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Home My WebLink About114337 BSN SPORTS INC - INSURANCE CERTIFICATE (3)i 1 ® ACORC! CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 07/31/2018 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 have ADDITIONAL INSURED provisions or 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. SALESFORCE TOWER CONTACT NAME: PHONE I FAX c No : AC. E-MAIL ADDRESS: 111 MONUMENT CIRCLE, SUITE 4300 INDIANAPOLIS, IN 46204-2492 INSURER S AFFORDING COVERAGE NAIC # INSURER A: James River Insurance Company 12203 CN101923697-BSN-GAWX-18-19 INSURED BSN Sports, LLC dba: Tomark Sports, Kesslers Team Sports, Dixie Sporting Goods, INSURER B : Travelers Indemnity Co Of CT 25682 INSURER C : N/A N/A INSURER D : Travelers Indemnity Company 25658 The Athletic Connection, Passon's Sports and U.S. Games 14460 Varsity Brands Way Farmers Branch, TX 75244 INSURER E : Travelers Property Casual Company of America 25674 INSURER F : COVFRAGFS CERTIFICATE NUMBER: CHI-008147246-16 REVISION NUMBER: 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 LTRIAN= TYPE OF INSURANCE ADOL SUER POLICY NUMBER MM DID/YYYY ICY EXP MMEFF LDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 000678244 07/30/2018 07/30/2019 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR SIR: 50,000 OccJ500,000 Agg DAMAGE TO PREMISES Ea occurrence) $ 50,000 X MED EXP (Any one person) $ CONTRACTUAL LIABILITY PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X PRO ❑ LOC POLICY ❑ JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER B AUTOMOBILE LIABIUTY 810-3D667574-TCT-18 07/30/2018 07/30/2019 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY X UMBRELLA UAB X OCCUR ZUP41 M9907718NF (Excess ALIEL) 07/30/2018 07/3012019 EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE SIR: $10,000 A 000633414 (Excess GL) 07/30/2018 07/30/2019 DED RETENTION $ $ D E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? N (Mandatoryin NH) NIA YVYCK-UB-501OX159-18(ADS) YJ UB 4H707138-18 (CA) 07130I2018 07/30/2019 07/30f2019 is- X STATUTE EORH 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 / 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. CFRTIFICATF HOI DF_R CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 215 N. Mason St., 2nd Floor THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee jlr( p��ppr, L J*0...1t�..+w• ct 9)1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD