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BASS CLUB LIABILITY INSURANCE!

- The Best Policy Available Anywhere! -

Now “low cost” high quality bass club liability insurance is available for your bass club when your club affiliates with Ameri - can Bass® Association. American Bass® and San Fernando/Valleyheart Insurance Services, (Stan & Ken Vanderburg), have put together a program that keeps the cost of insuring your bass club down. Liability Coverage: $1,000,000 Per occurrence/ $3,000,000 Aggregate,

Comprehensive General Liability, written with an “A+XI” Admitted carrier! What’s covered*: Coverage for your club includes your monthly meetings, board meetings, banquets, and club tourna - ments. Open Events: “Open Tournaments” (open to the public) If your club has open events, your club Representative needs to contact (Stan or Ken Vanderburg) for proper coverage. This important high quality coverage can be obtained by completing a simple application. Use the form on page 24, or American Bass can fax or mail you a form by calling (310) 376-1026, or visit our website for an online form at www.americanbass.com. Coverage will become effective upon acceptance by the Insurance Company. Contact Stan or Ken Vanderburg License #0589028 at San Fernando/Valleyheart Insurance Services, License #0290237 at 1-800-BASS BOAT, 1-800-227-7262 for any questions relating to this policy.

* Each individual that uses a boat in a club event needs to maintain at all times, a boat insurance policy with Liability Limits of $300,000 minimum. It is the individual’s responsibility to verify with their insurance company that coverage is provided under their policy for tournament participation. Coverage provided by the Club Policy is in excess of any homeowners, tenants, personal liability or personal umbrella coverage available to any club members, contestants, assistants, officials, referees’, statisticians, scorers, volunteer workers, participants and players.

American Bass® e-Magazine

American Bass Association Bass Club Insurance Program Mail-In Application

®

Application for Bass Club Insurance Policy

State ________

Club Name______________________________ Year Founded _________

Location________________________________________

Number of current members ___________

Previous insurance was with ______________________________________

Current President _______________________ Ph# ______________ (eve.)

Address __________________________

Ph# ______________ (day/work)

City ____________________________ State ______ Zip________________

Current Secretary ________________________ Ph# ______________ (eve.)

Address __________________________

Ph# ______________ (day/work)

City ____________________________ State ______ Zip________________

I certify that this club is organized as a non-commercial operation.

# of annual Club tournaments___________ Provide complete list of all club tournament dates and lakes where events will be held.

OPEN TOURNAMENTS AND SPECIAL EVENTS ARE NOT AUTOMATICALLY COVERED but must be added to our policy.

Call American Bass for the 2009 pricing. (310) 376-1026

I DECLARE THAT THE STATEMENTS IN THIS APPLICATION ARE COMPLETE AND TRUE.

_____________________________ ___________

Signature of Club Secretary or President

Send to the offices of: American Bass ® Association • 402 N. Prospect Ave. Redondo Beach, CA 90277

Date

This policy has a participants exclusion and does not take the place of boatowners liability. Each club should verify that their boat owners carry a minimum $300,000 boat liability policy. Club Insurance will become effective upon acceptance by the insurance company. Acceptance will depend on a COMPLETED APPLICATION, CLUB MEMBERSHIP ROSTER INCLUDING NAMES/ ADDRESSES/PHONE NUMBERS, ANNUAL DUES AND ANNUAL FEE FOR CLUB INSURANCE.

- American Bass - Bass Club Insurance Program

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