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UNITED STATES SOCCER FOUNDATION, INC.
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UNITED STATES SOCCER FOUNDATION, INC.
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Last modified
10/5/2021 2:42:04 PM
Creation date
7/13/2021 4:42:22 PM
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Contracts
Company Name
UNITED STATES SOCCER FOUNDATION, INC.
Contract #
A-2021-108
Agency
Parks, Recreation, & Community Services
Council Approval Date
7/6/2021
Expiration Date
7/6/2026
Insurance Exp Date
7/1/2022
Destruction Year
2028
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One Tower Square, Hartford- Connecticut 0,6183 <br />POLICY DECLARATIONS <br />EXCESS FOLLOW! -FORM AND UMBRELLA POLICY NO.: =-3S63336D-21-NF <br />LIABILITY INSURANCE POLICY ISSUE DATE: 07/16/2021 <br />I NSUR I N G COM PANT: 7 RAVE LER S PROPERTY CASUALTY COMPANY OF AMER ICA <br />1, NAMED INSURED AND MAILING ADDRESS: MUSCO CORPORATION <br />100 1ST AVE91JE WEST <br />OSKALOOSA :IA 52537 <br />i 2, POLICY PERIOD: F•, rl ^,'C1:'2321 to 07J01/202.212:01 A.M. Standard Time at your mailing address_ <br />3, LIMITS OF INSURANCE; <br />C OV ERA G ES <br />LIMITS OF LIABILITY <br />AGGREGATE LIMITS OF LIABILITY $10, 000, 000 GeneralAggregate <br />EXCESS FOLLOW- PORM AND <br />UMBRELLA LIABILITY <br />CRISIS MANAGEMENT SERVICE <br />EXPENSES <br />4, SELF -INSURED RETENTION; <br />5, PREMIUM: $ 154, 515 <br />6, TAXES AND SURCHARGES: <br />10, 000, 000 Products -Completed 0perat io'ns Aggregate <br />;10, 000, 000 Occurrence Limit <br />$1041 G00 all Crisis ManagementE-rents <br />; 10, 000 any one occurrence or event <br />x Flat Charge Adjustable (See Premium Schedule) <br />7, On die effecliye date shown in Item i., the Excess Follorv�-Forrn And Umbrella Liability Insurance Policy <br />n-mbered above includes this Declarations Page and any forms and endorsements shown on the Listing Of <br />Forms, Endorsements And Schedule Numbers. <br />a, f the Schedule Of Underlying Insurance includes any coverage provided on a claims -made basis, then the <br />crtia; ng d sclaimer applies. <br />COVERAGE WILL APPLY ON A CLAIMS -MADE BASIS WHEN <br />FOLLOWING CLAIMS -MADE UNDERLYING INSURANCE. <br />9. If the Schedule Of Underfying Insurance ncludes any coverage which includes, defense expenses with°n the <br />I mits of liabilirty- then the follov,ing disclaimer applies: <br />DEFENSE EXPENSES ARE PAYABLE WITHIN, AND ARE NOT IN <br />ADDITION TO, THE LIMITS OF INSURANCE WITH RESPECT TO SOME <br />R ALL OF THE COVERAGES PROVIDED. <br />NAME AND ADDRESS OF AGENT OR BROKER: <br />AON RISK SERV L'HTRAL-NEB - CF260 <br />17807 3URRE ST STE 401 <br />O[{ kL? NE 613118 <br />COUNTERSIGNED BY: <br />Authorized Representative <br />DATE: <br />OFFICE, SP-ST 9AUL <br />Risk ManagementDiviaian <br />} % z REVIEWED & APPROVED BY: <br />EU 00 02 09 20 : _ . g The Travek-n Indemnity Company. ,4. rights •eser: ed. �. p+aye R. V; ad <br />Risk Management Analyst <br />
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