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Acord Logo CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
02/07/2024
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: soda@sadlersports.com
PRODUCER CUSTOMER ID#:
INSURED
D/B/A SPORTSPLEX OPERATORS AND DEVELOPERS ASSOCIATION

16 Athletics Inc

2010 Connecticut
Niagara Falls, NY 14305
Club #: C.89203
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: State National Insurance Company 12831
INSURER B: SeriousPoint America Company 38776
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.
INSD
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
OTHER
X   OVE-0000286-00 12:01AM ET 08/30/2023 12:01AM ET 08/30/2024
EACH OCCURRENCE $2,000,000
DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000
MEDICAL EXPENSES (other than participants) $5,000
PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $3,000,000
PRODUCTS-COMP/OP AGG $1,000,000
LEGAL LIAB TO PARTICIPANTS $1,000,000
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
    n/a n/a n/a
COMBINED SINGLE LIMIT (Ea Accident) $1,000,000
BODILY INJURY (Per person)  
BODILY INJURY (Per accident)  
PROPERTY DAMAGE (Per accident)  
A
SEXUAL ABUSE / MOLESTATION
    n/a n/a n/a
EACH OCCURRENCE $1,000,000
AGGREGATE $2,000,000
 
UMBRELLA LIAB   OCCUR
EXCESS LIAB   CLAIMS-MADE
DEDUCTIBLE
RETENTION
    n/a n/a n/a
EACH OCCURRENCE n/a
AGGREGATE n/a
   
  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
PER STATUE

OTHER
 
E.L. EACH ACCIDENT  
E.L. DISEASE - EA EOMPLOYEE  
E.L. DISEASE - POLICY LIMIT  
B PARTICIPANT ACCIDENT     PHSA-BAM-10089-C.89203 12:01AM ET 08/30/2023 12:01AM ET 08/30/2024
EXCESS MEDICAL $100,000
AD&D $10,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

RE: COVERED Team(s) - Youth - Accident & General Liability
Baseball - 14 Team(s) - [Maximum 18 players per team]

Team Names:

  • Baseball Teams: Gronk Nation 7/8u, Gronk Nation 8u hybrid , Gronk Nation 9u, Gronk nation 10u , Gronk Nation 11u Black , Gronk Nation 11u Grey , Gronk Nation 12u , Gronk Nation 13u , Gronk nation 14u Navy, Gronk Nation 14u Grey , Gronk Nation 14u White , Gronk Nation 15u , Gronk Nation 2026 Showcase , Gronk Nation 2025 Showcase

(Accident Package Youth Team: $100,000 Excess Medical; $10,000 Accidental Death or Dismemberment; $250 per claim deductible)
(General Liability Package Youth Team: $2,000,000 Each Occurrence; $1,000,000 Participant Legal Liability Sublimit; $1,000,000 Neurodegenerative Sublimit; Waiver/Release Recommended)

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

3 Amigos LLC
5615 Kies Ave
Niagara Falls , NY 14304
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 (company A)
Company A Signature
AUTHORIZED REPRESENTATIVE (company B)
Company B Signature

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 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD

---

ENDORSEMENT NO. 0000

ATTACHED TO AND FORMING A PART OF POLICY NUMBER ENDORSEMENT EFFECTIVE DATE
(12:01 A.M. STANDARD TIME)
NAMED INSURED AGENT NO.
OVE-0000286-00 08/23/2023 16 Athletics Inc

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSUREDS OWNERS AND/OR LESSORS OF PREMISES, SPONSORS OR CO-PROMOTERS

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART

A. SECTION II—WHO IS AN INSURED is amended to include as an additional insured any per- son(s) or organization(s) of the types indicated by an “x” in any boxes shown below, but only with respect to liability for “bodily injury,” “property damage” or “personal and advertising injury” caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf:

  1. In the performance of your ongoing operations; or
  2. In connection with your premises owned by or rented to you. However:
    1. The insurance afforded to such additional insured only applies to the extent permitted by law; and
    2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to an additional insured owner and/or lessor of premises, this insurance does not apply to:
      1. An “occurrence” or offense which takes place while you are not a tenant in possession of the subject premises.
      2. “Bodily injury” or “property damage” arising out of:
        1. Structural alterations, new construction or demolition operations performed by or on behalf of the owner and/or lessor of premises;
        2. Any design defect or structural maintenance of the premises; or
        3. Any premises defect.

B. With respect to the insurance afforded to these additional insureds, the following is added to SECTION III—LIMITS OF INSURANCE: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

  1. Required by the contract or agreement; or
  2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less.

This endorsement shall not increase the applicable Limits of insurance shown in the declarations.

Schedule of Additional Insureds:

[X] Owners and/or Lessors of the premises leased, rented or loaned to you
[X] Sponsors
[X] Co-Promoters
[ ] Any individual person(s) or organization(s) listed below
COACHES, OFFICIALS AND VOLUNTEERS
WHILE ACTING WITHIN THE SCOPE OF THEIR DUTIES FOR THE INSURED.

KR-GL-56 (7-18)

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