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AMERCOW-02 BSINCLAIR <br />CERTIFICATE OF LIABILITY INSURANCE °^',E 2DOD <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED <br />REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br />IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDIT10NAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER License #26480 |c cT Becky Sinclair <br />2H6UOO srenati nSaLMbou0ntain States Limited c.NNEo.Ext):(208)433-1000 (A^tŠ,No):(866)898-4905 <br />PO Box 5815 ss:Boise,ID 83705 INSURER(S}AFFORDING COVERAGE NAIC # <br />l INSURERA:Mesa Underwriters Specialty Insurance 36838 <br />INSURED INSURER B : <br />American Cowboy Team Roping Association INSURER C: <br />4710 William Ave INSURER D : <br />Winnemucca,NV 89445 INSURERE: <br />INSURERF: <br />WVERAGES CERTIFICATE NUMBER:REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREINISSUBJECTTOALLTHETERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />TYPE OF INSURANCE D SnR POLICY NUMBER gy <br />gYO1 O LIMITS <br />A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br />1,000,000 <br />CLAIMS-MADE X occuR MPOO25002002876 12/1/2018 12/1/2019 giggy"e"occumincel <br />5 <br />100,000 <br />MED EXP (Any one person)$ <br />5,000 <br />PERSONAL &ADV INJURY s <br />1,000,000 <br />GE TL AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ <br />2,000,000 <br />POL1CY LOC PRODUCTS -COMP/OP AGo s <br />Included <br />I GmER HIRED NONOWNED 1,000,000 <br />COMBINED SINGl.E LIMITAUTOMOBILELIABILITYI(Ep acddepl)i <br />ANY AUTO BODILY INJURY (Per person)8 <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS BODILY INJURY (Per accident)$ <br />RT <br />S ONLY ASW "$°¾""JAMAGE <br />UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br />EXCESS LIAB CLAIMS-MADE I AGGREGATE 5 <br />DED i RETENTION $$ <br />l WORKERS COMPENSATlON <br />AND EMPLOYERS'LIABILITY <br />Y I N <br />STATUTE I _ER <br />ANY PROPRIETORIPARTNERIEXECUTIVE I EL EACH ACCIDEWT $ <br />OFFICERIMEMBER EXCLUDED?N I A <br />(Mandatory in NH)EL DISEASE -EA EMPLOYEE $ <br />If yes,doscribe under iIDESCRIPTIONOFOPERATIONSbelowE.L DISEASE -POLICY LIMIT I $ <br />i <br />DESCRIPTlON OF OPERATIONSI LOCAT10NSI VEHICLES (ACORD 101,AddtNonni Remarks Schedule,may be attachud If more space is required} <br />Cerdficate holder is an additional insured with regards to General Liability if required by written contract per form CG 20 11 04 13. <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED INKittitasCountyACCORDANCEWITHTHEPOLICYPROVISIONS.2015 West 5th <br />Ellensburg,WA 98926 <br />ACORD 25 (2016/03)©1988-2015 ACORD CORPORATION.AII rights reservi <br />The ACORD name and logo are registered marks of ACORD