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CERTIFICATE OF LIABILITY INSURANGE DATE (MM'DD'YYM <br />03t01t2023 <br />MATTER OF II{FORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AilIEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTTTUTE A CONTRACT BETI,ITEEN THE ISSU|NG TNSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />THIS CERTIFICATE IS ISSUEDAg A <br />McKay lnsurance Agency, lnc.842-2135 (641)828-2013 <br />NAIC #tA 50138 <br />COVERAGE <br />A statomont ontfSUBROGATIONtotefmstherswAlvED,conditionsand theof cefiainsubject an ondorgement-pollcy,maypolicies requirc <br />ccrtlflcatethis notdoos confer to certificatetho lnholder oflieu such <br />is an the must have or be <br />PRODUCER <br />meg@mckayinsagency.com <br />Evanston <br />106 East Main Straet <br />P O Box 151 <br />Knoxville <br />TNSURERB: Gerber Life lnsurance Company 70939 <br />INSURERC: <br />INSURERD: <br />INSURER E : <br />Silent Sports Association - NBTS SE <br />Vicious Cycle Events, lnc. <br />139 E. Sheet SW <br />Ephrata wA 98823 <br />INSURED <br />INSURERF: <br />COVERAGES CERTIFICATE NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCEAFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALLTHE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOVI/N MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR TYPE OF INSURANCE tNen lllh POLICYNUMBER FQLIGY EFF <br />IMM'DD'YYYYI UMITS <br />A <br />COMMERCIAL GENERAL UABILITY <br />lX *"r* <br />Participants <br />CLAIMS-MADE <br />lncludes Athletic <br />LIMITAPPLIES PER: <br />PRGJECr I I LOCPOLICY <br />Event <br />Y 3607AH010099-5 06111t2023 o6t12t2023 <br />EACH OCCURRENCE $ 1,000,000 <br />s 300,000 <br />MED EXP (Anv one oeBon)$ Excluded <br />PERSONAL &ADV INJURY $ 1,000,000 <br />GENERALAGGREGqTE $ 2,000,000 <br />PRODUCTS. COMP/OPAGG $ 2,000,000 <br />$ <br />AUTOMOBILE UABILITY <br />ANYAUTO <br />OWNED <br />AUTOS <br />HIRED <br />AUTOS <br />ONLY <br />ONLY <br />SCHEDULED <br />AUTOS <br />NONOVIJI{EO <br />AUTOS ONLY <br />$ <br />BODILY INJURY (Por person)$ <br />BODILY INJURY (Per a6idont) <br />s <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS-MADE <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />DED RETENTION S $ <br />WORKERS COMPENSAION <br />AND EMPLOYERS' LIABIUTY <br />ANY PROPRI ETORiPARTNER/EXECUTIVE <br />OFFICERYMEMBER EXCLUDED? <br />(Mandatory ln NHI <br />lf yes, describs under <br />DESCRIPTION OF OPERATIONS below <br />Y'N <br />N/A <br />Pht{ <br />STATUTE <br />OTH-FR <br />E.L. EACH ACCIDENT $ <br />E.L. OISEASE - EA FMPLOYEE $ <br />E.L, DISEASE - POLICY UMIT $ <br />B <br />Accident Medical <br />15-070944-22 06111t2023 o6t12t2023 <br />Excess <br />Deduc'tible $250 <br />$2s,000 <br />DESCRIPflON OF OPERATIONS t LOCATIONS / VEHICLES (ACORD l0l, Addltloml Rsnutkt Schodulq may be 8ttichod r nrore space ls ruqutmd) <br />Gran Fondo Ellensburg: June 11 , 2023. Certificate holder is an additional insured but only with respect to liability arising out of the operations of the abovenamed insured. "This policy is issued, pursuant to lowa Code section 515.147, by a nonadmitted company in loiva andls such is not covered by the lowa <br />lnsurance Guaranty Association." <br />Kittitas County <br />205 W. SthAve <br />Ellensburg wA 98926 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRAIION DATE THEREOF, NOTICE WLL BE DELIVERED IN <br />ACCORDANCE WITH TI{E POLICY PROVISIONS, <br />AUTHORIZED REPRESENTANVE <br />@ 1988-2015 ACORD CORPORATTON. Ail rlghts reserved. <br />TheAGORD name and logo are rsgistercd marks of ACORDACORD 25 (2016/03)