WORLDWIDE SPORTS INSURANCE ABN 65 003 922 487 AFS Licence 342385 Trading as WWSI is a Business Unit of PSC Insurance Brokers (Aust) Pty Ltd Level 1 PO Box 7675 Tel: 03 9862 6500 390 St Kilda Road St Kilda Road VIC 8004 Fax: 03 9867 6771 Melbourne VIC 3004 Email: [email protected]
CERTIFICATE OF CURRENCY From: Nicole Walravens - Sport We hereby confirm that we have arranged the insurance cover mentioned below:
Linda & Dean You Lee
NSW 2071 Date: 27/01/2015 Our Reference: LASERWARRI RENEWAL
Page 1 of 3
Class of Policy: Liability Insurance Policy No: PMEL99/0096000 Insurer: Lloyd's Of London Invoice No: 088122 Michaels House,10-12 Alie Street,London E1 8DE Period of Cover: ABN: 080862291 From 13/02/2015 The Insured: LaserWarriors Mobile Laser Tag to 13/02/2016 at 4:00 pm
Details: IMPORTANT INFORMATION The Proposal/Declaration: See attached schedule for a description of the risk insured is to be received and accepted by the Insurer has been received and accepted ü by the Insurer The total premium as at the above date is: to be paid by the Insured part paid by the Insured ü paid in full by the Insured paid by Monthly Direct Debit Premium Funding
This policy is Premium Funded
Please note that the policy defined above is subject to the receipt of the Proposal Declaration and acceptance by the Insurer (if not already completed and accepted) and subject to the full receipt and clearance of the total premium payable by the insured.
Signature: On behalf of: PSC Insurance Brokers (Melbourne) Schedule of Insurance Page 2 of 3 Class of Policy: Liability Insurance Policy No: PMEL99/0096000 The Insured: LaserWarriors Mobile Laser Tag Invoice No: 088122 Our Ref: LASERWARRI
Sports Injury and Liability Insurance
Insured: LaserWarriors Mobile Laser Tag
Business/Activity: Mobile Laser Tag Operation
Location: NSW
PUBLIC LIABILITY
Sum Insured $20,000,000 (Limit of Indemnity any one occurrence) for the conduct of the Sport / Activities detailed above
Interested Parties:
Auburn City Council Bankstown City Council The Hills Shire Council Blacktown City Council Camden Council Campbelltown City Council Fairfield City Council Holroyd City Council The Council of the Shire of Hornsby Ku-ring-gai Council Liverpool City Council Parramatta City Council Penrith City Council Pittwater Council Ryde City Council Sutherland Shire Council Warringah Council Ashfield Council The Council of the City of Botany Bay Burwood Council City of Canada Bay Council Canterbury City Council The Council of the Municipality of Hunters Hill Hurstville City Council Kogarah City Council Lane Cove Municipal Council Leichhardt Municipal Council Manly Council Marrickville Council Mosman Municipal Council North Sydney Council Randwick City Council Rockdale City Council Strathfield Municipal Council Council of the City of Sydney Schedule of Insurance Page 3 of 3 Class of Policy: Liability Insurance Policy No: PMEL99/0096000 The Insured: LaserWarriors Mobile Laser Tag Invoice No: 088122 Our Ref: LASERWARRI
Waverley Council Willoughby City Council Woollahra Municipal Council Blue Mountains City Council Gosford City Council Hawkesbury City Council Wollondilly Shire Council Wyong Shire Council The Council of the Municipality of Kiama Shellharbour City Council Shoalhaven City Council Wingecarribee Shire Council Wollongong City Council Cessnock City Council Dungog Shire Council Gloucester Shire Council Great Lakes Council Lake Macquarie City Council Maitland City Council Muswellbrook Shire Council Newcastle City Council Port Stephens Council Singleton Council Upper Hunter Shire Council
UNDERWRITTEN BY Sportscover Syndicate 3334 at Lloyd`s.