Orange County NC Website
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 />INSURER(S) AFFORDING COVERAGE <br />INSURER F : <br />INSURER E : <br />INSURER D : <br />INSURER C : <br />INSURER B : <br />INSURER A : <br />NAIC # <br />NAME:CONTACT <br />(A/C, No):FAX <br />E-MAILADDRESS: <br />PRODUCER <br />(A/C, No, Ext):PHONE <br />INSURED <br />REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES <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 />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 />OTHER: <br />(Per accident) <br />(Ea accident) <br />$ <br />$ <br />N / A <br />SUBR <br />WVD <br />ADDL <br />INSD <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 />$ <br />$ <br />$ <br />$PROPERTY DAMAGE <br />BODILY INJURY (Per accident) <br />BODILY INJURY (Per person) <br />COMBINED SINGLE LIMIT <br />AUTOS ONLY <br />AUTOSAUTOS ONLY NON-OWNED <br />SCHEDULEDOWNED <br />ANY AUTO <br />AUTOMOBILE LIABILITY <br />Y / N <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />DESCRIPTION OF OPERATIONS below <br />If yes, describe under <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />$ <br />$ <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. EACH ACCIDENT <br />EROTH-STATUTEPER <br />LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />EXCESS LIAB <br />UMBRELLA LIAB $EACH OCCURRENCE <br />$AGGREGATE <br />$ <br />OCCUR <br />CLAIMS-MADE <br />DED RETENTION $ <br />$PRODUCTS - COMP/OP AGG <br />$GENERAL AGGREGATE <br />$PERSONAL & ADV INJURY <br />$MED EXP (Any one person) <br />$EACH OCCURRENCE <br />DAMAGE TO RENTED $PREMISES (Ea occurrence) <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-MADE OCCUR <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO-JECT LOC <br />CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <br />CANCELLATION <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2016/03) <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />CERTIFICATE HOLDER <br />The ACORD name and logo are registered marks of ACORD <br />HIRED <br />AUTOS ONLY <br />11/15/2022 <br />Arthur J.Gallagher Risk Management Services,Inc. <br />201 E.4th Street,Ste 625 <br />Cincinnati OH 45202 <br />Susan D.Masters,CIC <br />513-977-3139 513-977-4641 <br />susan_masters-oh@ajg.com <br />Continental Insurance Company 35289 <br />CLUBLLC-01 Continental Casualty Company 20443ClubessentialHoldings,LLC <br />and all of its subsidiaries <br />4600 McAuley Place Ste 350 <br />Cincinnati OH 45242-4765 <br />Valley Forge Insurance Company 20508 <br />Crum &Forster Specialty Insurance Co 44520 <br />Indian Harbor Insurance Company 36940 <br />American Casualty Company of Reading,PA 20427 <br />541684075 <br />C X 1,000,000 <br />X 100,000 <br />5,000 <br />1,000,000 <br />2,000,000 <br />X X X <br />N N 6079684571 11/15/2022 11/15/2023 <br />2,000,000 <br />C 1,000,000 <br />X X <br />X Hired PhyDam <br />N N 6079684568 11/15/2022 11/15/2023 <br />Hired PhyDam 75,000 <br />A X X 2,000,000N607968460411/15/2022N 11/15/2023 <br />2,000,000 <br />X 10,000 <br />F <br />A XY6079684599 <br />WC679684585 <br />11/15/2022 <br />11/15/2022 <br />11/15/2023 <br />11/15/2023 1,000,000 <br />1,000,000 <br />1,000,000 <br />D <br />B <br />E <br />Prof/Cyber-CM <br />Crime-3rd Party <br />Excess Prof/Cyber-CM <br />TCM102448 <br />652175238 <br />MTE9044869 <br />3/23/2022 <br />11/15/2022 <br />3/23/2022 <br />3/23/2023 <br />11/15/2023 <br />3/23/2023 <br />Ea Claim/Agg <br />Ea Claim <br />Ea Claim <br />$5,000,000 <br />$1,000,000 <br />$5,000,000 <br />Complete Named Insured:Clubessential Holdings,LLC;Clubessential,LLC;ClubReady,LLC;LEGP II Blocker (CR),Inc.;iKizmet,Inc;GymHQ,LLC; <br />ClubReady Canada Software,ULC;RecTrac,LLC dba Vermont Systems;PrestoSports,LLC;Immersion Media,Inc dba ScoreShots;SuperFanU,Inc;RW2 <br />Marketing &Design,Inc dba 1-2-1 Marketing;GolfCompete,Inc dba ForeUP;Exerp Buy Co.;Exerp America Inc.;BlueGolf,LLC <br />OH Employers Defense Liability(Stop Gap):Policy#6079684571 11/15/2022-11/15/2023 $1,000,000/$1,000,000/$1,000,000 <br />CGL:CNA74872XX(01/15)CNA Technology Broadening Endorsement provides: <br />-Additional Insured by Contract,Agreement or Permit when required in a written contract with you; <br />See Attached... <br />Orange County Attn:Risk Management <br />200 South Cameron Street <br />PO Box 8181 <br />Hillsborough NC 27278 <br />USA <br />DocuSign Envelope ID: 028D978E-DF71-4D79-863D-8360D7144DD8