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CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <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: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. lf SUBROGATION lS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Rothert lnsurance <br />c/o Lael lnsurance and Financial Svs. <br />2301 W Dolarway Road, Suite 5 <br />Ellensburo wA 98926 <br />Lael <br />509-962-8800 509-962-8801 <br />INSURERIS) AFFORDING COVERAGE NAIC # <br />rNsuRER A : Caoitol Specialtv lnsurance Co <br />INSURED <br />Hilary Huffman <br />DBA: Huffman Farms <br />440 Buckboard Lane <br />Ellensburo WA 98926 <br />INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E: <br />INCI IPFR F , <br />COVERAGES CERTIFICATE 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 HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INUKITP TYPE OF INSURANCE tNqn POLICY NUMBER <br />tsULIL Y Etsts <br />IMM/DD/YYYYI <br />tsULILY EAT <br />IMMIDN/YYYYI LIMITS <br />FACH OCCI IRRFNCF s 1.000.000 <br />VI s 100.000 <br />MFn FXP /Anv nna narsdnl s 5.000 <br />PFRSONAI & ANV IN.II IRY q 1.000.000 <br />GFNFRAI AGGRFGATF s 2.000.000 <br />PRONI ICTS . NOMP/OP AGG s lncluded <br />A <br />GOMMERCIAL GENERAL LIABILITY <br />xCLAIMS-MADE OCCUR <br />LIMITAPPLIES <br />PRO-JECT I I <br />x <br />x POLICY <br />PER: <br />LOC <br />cs20002976-01 0912612020 1110112020 <br />$ <br />$ <br />BODILY INJURY (Per person)$ <br />BODILY INJURY (Per accident)$ <br />$ <br />AUTOMOBILE LIABILITY <br />ANYAUTO <br />ALL OWNED <br />AUTOS <br />HIRED AUTOS <br />SCHEDULED <br />AUTOS <br />NON-OWNED <br />AUTOS <br />$ <br />FACH O(]CI IRRFN(]F sUMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS-MADE AGGRFGATF <br />DED RETENTION $ <br />PhKqTATI ITtr UIH- <br />FP <br />F I FACH ACCINFNT s <br />F I DISFASF FA FMPI 6YFF <br />WORKERS COMPENSATION <br />ANO EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNERYEXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />lf yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />Y/N <br />N/A <br />F I NISFASF POt tcY I tMtT q <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD '101, Additional Remarks Schedule, may be attached if more space ls requlred) <br />THIS CONTRACT IS REGISTERED AND DELIVERED AS A SURPLUS LINE COVERAGE UNDER THE INSURANCE CODE OF THE STATE OF <br />WASHINGTON, TITLE 48 RCW. IT IS NOT PROTECTED BYANY WASHINGTON STATE GUARANryASSOCIATION LAW. <br />RON ROTHERT INSURANCE, INC. / <br />Pumpkin Patch <br />Certificate holder is added as an additional insured <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS.Kittitas County, its agents, employees and assigns <br />205 W Sth Ave <br />Ellensburg wA 98926 lLa4 <br />AUTHORIZED REPRESENTATIVE <br />@ 1988.2014ACORD CORPORATION. All rights reserved. <br />The AGORD name and logo are registered marks of ACORDACORD 25 (20',t41011