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HomeMy WebLinkAbout114337 BSN SPORTS INC - INSURANCE CERTIFICATE (2)ACOR" CERTIFICATE OF LIABILITY INSURANCE D11211412015Dnrrr) 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. CHASE TOWER CONTACT NAME: PHONE FAX AC No: E-MAIL ADDRESS: 111 MONUMENT CIRCLE, SUITE 4300 INDIANAPOLIS, IN 46204-2492 INSURERS AFFORDING COVERAGE NAIC d INSURER A: James River Insurance Company 12203 101168-BSN-PropOS-16 INSURED BSN Sports, LLC including subsidiaries: Tomark Sports, Kesslers Team Sports, Dixie Sporting Goods, INSURER B: Travelers Property Casualty Co. of America 25674 INSURER C : Continental Casualty Company 20443 INSURER D : N/A NIA The Athletic Connection, Passon's Sports and U.S. Games 1901 Diplomat Drive Farmers Branch, TX 75234-8914 INSURER E : INSURER F : CnVFRAn FS CFRTIFICATF NUMBER: CHI-005208528-08 RFVISION NUMRFR:2 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 OF INSURANCE ADDLTYPE INSD SUER POLICY NUMBER MM DDPOLICY /YYYY) IMMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY 678240 07/3012015 07130/2016 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE r _X1 OCCUR SIR: 50,000 Doe 1500,00 Agg DAMAGE TO RENTED PREMISES Ea occurrence $ 50,000 X MED EXP (Any one person) $ EXCLUDED CONTRACTUAL LIABILITY PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY 1BA3F9l6390CAGI5 12/12/2015 12/12/2016 . COMBINED SINGLE LIMIT Ea acddentl $ 1,00_0:000 X BODILY INJURY (Per person) _ $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIREDAUTOS HAUTOS C X UMBRELLA LIAR X OCCUR L6012289331(Eccess AUEL) 0713012015 07/30/2016 EACH OCCURRENCE $ 10,000,000 A X EXCESS UAB CLAIMS -MADE D00633411 (Excess GL) 07/30/2015 07/30/2016 AGGREGATE $ 10,000,000 DED RETENTION $ $ B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N/A YVYCE-UB-4F02061-0-15 (ADS) YJ-U&5009X95-9-15 (CA,MT,WI) 12112/2015 1211212015 12/12/2016 1211212016 X PER ETH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I 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. Shirley Murray ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD