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2019/12/15 Sports IT, Inc. Policy Change EndorsementZDR 9808351 07 3002716 Original Insured SPORTS IT INC 12402 SE 38TH STREET #201 BELLEVUE WA 98006 SPORTS IT INC 12402 SE 38TH STREET #201BELLEVUE WA98006SPORTS IT INC 12402 SE 38TH STREET #201 BELLEVUE WA 98006 401-0154 Page 1 Issued 01/22/2020 Original Insured Policy Change # 1 Effective 01/20/2020 This supersedes any previous declarations bearing the same policy number for this policy period Massachusetts Bay Insurance Company (A Stock Company) 440 Lincoln Street, Worcester, MA 01653-0002 Commercial Line Policy Common Declarations AE Policy Number Policy Period From To Coverage is Provided in the: Agency Code ZDR 9808351 07 12/15/2019 12/15/2020 Massachusetts Bay Insurance Company 3002716 Named Insured and Address : Agent : SPORTS IT INC 12402 SE 38TH STREET #201 BELLEVUE WA 98006 MONUMENT SPORTS GROUP MARK OF RICHMOND INC T/A 1365 OVERBROOK RD, SUITE 1 RICHMOND VA 23220 Branch : Richmond Branch Office Policy Period : From 12/15/2019 To 12/15/2020 12:01 A.M. Standard Time at Your Mailing Address Shown Above. Business Description : Office Legal Entity : Corporation In Consideration of the premium, insurance is provided the Name Insured with respect to those premises described in the attached schedule(s) for which a specific limit of insurance is shown. This is subject to all terms of this policy including Common Policy Conditions. Coverage Parts, Forms and Endorsements may be subject to adjustment and/or a policy minimum premium. Commercial Property Coverage $155.00 Commercial General Liability Coverage $965.00 Commercial Inland Marine Coverage Not Covered Commercial Crime Coverage Not Covered Commercial Auto Coverage $240.00 Total Surcharge Premium N/A Additional Premium For Policy Minimum N/A ** Total $1,360.00 Additional/Return Premium for Endorsement :$45.00 **INCLUDES PREMIUM, IF ANY, FOR TERRORISM; REFER TO DISCLOSURE NOTICE Countersigned ____________________________________ By ___________________________________________ Equal Monthly Group Number ZTS 401-0154 Page 2 Issued 01/22/2020 Original Insured SPORTS IT INC ZDR 9808351 07 MONUMENT SPORTS GROUP This supersedes any previous declaration bearing the same policy number for this policy period Endorsement Recap Endorsement Number:1 Effective:01/20/2020 Reason for Endorsement: Multiple Changes 1. Add CG 2010 charge $50 Forms And Endorsement Added / Deleted / Amended Form Number Edition Date Detail Chg Type Value CG 20 10 04/13 General Liability Amended Additional Insured - Owners, Lessees Or Contractors - Scheduled Person or Organization Schedule of Additional Interest Changes Level LOC ValueDetailChg Type GL 1 Type Added Owners Lessees Or Contr CG2010 Name City of Menifee Address 2 29844 Haun Road City Menifee State CA Zip Code 92586 Commercial General Liability Changes LOC Class Code - DESC Coverage Detail Chg Type Value Owners Lessees Or Contr CG2010 Added Premium $50.00 ZDR 9808351 07 3002716 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE POLICY NUMBER: ZDR 9808351 07 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations City of Covina & Its Officials, Agents, Employees and Volunteers 1250 N Hollenbeck Ave, Covina, CA 91722 City of Menifee 01 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1.Your acts or omissions; or 2.The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 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. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1.All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2.That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. ZDR 9808351 07 3002716 Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 C.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.