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COVERAGES <br />CERTIFICATE OF LIABILITY INSURANCE <br />CERTIFICATE NUMBER:I 922555858 REVISION NUMBER: <br />DATE (MM/DD/YYYY} <br />0212512019 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOTAFFIRMATIVELYOR NEGATIVELYAMEND, EXTENO ORALTERTHE COVERAGEAFFORDED BYTHE POLICIES <br />BELOW. TH|S CERTTFICATE OF TNSURANCE DOES NOT CONSTTTUTE A CONTRACT BETWEEN THE TSSUTNG TNSURER(S), AUTHORTZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANï lf the cert¡f¡cate holder is an ADDITIONAL INSURED, the pol¡cy(¡es) must have ADDITIONAL INSURED prov¡s¡ons or be endorsed. <br />lf SUBROGATION lS WAIVED, subject to the terms and cond¡tions of the policy, certa¡n pol¡c¡es may require an endorsement. A statement on <br />th¡s cert¡f¡cate does not confer r¡ghts to the certificate holder in lieu of such endorsement(s). <br />fiXilf'' Meg Stanley <br />meg@mckayinsagency.com <br />(641) 828-2013(641) 842-2135 <br />INSURERIS) AFFORDING COVERAGE NAIC # <br />PRODUCER <br />McKay lnsuranceAgency, lnc. <br />106 East Main Street <br />P O Box 151 <br />Knoxville lA 50138 tNsuRERA : Evanston lnsurance Company 35378 <br />tNsuRER B . Gerber L¡fe lnsurance Company 70939 <br />INSURER C <br />INSURER D <br />INSURER E <br />Silent Sports Association-NBTS SE <br />Vìcious Cycle Events, lnc. <br />139 E. Street SW <br />Ephrata wA 98823 <br />INSURED <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. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO \AiI.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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOIVN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INSR <br />LTR TYPE OF INSURANCE INSD POLICY NUMBER <br />POLIGY EFF <br />IMM/DD/YYYYI IMM/DD/YYYYI LIMITS <br />A <br />COMM ERCIAL GENERAL LIABILITY <br />clArrrs-iirADE lX o."r" <br />lncludes Athletic Participants <br />LIMITAPPLIES PER: <br />5F3; l-1,o"POLICY <br />orHER. Event <br />N 36074H01 0099-1 06t16t2019 06117 t2019 <br />EACH OCCI.JRRFNCF s 1,000,000 <br />u tvt^þtr tuKtrtItÈu <br />PPFMIStrS f Fâ ô..,úrÞñ¡ô\$ 300,000 <br />ÀrED EXP lAnv onê oersonl , Excluded <br />PERSONAL&ADV INJURY s I,000,000 <br />GENERALAGGREGATE $ 2,000,000 <br />PRODUCTS - COMP/OPAGG $ 2,000,000 <br />$ <br />AUTOMOBILE LIABIUry <br />ANYAUTO <br />OWNED <br />AUTOS ONLY <br />HIRED <br />AUTOS ONLY <br />SCHEDULED <br />AUTOS <br />NON.O\ANED <br />AUTOS ONLY <br />$ <br />BODILY INJURY (Per person)$ <br />BODILY INJURY (Per accident)$ <br />$ <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAI¡J]S.MADE <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />DFD RETENTION $$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRI ETOR/PARTN ER/EXECUTIVE <br />OFFICER/MEIVBER EXCLUDED? <br />(Mandatory ¡n NH) <br />lf yes, describe under <br />DESCRIPTION OF OPERAïIONS below <br />N/A <br />PER <br />STATI ITF <br />urn- <br />FR <br />E.L, EACH ACCIDENT s <br />E.L, DISEASE - EA EMPLOYEE s <br />E.L. DISEASE. POLICY LIMIT I <br />B <br />Accident Medical <br />15-070944-18 06/1 6/201 I 0611712019 <br />Excess <br />Deductible $250 <br />$25,000 <br />DESCRIPTIONOFOPERATIONS/LOCATIONS/VEHICLES (ACORD101,Add¡tionalRemarksSchedule,maybeattached¡fmorespace¡srequ¡red) <br />GranFondoEllensburg: June16,2019. Kitt¡tasCounty,itsofficersandemployeesareanadditional insuredbutonlywithrespecttoliabilityar¡singoutofthe <br />operationsoftheabovenamedinsured. "Thispolicyisissued,pursuanttolowaCodesection5l5.l4T,byanonadmittedcompany¡nlowaandassuchis <br />not covered by the lowa lnsurance Guaranty Associat¡on." <br />HOLDER <br />@ 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE ÈXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVIS¡ONS. <br />wA 98926Ellensburg <br />Kittitas County <br />205 W Sth Ave <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2016/03)