CERTIFICATE OF INSURANCE THIS IS TO CERTIFY THAT POLICIES OF INSURANCE AS HEREIN DESCRIBED HAVE BEEN ISSUED TO THE INSURED NAMED BELOW AND ARE IN FORCE AT THE DATE HEREOF. THIS CERTIFICATE IS ISSUED AT THE REQUEST OF: SEE ATTACHED NAME OF INSURED KARATE BC & MEMBER CLUBS LOCATIONS AND OPERATIONS TO WHICH THIS CERTIFICATE APPLIES BRITISH COLUMBIA ABOVE ARE ADDED AS ADDITIONAL INSURED, BUT SOLELY WITH RESPECT TO THE LIABILITY WHICH ARISES OUT OF THE ACTIVITIES OF THE NAMED INSURED. SANCTIONED KARATE ACTIVITIES TO WHOM NOTICE WILL BE MAILED IF SUCH INSURANCE IS CANCELLED OR IS CHANGED IN SUCH A MANNER AS TO AFFECT THIS CERTIFICATE TERM: AUGUST 1, 2016 TO OCTOBER 1, 2017 KIND OF POLICY POLICY NO. INSURERS LIMIT OF LIABILITY GENERAL LIABILITY AL1288 CERTAIN UNDERWRITERS AT LLOYDS AS ARRANGED BY ALL SPORT INSURANCE MARKETING LTD. $ 5,000,000.00 LIMIT Per occurrence and in the aggregate with respect to products & completed operations DEDUCTIBLE $ 500.00 POLICY EXTENSIONS: CROSS LIABILITY CLAUSE INCLUDED PARTICIPANT COVERAGE INCLUDED SUBJECT TO 30 DAYS WRITTEN NOTICE OF CANCELLATION THE INSURANCE AFFORDED IS SUBJECT TO THE TERMS, CONDITIONS, AND EXCLUSIONS OF THE APPLICABLE POLICY. SBC INSURANCE AGENCIES LTD. AUTHORIZED REPRESENTATIVE 250 999 Canada Place, Vancouver, BC, V6C 3C1 Tel (604)737-3018 April 24, 2017
THIS CERTIFICATE IS ISSUED AT THE REQUEST OF: City of Abbotsford, School District 34 Abbotsford Christian School Society Arrow Lakes School District #10 Ashcroft HUB Society Braefoot Community Association Brennan Park Recreation Centre City of Burnaby, School District City of Campbell River, School District 72, Strathcona Regional District Capital Regional District City of Chilliwack, Canadian Recreation Excellence (Cheam Leisure Centre / Chilliwack Landing Centre/ Rotary Outdoor Pool) Corp, School District 33 Comox Valley Regional School District City of Coquitlam, School District 43 Cordova Bay United Church Cowichan Regional District, Municipality of North Cowichan. City of Duncan Dunbar Heights United Church District of 100 Mile House, School District 27 Jewish Community Centre (Vancouver) City of Kamloops, School District 73 City of Langford Township of Langley City of Maple Ridge, City of Pitt Meadows, Maple Ridge & Pitt Meadows Parks & Leisure Services Commission School District 42 Marpole Scout Hall (Vancouver) District of Mission, School District 75 National Nikkei Museum & Heritage Centre Village of Pemberton, Squamish Lillooet Regional District District of Peachland & City of Penticton, School District 67 City of Port Coquitlam City of Prince George City of Revelstoke City of Richmond, Richmond Arenas, East Richmond & Sea Island Community Centre Associations, Richmond Olympic Oval Corporation, School District 38 Steveston Community Society 1
School District 35 (Langley) St. Andrews Presbyterian Church St Pius X Parish City of Surrey & School District 36 District of Squamish Tsawwassen First Nations Recreation Centre Treadlightly Hall, 1164 Roberts Creek Road, Roberts Creek Society of Saint Vincent De Paul of Vancouver Island City of Vancouver, Its Board of Parks & Recreation & Affiliated Community Centre Associations & Societies Vancouver Police Board, Their Officials, Officers, Employees, Servants & Agents City of Victoria, School District 61, West Shore Parks & Recreation Society District of West Kelowna, School District 23 Corporation of the District of West Vancouver Resort Municipality of Whistler, School District 48 Big White Ski Resort ABOVE ARE ADDED AS ADDITIONAL INSURED, BUT SOLELY WITH RESPECT TO THE LIABILITY WHICH ARISES OUT OF THE ACTIVIVITIES OF THE NAMED INSURED SBC INSURANCE AGENCIES LTD. AUTHORIZED REPRESENTATIVE 2
MEMBER CLUBS It is understood and agreed that coverage under the within policy is provided for the following clubs: 1) Abbotsford Isshin-Ryu Karate Club (Abbotsford Christian School) 2) Abbotsford Karate Club (SD34) 3) Abbotsford Tekken Shotokan Karate 4) Aldergrove Karate Club (SD35) 5) Arbutus Club Shito-Ryu International Karate-Do 6) Ashcroft Karate Club 7) BC Kyokushinkai (Jewish Community Centre, Vancouver) 8) Burnaby Chito-Ryu aka Nishi Kaigan Chito-Ryu & Chito-Ryu Yuseikan (Bonsor & Edmonds Community Centres) 9) Burnaby Karate Academy 10) Burnaby Mountain Karate 11) Campbell River Shito-Ryu 12) Campbell River Wado Karate 13) Canada Shoseikan Vancouver & Richmond (Marpole Scout Hall & Richmond Oval) 14) CASK Shiai Karate School 15) Castlegar Karate Club 16) Chilliwack Chito-Ryu Karate Club (SD33) 17) Chilliwack Isshin-Ryu Karate Club 18) Chilliwack Uechi-Ryu Karate-Do 19) Chuso Dojo 20) Comox Valley Shito-Ryu (CVRD) 21) Cordova Bay Kimura Shukokai Karate Club 22) Coquitlam Shotokan (SD43) 23) Courtenay Shito-Ryu 24) Delta Karate School 25) Dragon Dojo Isshin-Ryu Karate (SD34) 26) East Sooke Goju-Ryu 27) Elite Karate Academy Surrey 28) Fernando Correia School of Karate (Cowichan & Duncan) 29) Fraser Valley Shito-Ryu Karate Club 30) Guseikai Karate Club (Willingdon Centre Burbaby) 31) Haida Gwaii Shito-Ryu 32) Hayabusa Karate Club 33) Hinode Shotokan Karate Club 1
34) Hollyburn Karate Club 35) Ippon Goju-Ryu Karate Club 36) Jushinkan Martial Art 37) Kaigan Karate-Do (Treadlightly Hall, Roberts Creek) 38) Kaizen Family karate 39) Kamloops Renshikan Karate-Do (Kamloops SD74, St. Andrews Church) 40) Kelowna Tsuruoka Karate Club 41) Kenzen Sports Karate (Victoria) 42) Kimera Shukokai Karate 43) Kimeru Shotokan Karate Club (8167 Main Street, Vancouver) 44) KimNik Shotokan Karate Academy (SD35 Langley) 45) Kingsway Shito-Ryu 46) Kitmat Karate Club 47) Kootenay Renshikan Karate-Do 48) Ladner Shito-Ryu Karate 49) Langara Shotokan Karate Club 50) LM Renshikan Karate 51) Metro Renshikan Karate-Do 52) Mission Isshin-Ryu Karate Club 53) Mount Pleasant Seiwa Kai 54) Mountain Karate Association 55) Nakusp Shotokan Karate Club 56) Nanaimo Shotokan Karate-Do 57) Nechako Karate Club 58) Nikkei Shito-Ryu (National Nikkei Heritage Ctr) 59) North Vancouver Shidokan (St. Plus X Parish) 60) North West Shito-Kai 61) Northern Rockies Karate-Do Ft. St. John 62) Northern Rockies Karate-Do Hudson s Hope 63) Northern Rockies Karate-Do Prince George 64) Northern Rockies Karate-Do Tumbler Ridge 65) Pacific Spirit Wado Kai Karate Club (Dunbar Heights United Church) 66) Pemberton/Whistler Karate Club 67) PoCo Torakai Karate Club 68) Prince Rupert Karate Club 69) Revelstoke Shotokan Karate Club 70) Rodney Hobson Karate Academy 71) School of Kyokushin Karate 2
72) Shima Karate School Nanaimo 73) Shito-Ryu International Richmond Dojo (Rmd. E Rmd/Sea Is) 74) Sho Bu Kai Karate Club (SD33) 75) Sho Shoh-Ryu Karate-Do (Savona SD73) 76) Shotokan Karate-Do, Yoi Seishin Dojo 77) Shudokan Delta (Tsawwassen First Nations Rec Ctr) 78) Shudokan East Vancouver 79) Sooke Kimura Shukokai Karate 80) South Surrey Karate Club (SD36) 81) Sri Fudoshin Martial Arts (4364 Fraser Street, Vancouver) 82) Steveston Karate Club 83) Surrey YMCA Shotokan Karate Club 84) Taneda Dojo Kelowna Chito-Ryu 85) Taneda Dojo Penticton Chito-Ryu 86) Taneda Dojo Summerland Chito-Ryu 87) Taneda Dojo Westbank Chito-Ryu 88) Thompson Karate Club 89) Thompson-Nicola Shotokan Karate Club 90) Tiger s Eye Karate-Do (North Shore) 91) Tiger s Eye Karate-Do (Yaletown) 92) Tom Mah School of Karate 93) Top Karate Port Coquitlam 94) Toushinkai Karate Club 95) Tsunami Shotokan Karate Club 96) UBC Shito-Ryu Seikokai Karate Club 97) University of Victoria Shotokan 98) Vancouver Karate and Kobudo (Hillcrest Community Ctr.) 99) Vancouver Seiwa-Kai (Renfrew Community Centre & Mt. Pleasant) 100) Vancouver Shito-Ryu Seiko-Kai 101) Vancouver Shotokan (West Vancouver) 102)Victoria Renshikan Karate 103)Victoria Shito-Ryu Seiko Kai 104)Victoria Shotokan Karate Club 105)Victoria Yuishinkai & Ryukyu Kobujutsu 106)Way of Life Martial Arts 107)West Coast Goju-Kai 108)West River Karate 109)West Shore Kimura Shukokai 3
110)Westwood Goju-Ryu 111)White Rock Gima-ha Shotokan-Ryu ABOVE ARE ADDED AS ADDITIONAL INSURED, BUT SOLELY WITH RESPECT TO THE LIABILITY WHICH ARISES OUT OF THE ACTIVIVITIES OF THE NAMED INSURED SBC INSURANCE AGENCIES LTD. AUTHORIZED REPRESENTATIVE 4