8935 S. Pecos Road, Suite 22B, Henderson, NV 89074
PHONE: 1-866-998-3864 FAX: 702-387-9732
INSURANCE BINDER COMMERCIAL GENERAL LIABILITY/PARTICIPANT ACCIDENT
Basic Information
Named Insured: Southern California Motorcycle Riding Association
Mailing Address: PO Box 487
Norwalk
CA
90651
Policy Period: January 1, 2012 to January 1, 2013
Policy No.: SE-CGL-TBA
Liability Limits and Deductibles
| Liability Limits: $ 1,000,000 Each Occurrence, Bodily Injury and Property Damage Liability $ 1,000,000 Personal Injury and Advertising Injury Liability $ 100,000 Fire Legal Liability – each location, occupied, leased or rented by insured $ NIL Medical Payments – each person $ 2,000,000 General Aggregate Per Event |
Operations: Annual operations for Motorcycle Assn including meetings, promotional activities and 12 ride events
.
| Coverage Details Property Damage on an Occurrence Basis Broad Form Property Damage Blanket Contractual Liability Personal Injury Liability Employees as Additional Insureds Incidental Medical Malpractice Intentional Injury in Defense of Property Independent Contractors Host Liquor Liability Cross Liability, Severability of Interest Injury to Participants (Participant legal liability) Any person or organization engaged in operating, managing, sanctioning, or sponsoring the covered program or providing the premise for a covered program including officials of the covered program are included as additional insured Any participant, competition vehicle owner and competition vehicle sponsor are included as additional insured Volunteers are included as additional insured Coverage Details Medical professionals added as additional insured, subject to $300,000 limit of liability per occurrence/per aggregate Errors and Omissions, event only, subject to $50,000 limit of liability per occurrence/per aggregate $2,500 deductible Participant property damage legal expenses, subject to a limit of liability of $100,000 per occurrence/per aggregate, $2,500 deductible. |
Exclusions
| Events or activities not scheduled or not usual to your business Fireworks and concerts Amusement devices (mechanically operated) Intended or expected injury to others Any obligation of the insured for a workers compensation, disability benefits or unemployment compensation law or similar law Bodily injury to an employee of the insured arising out of and in the course of employment of the insured Employment related practices, sexual harassment and discrimination Bodily injury to any person in a restricted area from whom you have not obtained a valid waiver and release and waiver unless by inadvertent error Bodily injury or property damage arising out of the ownership, use or operation by or on behalf of the insured of any automobile other than competition vehicles or official vehicles during a covered program while on the premises Watercraft, Aircraft, Air cushion vehicles Property damage to property you own, property you sell or give away, property in your care, custody and control Property damage to property owned, leased to, rented to or used by any participant or employee when in the restricted area Limited pollution Nuclear liability, war and terrorism Asbestos Mold, bacteria and/or fungi |
Participant $ 10,000 Accidental Death and Dismemberment
Accident:
Master Policy $ 10,000 Excess Medical
Deductible $ 2,500 Excess Medical Deductible
| Coverage Details Benefits paid when a participant suffers a loss or injury as a direct result of a covered accident. Loss must be within 365 days of accident Excess Medical-first expense incurred within 60 days after the covered accident Excess Medical Expense-incurred up to 156 weeks (or coverage limit) Air Ambulance is NOT included Claims must be reported within 60 days of date of loss Proof of loss must be submitted within 90 days of date of loss. |
The coverage above as presented is only a summary and is subject to the detailed terms, provisions and conditions of the policy to which it pertains.
| Insurer Premium Signature Liability/Participant Accident First Mercury Corporation/Lloyds See below Authorized Representative Binding in effect until the delivery of the respective policy at the office of JB Motorsports. January 5, 2012 PREMIUM SUMMARY Premium Summary Liability $ 2,150.00 Participant Accident $ 150.00 First Mercury Policy fee/Member Fee $ 150.00 Liability Surplus lines tax $ 67.50 Liability Stamping Fee $ 5.63 Participant Accident Surplus lines tax $ 0.38 Participant Accident Stamping Fee $ 4.50 Payment Due at Inception $ 2,528.01 Minimum and Retained: $1,000.00 Date: January 5, 2012 Per, Kevin Besta, CIP Managing Partner Motorsport |
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