Laserfiche WebLink
COVERAGES <br />CERTIFICATE OF LIABILITY INSU RANCE <br />CERTTFTCATE NTJMBER: 2020 $2M A.l.REVISION NUMBER: <br />DATE (MM/DD/YYYY) <br />0212412020 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 CONSTTTUTE A CONTR.ACT BETWEEN THE tSSUtNc TNSURER(S), AUTHORTZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: lf the certilicate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />lf SUBROGATION lS 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 <br />lnsurance Management Group <br />12730 Coldwater Rd Ste 103 <br />Fort Wayne lN 46845 <br />Mayers <br />(76s) 664-0761 <br />mmayers@insmgt.com <br />338-2925 <br />INSURER(S} AFFORDING COVERAGE NAIC # <br />tNsuRER A : National Casualty Company 11991 <br />INSURED <br />Road Runners Club of America/2020 and lts Member Clubs <br />1501 Lee Highway <br />Suite 140 <br />Arlington VA 22209 <br />tNsuRER B . Nationwide Life lnsurance Company 66869 <br />INSURER C <br />INSURER D <br />INSURER E <br />INSURER F <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. NOTWTHSTANDING ANY REQUIREI\iIENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO \fi-IICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOVVI{ MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSKtTp TYPE OF INSURANCE tNsn WD POLICY NUMBER <br />FULIUY EFF <br />IMM/DD/YYYYI <br />FVLIUY EAF <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS.MADF lXlo.",* <br />Legal Liability to <br />Participant $2, 000,000 <br />LIMITAPPLIES PER: <br />PRO.JECT | | LOcPOLICY <br />orHER: Per Event Basis <br />KRO00000081 94200 12t31t20't9 1213112020 <br />EACH OCCIIRRENCE s 2,000,000 <br />UN IVIAUE IU KEI\ I trU <br />PRFMISFS lFa...".rpn.al s 500,000 <br />MED EXP (Anv one oerson)s 5,000 <br />PERSONAL&ADV INJURY $ 2,000,000 <br />GENERALAGGREGATE $ 5,000,000 <br />PRODUCTS - COMP/OPAGG $ 2,000,000 <br />Abuse and Molestation $ 500,000 <br />A <br />AUTOMOBILE LIABILITY <br />ANYAUIO <br />OWNED <br />AUTOS ONLY <br />HIRED <br />AUTOS ONLY <br />SCHEDULED <br />AUTOS <br />NON.O!\AIED <br />AUTOS ONLY <br />KRO00000081 94200 12t31t2019 1213112020 <br />COMBINED SINGLE LIMIT <br />lFa accidenll $ 2,000,000 <br />BODILY INJURY (Per person)$ <br />BODILY INJURY (Per accident) <br />PROPLR I Y IJAMAGE <br />IPer accidenl)$ <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIIUS.MADE <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />DED RETENTION S $ <br />WORKERS COMPENSATION <br />ANO EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE T---'1 <br />OFFICER/MEIUBER EXCLUDED? LI(lllandatory in NH) <br />lf yes, describe under <br />DESCRIPTION OF OPERATIONS belw <br />N/A <br />PhR <br />STATTITE <br />IOIH-IFR <br />E.L. EACH ACCIDENT $ <br />E.L. DISEASE - EA EMPLOYEE ! <br />E,L. DISEASE - POLICY LIMIT $ <br />B <br />Excess Medical & Accident <br />($250 Deductible/Claim)8AX0000031 001 200 12t31t2019 1213112020 <br />Excess Medical <br />AD & Specific Loss <br />$1 0,000 <br />s2,500 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />\ hshington State Department ofTransportation, the State of \ hshington, its elected and appointed ofiicials and officers, is departments, agencies, boards, <br />commissions, authorized agents and employees are NAMED AS AN ADDITIONAL INSURED AS RESPECTS THEIR INTEREST lN THE OPEMTIONS OF <br />THE NAMED INSURED. DATE OF EVENT(S): O4l04l2OYakima RiverCanyon Marathon INSURED RRCACLUB/EVENTMEMBER: Hard Core <br />RunningClubofCentral \/bshington,Att'n: FrankPurdy,POBox1511,Yakima,WA98907 Attached: PCN0114-KRGL56&KRGL7g <br />Processed by MMM <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS.O4lO4l20 Kittitas County <br />205 W Fifth Avenue <br />wA 98926Ellensburg !r*1R /Dl/. <br />AUTHORIZED REPRESENTATIVE <br />@ 1988-20{5 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03)