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ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />ACORD™CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <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 have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />K&K INSURANCE GROUP, INC. <br />1712 MAGNAVOX WAY <br />PO BOX 2338 <br />FORT WAYNE IN 46801 <br />CONTACT NAME:Nick Davey <br />PHONE(A/C, No. Ext):800-736-7358 FAX(A/C, No):847-953-2873 <br />E-MAILADDRESS:Nick.Davey@kandkinsurance.com <br />INSURED INSURER(S) AFFORDING COVERAGE NAIC # <br />MEMBER NO:INSURER A: New Hampshire Insurance Company <br />INSURER B: National Union Fire Ins Co of Pittsburgh <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: <br />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. <br />INSRLTR TYPE OF INSURANCE ADDLINSD SUBRWVD POLICY NUMBER POLICY EFF (MM/DD/YYYY)POLICY EXP (MM/DD/YYYY)LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />Y AIL0003450194700 12:01 AM <br />02/01/202312:01 AM <br />EACH OCCURRENCE $2,000,000 <br />CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence)$ 300,000 <br />MED EXP (Any one person)$ 5,000 <br />PERSONAL & ADV INJURY $2,000,000 <br />GEN’L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $5,000,000 <br />POLICY PROJECT LOC PRODUCTS-COMP/OP AGG $2,000,000 <br />OTHER: PARTICIPANT LEGAL LIABILITY $2,000,000 <br />A <br />AUTOMOBILE LIABILITY <br />AIL0003450194700 <br />12:01 AM <br />02/01/202312:01 AM <br />COMBINED SINGLE LIMIT(Ea Accident)$1,000,000 <br />ANY AUTO BODILY INJURY (Per person) <br />OWNEDAUTOSONLY SCHEDULEDAUTOS BODILY INJURY (Per accident) <br />X HIREDAUTOS ONLY X NON-OWNEDAUTOSONLY PROPERTY DAMAGE(Per accident) <br />UMBRELLA LIAB #Ää ÄãÄè Äí Ãà ÃáÃà Ãà êÀàÀ àÀàÀ êÀàÀ àÁà ÅèÈà ÀàÂë ÀàÀ àÀàÀ àÀàÁ âÀà æÀàÄä ÄãÄè Äí Ãà ÃáÃà Ãà êÀàÀ àÀàÀ àÀàÀ àÀà ÀàÀï À è <br />OCCUR EACH OCCURRENCE <br />EXCESS LIAB #Ää ÄãÄè Äí Ãà ÃáÃà Ãà êÀàÀ àÀàÀ êÀàÀ àÁà ÅèÈà ÀàÂë ÀàÀ àÀàÀ àÀàÁ âÀà æÀàÄä ÄãÄè Äí Ãà ÃáÃà Ãà êÀàÀ àÀàÀ àÀàÀ àÀà ÀàÀï À è <br />CLAIMS-MADE AGGREGATE <br />DED RETENTION <br />WORKERS COMPENSATIONAND EMPLOYERS’ LIABILITYANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED?(Mandatory in NH)If yes, describe underDESCRIPTION OF OPERATIONS below <br />Y / N <br />N / A <br />PERSTATUTE OTHER <br />E.L. EACH ACCIDENT <br />E.L. DISEASE –EA EMPLOYEE <br />E.L. DISEASE –POLICY LIMIT <br />B PARTICIPANT ACCIDENT AIB0003450195100 12:01 AM <br />02/01/2023 <br />12:01 AM Excess Medical $250,000 <br />AD&D $15,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, BUT SOLELY WITH RESPECT TO THE OPERATIONS OF THE NAMED INSURED. <br />SEXUAL ABUSE/MOLESTATION: $1,000,000 PER OCCURRENCE/$2,000,000 AGGREGATE <br />CERTIFICATE HOLDER CANCELLATION <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 />23841 <br />19445 <br />1/21/2022 <br />HILLSBOROUGH YOUTH A.A. BABE RUTH LG <br />DBA: Hillsborough Youth Athletics Association Inc. <br />7607 Vista Lane <br />Hillsborough, NC, 27278 <br />02/01/2022 <br />02/01/2022 <br />02/01/2022 <br />Owner, manager or lessor of the premises where you conduct practices or games <br />Orange County Government <br />PO Box 8181 <br />Hillsborough,NC 27278 <br />DocuSign Envelope ID: 5DFF29A6-C11C-418F-A55E-44A9EEE163A4