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CERTIFICATE OF INSURANCE <br />AGENCY: <br />ESIX 3 LLC <br />d/b/a Entertainment & Sports Insurance eXperts (ESIX) <br />d/b/a Entertainment and Sports Insurance Agency (California) <br />2727 Paces Ferry Road, Building Two, Suite 1500 <br />Atlanta, GA 30339 <br />678-324-3300 (Phone), 678-324-3303 (Fax) <br />NAMED INSURED: <br />DATE: 12/27/2016 <br />CERTIFICATE NUMBER: 20161222490034 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND <br />CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES <br />NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW - <br />INSURERS AFFORDING COVERAGE: <br />USA Triathlon of Colorado DEANNA MULLER INSURER A: Philadelphia Indemnity Ins. Co. NAIC #: 18058 <br />Delm Springing emn <br />s CO 80919-2401 p y Drive <br />Colorado Springs INSURER B: Philadelphia Indemnity Ins. Co. NAIC #: 18058 <br />Colo <br />EVENT INFORMATION: <br />Ellensburg Triathlon (Olympic and Sprint) (7/22/2017 - 7/22/2017) <br />POLICY/COVERAGE INFORMATION: <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE <br />INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE <br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br />INS TYPE OF INSURANCE: POLICY NUMBER(S): EFFECTIVE: EXPIRES: LIMITS:. <br />A GENERAL LIABILITY <br />X Occurrence PHPK1579791 12/1/2016 12/1/2017 GENERAL AGGREGATE (Applies Per Event) $2,000,000 <br />12:01 AM 12:01 AM <br />X Participant Legal Liability EACH OCCURRENCE $1,000,000 <br />DAMAGE TO RENTED PREMISES (Each Occ) $1,000,000 <br />MEDICAL EXPENSE (Any one person) EXCLUDED <br />PERSONAL & ADV INJURY $1,000,000 <br />PRODUCTS-COMP/OP AGG $2,000,000 <br />B UMBRELLA/EXCESS LIABILITY <br />X Occurrence PHUB564242 12/1/2016 12/1/2017 EACH OCCURRENCE $10,000,000 <br />12:01 AM 12:01 AM <br />AGGREGATE (Applies Per Event) $10,000,000 ! <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS: <br />Coverage applies to the USA Triathlon sanctioned or approved event specified on this certificate <br />The certificate holder is an additional insured as per form PI -AM -002: Additional Insured - Certificate Holders, <br />The General Liability policy is primary as per Form CG0001 (04/13). <br />The General Liability policy contains Form CG2404 (05/09): Waiver of Transfer of Rights of Recovery Against Others to US, but only as required by written contracl or <br />agreement executed by the named insured prior to an occurrence resulting in a loss or a claim. <br />CERTIFICATE HOLDER: <br />Kitittas County, It's Officers, Officials, Employees <br />205 W 5th Ave <br />Ellensburg WA 98926 <br />NOTICE OF CANCELLATION: <br />Should any of the above described policies be cancelled before the expiration date thereof, <br />notice will be delivered in accordance with the policy provisions <br />AUTHORIZED REPRESENTATIVE: <br />