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Client#: 19406 USPROFES <br />TE I m DDIYYYY) <br />I <br />ACORD,. CERTIFICATE OF LIABILITY INSURANCE , =21m, 2 0 16 <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 INSURERI AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(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 andorsement(s). <br />PRODUCER NAONTACT <br />ME' Edgewood Partners Insurance Center PHONE FAX <br />Ext): (AIC, No): <br />27 School Street, Suite 404 E <br />Boston. MA 02108 <br />INSURED, <br />United States Professional <br />Tennis Association Inc <br />3535 Briarpark Drive, Suite 202 <br />Houston, TX 77013 <br />INSURER(S) AFFORDING COVERAGE NAC # <br />INSURERA . Phill "dip'hia-lindemnity Ins Comp 118058 <br />INSURER B: <br />INSURER ­.C: - - --- ---- - -------- <br />INSURER 0: <br />INSURER <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS <br />IS TO CERTIFY THAT THE POLICIES <br />OF <br />INSURANCE <br />LISTED BELOW HAVE BEEN <br />ISSUED TO THE INSURED <br />NAMED ABOVE FOR THE <br />POLICY PERIOD <br />INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, <br />TERM OR CONDITION OF ANY <br />CONTRACT OR OTHER DOCUMENT <br />WITH RESPECT <br />TO WHICH THIS <br />CERTIFICATE <br />MAY BE ISSUED OR MAY PERTAIN, <br />THE INSURANCE AFFORDED BY THE <br />POLICIES DESCRIBED <br />HEREIN IS SUBJECT TO <br />ALL THE TERMS, <br />EXCLUSIONS <br />AND CONDITIONS OF SUCH <br />POLICIES. <br />LIMITS SHOWN MAY HAVE BEEN <br />REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDILtUBR <br />INSR <br />WVD <br />POLICY NUMBER <br />POLICYIEFF POLicYtX0 <br />LDIYYYYJ <br />�IMLQ­ _JMMIC <br />LIMITS <br />A <br />GENERAL LIABILITY <br />PHPK1417813 <br />12131/2015 1213112010EAcHcccURRENCE <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE Fx1OCCUR <br />PREMISES TQ 11FI ES (Ea occurrencpi <br />5100000 <br />M .. E - D - EXP (Any one person) <br />S <br />PERSONAL& ADV INJURY <br />­­ ..... . .... <br />GENERAL AGGREGATE <br />S1,000,000 <br />s2,000,,000 <br />PRODUCTS - COMPICIP AGG <br />S1,000,000 <br />GENL AGGREGATE LIMIT APPLIES PER <br />V� POLICY F PI LOC <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />\,Jw <br />(Ea aI <br />S <br />S <br />BODILY INJURY QPar person) <br />S <br />ALL CANNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) <br />S <br />I NON -OWNED <br />JI HIREDAUTOS AUTOS <br />PROPERTY-15AWAGE <br />_(Per arxidenn <br />A <br />. . . .... ....... <br />XI MEIRELLA LIAS <br />U 7, OCCUR <br />PHUBS21030 <br />1213112015 12/3112016 <br />EACH OCCURRENCE <br />S5,000,000 <br />EXCESS LAB CLAIMSMADE <br />AGGREGATE <br />$5,000,000 <br />DED RETENTION S <br />$ <br />WORKERS COMPENSATION- <br />WC STATIJ-�CTH- <br />AND EMPLOYERS' LIABILITY YIN <br />ANY I ETORIPARTNERiEXECUTIVE ­--� <br />OFFICER/MEMBER EXCLUDED? ❑NIA <br />—.T.1.QFY,.UMJI . I <br />E L. EACH ACCIDENT <br />$ <br />. ........ — <br />E.L. DISEASE - EA EMPLOYEE <br />I $ <br />(Mandatory in I <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS low be <br />. . .......... . ..... . <br />E L. DISEASE - POLICY LIMIT <br />1$ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />USPTA Members are insured for General Liability for playing, teaching or officiating in tennis, pickleball <br />and platform tennis or operating a tennis ball machine for practicing or teaching. <br />Arlene Ruffin #54144 City of Santa Ana, its officers, employees, agents, volunteers, and representatives <br />with respects to claims arising out of the operations and uses performed by or on behalf of the named <br />insured, such insurance as is afforded by this policy is primary and is not additional to or contributing <br />with any other insurance carried by or for the benefit of the additional insureds. <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <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 />@ 1988-20110 ACORD CORPORATION. All rights reserved.. <br />ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD <br />#S4421321M421902 CMAR2 <br />