Certificate Of Insurance

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)
11/20/2013

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 endorsement(s).

PRODUCER SADLER & COMPANY, INC. P.O. BOX 5866 COLUMBIA, SOUTH CAROLINA 29250-5866
	CONTACT NAME: Sports Dept
	PHONE (A/C, No. Ext): 800-622-7370 \| FAX (A/C, No): 803-256-4017
	E-MAIL ADDRESS: amateur@sadlersports.com
	PRODUCER CUSTOMER ID#:

INSURED Tri-State Home School Athletic Association 6589 W Pagosa Place Fayetteville, AR 72704 Application ID: 86255 A Member of the Sports, Leisure & Entertainment RPG
	INSURER(S) AFFORDING COVERAGE	NAIC #
	INSURER A: NATIONWIDE MUTUAL INSURANCE COMPANY
	INSURER B:
	INSURER C:
	INSURER D:

COVERAGES

CERTIFICATE NUMBER

REVISION NUMBER

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.

INSR LTR	TYPE OF INSURANCE	ADDL INSR	SUBR WVD	POLICY NUMBER	POLICY EFF (MM/DD/YYYY)	POLICY EXP (MM/DD/YYYY)	LIMITS
A	GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR ____________________ ____________________ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC	X		RPG53816	11:03PM ET 07/15/2013	12:01AM ET 07/15/2014
							EACH OCCURRENCE	$2,000,000
							DAMAGE TO PREMISES RENTED TO YOU (Fire Legal Liability)	$300,000
							MEDICAL EXPENSES (other than participants)	$5,000
							PERSONAL & ADV INJURY	$2,000,000
							GENERAL AGGREGATE (other than Products-completed Operations)	$5,000,000
							PRODUCTS-COMP/OP AGG	$2,000,000
							LEGAL LIAB TO PARTICIPANTS	$1,000,000

	AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS
							COMBINED SINGLE LIMIT (Ea Accident)
							BODILY INJURY (Per person)
							BODILY INJURY (Per accident)
							PROPERTY DAMAGE (Per accident)

	UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DEDUCTIBLE RETENTION
							EACH OCCURRENCE
							AGGREGATE


	WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below			N/A
							WC STATUTORY LIMITS OTHER
							E.L. EACH ACCIDENT
							E.L. DISEASE - EA EOMPLOYEE
							E.L. DISEASE - POLICY LIMIT
A	PARTICIPANT ACCIDENT			RPG53816	11:03PM ET 07/15/2013	12:01AM ET 07/15/2014
							EXCESS MEDICAL	$250,000
							AD&D	NONE
							DEDUCTIBLE	$100

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)

RE: COVERED SPORTS Basketball 12 & Under, Basketball 13-15, Basketball 16-19,

NOTE: The Participant Accident policy, if included above, is not a part of the ERS Risk Purchasing Group Association, Inc.

Abuse, Molestation, Harassment or Sexual Conduct Defense Cost Reimbursement - $100,000

The certificate holder is added as an additional insured, but only with respect to the liability arising out of the operations of the insured above.

CERTIFICATE HOLDER

CANCELLATION

RELATIONSHIP: Property Owner/Lessor John Brown University 2000 West University Siloam Springs, AR 72761	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

Coverage is only extended to U.S. events and activities
** NOTICE TO TEXAS INSUREDS: The Insurer for the purchasing group may not be subject to all the insurance laws and regulations of the State of Texas.

ACORD 25 (2009/09)

The ACORD name and logo are registered marks of ACORD