 4300
INDIANAPOLIS, IN 46204-2492
PHONE
C Ext) A/C No
--
E-MAIL
IL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
101 168-BSN-Prop-1 4-16 _
INSURER A: James River Insurance Company
12203
INSURED
BSN Sports, LLC including subsidiaries:
INSURER B ; Travelers Property Casualty Co. of America
25674
INSURER C : N/A
WA
Tomark Sports, Kesslers Team Sports, Dixie Sporting Goods,
The Athletic Connection, Passon's Sports and U.S. Games
1901 Diplomat Drive
INSURER D : N/A
N/A
INSURER E :
Farmers Branch, TX 75234-8914
INSURER F :
COVERAGES CERTIFICATE NLIMRFP: CHI-005208528-08 IMM, ,u .
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
I TYPE OF INSURANCE
DDL
SUBR
POLICY NUMBER
POLICY EFF
MM/DD/YYYY)
POLICY EXP
(MM/DDfYYYYI
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
CONTRACTUAL LIABILITY
678240
'07/30/2015
07/30/2016
EACH OCCURRENCE
CO7F
$ 1,000,000
PREMISES occurrence) ence
$ 50,000
X
MED EXP (Any one person)
$ EXCLUDED
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
X
AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PRO- ❑
JECT LOC
OTHER
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
BA3F91639014CAG
12/12/2014
12/12/2015
COMBINED SINGLE LIMIT
Ea accident
g 1,000,000
X
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
B
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
N / A
YJUB4F02061414
I
12/12/2014
I
12/12/2015
I
EACH OCCURRENCE
$
AGGREGATE
$
DED RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
EXCLUDED? N
(Mandatoryin NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
X PER OTH-
STATUTE ER
$
E.L.OFFICER/MEMBER EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEEI
$ 1,000,000
E.L. DISEASE - POLICY LIMIT 1
$ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: 13-46239
The City, its officers, agents and employees are included as additional insured (except workers' compensation) where required by written contract.
City of Fort Collins
215 N. Mason St., 2nd Floor
PO Box 580
Fort Collins, CO 80522
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
of Marsh USA Inc.
ACORD 25 (2014/01)
Shirley Murray
v 1auts-ZU14 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD