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CERTIFICATE OF LIABILITY INSURANCE °"��0;9°"'"Y' <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT <br />AFFIRMATIVELY OR NEOATNELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT <br />CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certleoate holder Is an ADDITIONAL INSURED, tiro poticy(ioa� must he endnrsed. IT SUSROGATION IS WANED, subject to tho terms and conditions of <br />the policy, certain policies may require an endorsomonL A statement on this cer cato does not confo-r rights to tho corbIRzto holder In lieu of ouch onftmornonQs). <br />PRODUCER: <br />CONTACT NAME: Leslie Casanova <br />Sportsman's Insurance Agency, Inc. <br />1364 North US 1, Suite 503 <br />PHONE: 800 925-7767 Ext 111 FAX: 366 677-3292 <br />E-MAIL ADDRESS: lemanova@siai.net <br />Ormond Beach, FL 32174 <br />INSURED: <br />LOSTINSURER <br />LOST PAIR RANCH, LLC <br />(S) AFFORDING COVERAGE <br />P.O. BOX 814 <br />INSURER A: T.H.E. INSURANCE COMPANY <br />SOUTH CLE ELUM WA 98943-0814 <br />INSURER B: <br />INSURER C: <br />COVERAGES <br />THIS I TO CERT1 T?IAT THE POLE INSURANCE LIST1EDecLowmAvE8EENtSsu9oTOTHE INSURED NAMPO ABOVE FOR THE POLICY PER= INDICA D NOTWITHSTANDING ANY <br />REQUIREMENT TERM OR CONDfrlphl OF AM1fY CONTRACTOR OTHER 17OCUMiENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 0Ei ISSUE❑ OR MAY PERTAIN, FEE INSURANCE AFFORDED <br />BYTHE POLICl 0 DEBCR(HED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDFCIONS OF SUCH P LILIES. LI iT H IAA HA E C ePAD CVOMS <br />INSR POLICY EFF POLICY EXP <br />LTR TYPE OF INSURANCE POLICY NUMBER (MhyDONM (MMNDONYYY) LIMITS <br />A <br />GENERAL LIABILITY <br />FX 1 COMMERCIAL GENERAL LIABILITY <br />E) OCCURRENCE ❑ CLAIMS MADE <br />MASTER POLICY # <br />GGLO1001 <br />3/25/2019 <br />3/25/2020 <br />GENERAL AGGREGATE <br />NONE <br />PRODUCTS-COMP/OP AGG <br />$1,000,000 <br />PERSONAL & ADV. INJURY <br />$1.000,000 <br />E] PREMISEaIOPERATIONS <br />CERTIFICATE # <br />EACH OCCURRENCE <br />81.000.000 <br />DAMAGE TO PREMISES RENTED <br />TO YOU (A11Y Olkr� hses <br />S 100.000 <br />xl HIRED ALTO 8 NON-OWNED AUTO <br />NGC 2917 -01 <br />MED. EXP (Any One Person) <br />$ 10,000 <br />LIQUOR LIABILITY <br />Each Common Cause <br />❑ OCCURRENCE <br />Aggregate <br />❑ ExcESs LIABILITY <br />EACH OCCURRENCE <br />❑MCURRENCE ❑ CLAIMS MADE <br />Om ❑ RETENTION i <br />AGGREGATE <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />❑ WC STATU- ❑ OTHER <br />TORY LIMITS <br />E.L. EACH ACCIDENT <br />YIN <br />ANY PROPRIETOWPARTHER1EXECUTIVE ❑ <br />OFFICERIMEMBER EXCLUDED? <br />E.L. DISEASE - POLICY LIMIT <br />�ay6 das&b H <br />DE&L�RIPTION OF OPERATIONS 6alaw <br />E.L. DISEASE - EA EMPLOYEE <br />DESCRLPT10N OF OPERAT1ONSILOCATTON&ISPECTAL ITEMS —CERTIFICATE HOLDER 18 ADDED AS AN ADDITIONAL INSURED -MANAGERS OR LESSORS OF PREMISES BUT ONLY WTH <br />RESPECT TO THE OPERATIONS OF: <br />LOST PAIR RANCH, LLC <br />KITTITAS COUNTY IS ADDED AS ADDITIONAL INSURED ON A PRIMARY/NONCONTRIBUTORY BASIS, BUT ONLY WITH <br />RESPECTS TO THE NAMED INSUREDS OPERATION. LIABILITY COVERAGE IS NOT EXTENDED FOR ANY OTHER <br />ACTIVITIES. <br />111411:191111114V <br />KITTITAS COUNTY <br />205 W. 5TH, AVE. <br />ELLENSBURG, WA 98926 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE I <br />THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />FMPCO12011 072013 Includes copyrighted material of 1988-2010 ACORD CORPORATION <br />