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ACC)iI <br />1`. - CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 <br />DATE (MMIDDM/YY) <br />11/06/2013 <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 endorsement(s). <br />PRODUCER <br />CONTACT <br />Willis Insurance Services of Georgia, Inc. <br />C/o 26 Century Blvd. <br />P.O. Box 305191 <br />Nashville, IN 37230 -5191 <br />PHONE FAX <br />No Fxi) 877 - 945 -7378 888- 467 -2376 <br />E -MAIL <br />CertifiCatesQwilliB. COm <br />INSURERS)AFFORDING COVERAGE <br />NAIL# <br />INSURERA: Philadelphia Insurance companies <br />18058 -900 <br />PHPK948137 <br />INSURED <br />enited States Professional Tennis Association, Inc. <br />INSURERS: ACE American Insurance Company <br />22667 -008 <br />INSURERC: <br />DAMAGETORENTED <br />PREMISES Ea occurence <br />3535 Briarpark Drive <br />Suite One <br />Houston, TX 77042 <br />INSURERD: <br />COMMERCIAL GENERAL LIABILITY <br />INSURER E' <br />INSURER F'. <br />COVERAGES CERTIFICATE NUMBER: 20692140 REVISION NUMBER:See Rem. rks <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 />IITR <br />TYPE OF INSURANCE <br />RR <br />SUB <br />POLICYNUM85R <br />POLICY EFF <br />POLICY EXP <br />LIMITS <br />A <br />GENERAL <br />LIABILITY <br />Y <br />PHPK948137 <br />12/31/201212/31 <br />/201 <br />EACHOCCURRENCE <br />$ 11000,000 <br />DAMAGETORENTED <br />PREMISES Ea occurence <br />$ 500,000 <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS- MADErx]OCCUR <br />MED EXP(Anyone perscn ) <br />$ <br />&ADVINJURY <br />$ 11000,000 <br />Athletic Participant <br />�yL <br />n b p,0 y fs <br />��, +'�(� <br />JCA� p ,,,..PERSONAL <br />CAI <br />""`p <br />ENERALAGGREGATE <br />$ 21000,000 <br />GEN'LAGGREGATE LI MIT APPLIES PE R. <br />PRODUCTS - COMPIOPAGG <br />$ 11000,000 <br />d'+ <br />- <br />.�— <br />X POLICY PRO- LOC <br />m "��� <br />m <br />AUTOMOBILE LIABILITY <br />I iatt <br />1IIBy <br />COMBINED SINGLE LIMIT. <br />(Eaaccido, <br />$ <br />BODILY INJURV(Per perscn) <br />$ <br />ANY AUTO <br />AU OWNED SCHEDULED <br />AUTOS AUT <br />ASSISI <br />rIt Cl�, <br />' / <br />BODILY INJURVPereccidenl <br />( ) <br />$ <br />IS <br />HIRED AUTOS AUTOWNED <br />AUTOS <br />PROPdd.nt) MAGE <br />(Par eccltlen0 <br />$ <br />$ <br />4/// <br />A <br />UMBRELLALIAB <br />X <br />OCCUR <br />PHUB403104 <br />12/31/2012 <br />12/31/201 <br />EACHOCCURRENCE <br />$ 3,000,000 <br />L <br />AGGREGATE <br />5 3,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I X RETENTION$ 10,00C <br />5 <br />WORKERS COMPENSATION <br />OTH- <br />ANDEMPLOYERS'LIABILITV YIN <br />ANY PRCPRIETORIPARTNERIEXECUTIVE❑ <br />NIA <br />E.L. EACH ACCIDENT <br />$ <br />OFFICERIMEMBER EXCLUDED? <br />fyMandatary in NH) <br />es, tlescribe under <br />E. L. DISEASE - EA EMPLOYEE <br />$ <br />EL DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTIONOFOPERATIONSbs.. <br />B <br />XCQ 625833442 <br />12/31 201212/31/201 <br />Excess Liability <br />$5,000,000 Limit <br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required) <br />THIS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE DATED: 5/28/2013 WITH ID: 19874505 <br />Elson De Cantuaria 53128 <br />USPTA Members are Insureds for General Liability for playing, teaching or officiating in tennis or <br />operating a tennis ball machine for practicing or teaching. <br />CERTIFICATE HOLDER CANCELLATION <br />Coll:4259598 Tpl:1596672 Cert:20692140 © 1988 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010 /05) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />City of Santa Ana <br />20 Civic Center Plaza, PO Box 1988 <br />Santa Ana, CA 92702 <br />Coll:4259598 Tpl:1596672 Cert:20692140 © 1988 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010 /05) The ACORD name and logo are registered marks of ACORD <br />