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CERTIFICATE OF LIABILITY INSURANCE Issue Date 713/2018 ISSUED BY: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY State of Washington AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Department of Enterprise Services CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE STATE OF WASHINGTON SELF INSURANCE Office of Risk Management LIABILITY PROGRAM. PO Box 41466 Olympia WA 98504-1466 COVERAGE AFFORDED BY State of Washington Self Insurance Liability Program INSURED: THE STATE OF WASHINGTON, INCLUDING ALL ITS AGENCIES AND DEPARTMENTS, IS SELF-INSURED FOR TORT LIABILITY CLAIMS. ALL State of Washington CLAIMS MUST BE FILED WITH THE STATE OFFICE OF RISK Central Washington University MANAGEMENT FOR PROCESSING IN ACCORD WITH STATUTORY REQUIREMENTS. ATTN: Toni Burvee 400 E University Way Ellensburg, WA 98926 COVERAGES THIS IS TO CERTIFY COVERAGE DESCRIBED BELOW IS PROVIDED TO THE INSURED NAMED ABOVE FOR THE PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE COVERAGE AFFORDED BY THE SELF-INSURANCE LIABILITY PROGRAM IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH PROURAIVI. POLICY EFFECTIVE EXPIRATION TYPE OF COVERAGE NUMBER DATE DATE LIMITS GENERAL LIABILITY Self-Insured Continuous Continuous BODILY INJURY, PROPERTY $5,000,000 ® GENERAL LIABILITY DAMAGE & PERSONAL INJURY ® OCCURRENCE COVERAGE COMBINED EACH OCCURRENCE AUTOMOBILE LIABILITY BODILY INJURY & PROPERTY $5,000.000 ❑ DAMAGE COMBINED EACH ANY AUTO ® ALL OWNED AUTOS ACCIDENT ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON-OWNED AUTOS WORKERS COMPENSATION AND L & I Continuous Continuous WC — STATUTORY EMPLOYERS LIABILITY OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESISPECIAL ITEMS: Coverage applies as respects tort liability claims against the State of Washington as covered by the Tort Claims Act (RCW 4.92 et seq.) The Certificate Holder is named as additional insured, but only as respects the negligence of the State of Washington. CERTIFICATE HOLDER: CANCELLATION SHOULD THE SELF INSURANCE LIABILITY PROGRAM BE CANCELLED, THE KITTITAS COUNTY STATE OF WASHINGTON WILL ENDEAVOR TO MAIL 4g DAYS WRITTEN SPECIAL EVENTS REPRESENTATIVE NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE 205 WEST 5TH, SUITE 108 TO MAIL SUCH NOTICE SHALL NOT IMPOSE ANY OBLIGATION OR LIABILITY UPON THE STATE OF WASHINGTON, ITS OFFICIALS, EMPLOYEES, AGENTS ELLENSBURG, WA 98926 OR REPRESENTATIVES. MANASTASH METRIC BIKE RIDE OCTOBER 6, 2018 A ORIZED REPR' NTATIVE: e__4 l =-u_t _ CERTIFICATE NUMBER CRT 19-05 son Sisins. State Manager