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CERTIFICATE OF L'AB'S IW INSURANCE NSU _ NCE Fr' AT 8118/ DIYYYY) 9{� 9Bo,. 1p�0�9 08/18/2022 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 endorsemertt s . PRODUCER CONTACT Pettineo Insurance NAME: AH1 No Ext : (954) 493-9424 FAX. lc No): 2428 E COMMERCIAL BLVD FT LAUDERDALE, FL 333084040 E-MAIL ADDRESS: frank@pettineo.com INSURERS) AFFORDING COVERAGE NAIC # INSURERA: United States Fire Insurance 21113 INSURED SPORTS AND RECREATION PROVIDERS ASSOCIATION (PURCHASING GROUP) AND ITS PARTICIPATING MEMBERS: INSURER B: INSURER C: Eagle Eye Officiating, LLC. INSURER D: 9160 NW 25th Street Sunrise, FI- 33322 INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER: USP360010 REVISION NIJMRPR! 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. INS LTR TYPE OF INSURANCE ADOL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDNM LIMITS GENERALLIABIUTV EACH OCCURRENCE S1,000,000 �( COMNERCIALGENERALDABILITY FIRE DAMAGE 1Any-e fire) $300,000 MED EXP (Any one person) SO I'LAIMSMaDE nxOCCUR A X SRPGAPML-101-0122 12:00 AM 12:00 AM 08!16/ AM 12:01 AM PERSONAL & ADV INJURY 21,000,000 X INCLUDES ATHLEriCPARTICIPANTS GENERAL AGGREGATE S2.,00D,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP:OP AGG 52,000,1)00 X PRO• POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea aecidenl BODILY INJURY (Per person) ANY AUTO ALLUAINED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident HIRE& AUTO NON-OWNIED AUTOS PROPERTY DAMAGE acciden Per t) UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESSLIAB CIAIMS-MADE AGGREGATE DED RETENTION 5 A Accident/Medical Coverage US1671099MAXIMUM 08/16/2022 12:00 AM 08/16/2023 12:01 AM AD&D $5,000 MEDICAL 510,000 DEDUCTIBLE $0 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach AVORD 101, Additional Remarks Schedule, if more space is required) Covered Activities: Athletic Officials Activities The Certificate Holder is added as an additional insured but only with respect to liability arising out of the named insured during the policy period. Scheduled Activities Exclusion Applies -Please Refer to Named insured Member Certificate of Coverage CERTIFICATE HOLDER CANCELLATION City of Sunny Isles 18070 Collins ave Sunny Islets Beach, FL 33160 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 Pe f -w& . 1 to yt.WQ-vvc� ACORD 26 (1016103) ©1988-2016 ACORD CORPORATION. AI.i rights reserved. rA.., nnr,nn.....,.........e a...«......., ....«t..a..,...a —T.— —4-' it ^nn