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OP ID: AY <br />ACORO « <br />?? CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/`/YYY) <br /> 03/04/11 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsements . <br />PRODUCER 800-526-1379 CONTACT <br />NAME: <br />Bollingger, Inc. 973-921-2876 <br />101 JFK Parkway <br />PHONE aC No : <br />Short Hills, NJ 07078-5000 <br />AJ M -MAIL <br />organ PRODUCER <br />. USABA-2 <br /> INSURERS AFFORDING COVERAGE NAIL K <br />INSURED USA Badminton INSURERA:Markel Insurance Com an 38970 <br />$a its member clubs INSURER B <br />One Olympic Plaza <br /> INSURERC: <br />Colorado Springs, CO 80909 <br /> INSURER D <br />r? ? <br />•? ?M ? ? O ? Jr-?OO? INSURER E <br />V?? VV CJ INSURER F <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE ADDL SUER <br />POLICY NUMBER POLICY EFF <br />MM/DD POLI Y EXP <br />MM/DD <br />LIMITS <br /> GENERAL LV\BILITY EACH OCCURRENCE $ 1,000,000 <br />A X COMMERCIAL GENERAL LIABILITY X 8502AH0245D4 03/01/11 03/01/12 PREMISES Ea occurrence $ 100.000 <br /> <br /> CLAIMS-MADE ? OCCUR MED EXP (Any one person) $ 5,00 <br /> J( Intl Participants PERSONALBADV INJURY $ 1,000,000 <br /> J( Intl Drug Testing GENERAL AGGREGATE $ 5.000.00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 1.000,000 <br /> POLICY PRO X LOC Abuse/Mol $ lmil/2mi1 <br /> AUT OMOBILE LUIBILITY COMBINED SINGLE LIMIT $ <br /> (Ee eccitlent) <br /> ANV AUTO <br />BODILY INJURY (Per person) <br />$ <br /> ALL OWNED AUTOS BODILY INJURY (Per accitlent) $ <br /> SCHEDULED AUTOS <br />DAMAGE <br />O <br />R <br /> HIRED AUTOS G nt <br />Pe <br />r a¢ $ <br /> NON-OWNED AUTOS $ <br /> <br /> UMBRELLA LIAR )( OCCUR EACH OCCURRENCE $ 1,000.000 <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000 <br />A 4602A H024505 03/01 /11 03/01 /12 <br /> DEDUCTIBLE $ <br /> RETENTION $ <br /> WORKERS COMPENSATON <br />AND EMPLOYERS' LIABILITY T?T? / \ a ? s? c <br />J <br />?PS y?V V • ?,j, ? ??1 r-/? <br />V 1' V ? n <br />1v1 WC STATU- OTH- <br /> Y/ N . <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br />? <br />N /A <br />) <br />E.L. EACH ACCIpENT <br />$ <br /> OFFICER/MEMBER EXCLU DED9 / <br /> (Mantla[ory In NN) - E.L. DISEASE - EA EMPLOYEE $ <br /> IT yes, tlescriba untler <br /> DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ <br /> Laura Slit S' erdy <br /> Assistant C=ity ttorncy <br />DESCRIPTON OF OPERATONS /LOCATIONS /VEHICLES (AHach ACORD LOS, Adtlltlonel Remanca SebaCUle, If more space is requiretl) <br />The certificate holder is named as an additional insured under the liability <br />policy. Coverage is provided under this policy for sponsored/supervised <br />actlVltles of the named insured. This certificate is issued on behalf of <br />the USNBF Club. <br />CERTIFICATE HOLDER CANCELLATION <br />SALGCAI <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Salgado Community Center THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />706 NOrth NBWhope Street ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana <br />CA 92703 <br />, AUTHORIZED REAP, R/EjS?yEfN?T?/A//TI?V?E <br />?/ <br />© 1988-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD