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CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 4/1/2019 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). PRODUCER TRUSS 9200 Ward Parkway Suite 500 CONOCT N,e,M Certificate Department PwoiE. PAX EI�(g0.61s-70&-0600 Ndi; 516-708-9193 Annus: 'Cer0fIcatesQTrussAdvantage eom _ .INSUMNM AFFORDING COVERAGE NAIC1f Kansas City MO 64114 INSURER A: Church Mutual Insurance CO 18767 INSURER EL,_ INSURED Fellowship Of Christian Athletes 8701 Leeds Road INSURER C INSURER D : Kansas City MO 64129 INSURER E: DAMA T PREMISES fEa orcurrence INSURER F _ COVERAGES CERTIFICATE NUMBER: 976962354 REVISION NUMBER: 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. E7CP LIMITS IR9R TYPE OF INSURANCE POLICY NUMBER DOMYYI tam A X COMMERCIAL GENERAL LIABILITY Y 026165602145609 9/1/2018 911/2019 EACH OCCURRENCE $ 2,000.000 CLAIMS -MADE X OCCUR DAMA T PREMISES fEa orcurrence $ 300,000 MED EXP (Any one person) S $,000 PERSONAL & ADV INJURY $ 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5 ' 000,000 X POLICY 1 PRO JECT n LOC PRODUCTS-COMP/OPAGG _ $2.000,000 OTHER $ AUTOMOBILE LIABILITY COhg2iI3EU5i GiFLiMR [_E9 ecddd�ill $ _ BODILY INJURY (Per person) ANY AUTO $ ALL OWNEDSCHEDULED AUTOS AUTOS $ BODILY INJURY (Per accident) PROPERTYDAMAGE t+tr NON -OWNED HIRED AUTOS AUTOS $ $ UMBRELLA LIAB OUR EACH OCCURRENCE . $ AGGREGATE EXCESS LIAB p AIMSQADE $ QED I RETENTIWN% $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY VIN PER - T T TE FR ANY PROPRIETOR/PARTNER/EXECUTIVE EL. EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? ❑ N / A — (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additlonal Remarks Schedule, may be attached If more space Is required) Re: Night of Champions Fundraiser - May 28, 2019. Kittitas County is primary, non-contributory additional insured as respects General Liability. CERTIFICATE HOLDER CANCELLATION Brightside Vintage Farm LLC 511 Monreau Road Ellensburg WA 98926 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 ,��7 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD