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I DATE (MM/DD/YYYY) AC -"R" CERTIFICATE OF LIABILITY INSURANCE 2/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCERCO I�TACT Margaret M. Mayers STAR Insurance - Fort Wayne Office 2130 East Dupont Road ext); (260) 467-5689 i F (260)467-55691 s.Margaret.mayers@starfinancial.com INSURER(S) AFFORDING COVERAGE ....... ............ ..., Fort Wayne IN 46825 INSURERANational Casualty Company INSURED INSURER B Nationwide Life Insurance Co. Road Runners Club of America/2016 and Its INSURERC: Member Clubs INSURERD:.... 1501 Lee Highway Suite 140 INSURERE� Arlington VA 22209 1 INSURER F: rnvFDAr_PQ f'FRTIFIroTF NI IMRFR•2016 SIM A.I. REVISION NLIMRER- 6 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .�.....ADOL.$Ui1#: .. POLI�y FFF P .... ... . MSR TYPE OF INSURANCE I I UfYY �y YY LIMITS I TR V POLICY NUMBER l4EM10YY YY • COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE XI OCCUR f $ 500,000 Ellis occurrence _P MED EXP��ny one person) X Legal Liability to KROOO00005887400 12/31/2015 12/31/2016 12:01 AM 12:01 AM $ 5,000 $ 1,0002000 $ Unlimited Partic4ant__$1.,,- W, 000 PERSONAL &ADV INJURY GGEENI AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE PRODUCTS A (POLICY ❑ PRO 11LOC JECT Abuse & Molestation $ 1,000,000 Abuse & Molestation """""�j OOHSI Aggregate $5,000,000 $ 500,000 AUTOMOBILE LIABILITY Eagc� ) $ 1,000,000 BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED _ ,AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS$ KR00000005887400 12/31/2015 12:01 AM 12/31/2016 12:01 AM $ BODILY INJURY (Per accident) rsccldeng. E $ T UMBRELLA LIABOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE $ DED RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITYSTATUTE ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N PER- E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? n (Mandatory in NH) N/A - E.L DISEASE - EA EMPLOYE $ E L DISEASE -POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below B Excess Medical & Accident SPX0000027201500 j 12/31/201512/31/2016 Excess Medical $10,000 ($250 Deductible/Claim) 12:01 AM 12:01 AM AD&Specific Loss $2,500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED AS RESPECTS THEIR INTEREST IN THE OPERATIONS OF THE NAMED INSURED. DATE OF EVENT(S): 04/02/16 Yakima River Canyon Marathon and Half Mararthon (13.1 & 26.2 road race) INSURED RRCA CLUB/EVENT MEMBER: Hard Core Running Club, Att'n: Lenore Dolphin; PO Box 1511, Yakima, WA 98907 Ila 04/02/16 Kittatas County 205 W. 5th Room 108 Ellensburg, WA 98926 V.A IVI.r LL/i I IUIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 'Terry Diller/LIO U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 onlanl)