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HomeMy WebLinkAboutCert. of Liability Ins.DATE (MMIDDIYYYY) AC�RU® CERTIFICATE OF LIABILITY INSURANCE 2/17/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holdor is an ADDITIONAL INSURED, the pDlicOes) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). cornCr g PRODUCER NA"'" Mar aret Mayers _ ...- PHONE (260)467-5689 ...1F..(z6o)467-5691 - S7 Insurance - Fort Wayne Office (HI�,.Na, Factl: -rat - Wrau marg-rat. mayers8starfinancial.com 2130 East Dupont Road asllsFrEss:.w . r.,Qe.ne i NA)C u Fort Wayno IN 46825 INSURER A National Casual INSURED INSUF,r,fd R Nat..3.OnwIde Life Road Runners Club of America/2017 and Its IH9ilHER c Member Clubs °' 1501 Lee Highway, Suite 140 IlrSt)RE�E=-. - Arlington VA 22209 INSURERF_ REVISION NUMBER: COVERAGES CERTIFICATE NUMBER2017 $2M A. I. TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES CERTIFICATE POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _. J EXCLUSIONS AND CONDITIONS OF SUCH I'DUCY EFF 1?OLICY EXP LIMITS lHSft TYPE OF INSURANCE POLICY h1U1ABElt MMJDDlYV 1,0410D+xYYY 2,000,000 LSF EACHOGGIiRRf_TECE. S X COMMERCIAL GENERAL LIABILITY i;'I(AfAG�1 $ 500,000 1 CLAIMS -MADE ❑X OCCUR "E}$4a4J 5,000 A -_ KR00000006655400 12/31/2016 12/31/2017 MED EXP One parson) ,1 _ 3L 14egaI 7,iabil3U[ is 12 : 01 AM 12: 01 AM PVI SpNAL & ADV INJURY S 2 , 0001000 pa=w* G2 OQ�Oy QOb f ^ GENERAL AGGREGATE $ Unlimited ._ GENT AGGREGATE LIMIT APPLIES PER: ❑ Abuse & Molestation X LOC PRODUCTS-COMPIOP AGG $ 2 , 000 , 0 00 500 000 POLICY Agrgregal_5 $5,000,000 O ERI Abuse and Molestabon {7 $IN LE $ $ , 2,000,000 � 1 � AUTOMOBILE LIABILITY _ BODILY INJURY (Per person) E A _ ANY AUTO _ 112/31/2016 12/31/2017 BODILY INJURY (pGracadeM) 8 ALL OWNED SCHEDULED gR00000006655400 AUTOS PROPERTY DAM�E $ AUTOS _ X NON -OWNED 12:01 AM 12:01 AMBO_....... X HIRED AUTOS AUTOS E EAC pC(x1pRENGE $ UMBRELLA LIAR OCCUR-T�� AGGREGATE $ -_... .............—.. EXCESS LIAR CLAIMS -MADE .....,--- -.... --.. $ DED RETENTION$ wGRKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN E L EACH ACCIDENT _ S ANY YROPHlFJ0R)PARI'NCPJEKC.C,UTIVE j .._i NIA OFFICERIML=MBER EXCLUDED? ` 1 E L- DISEASE - EA EMPLOYE $ (Mandatary in NH) If yds, describe under DES E.L DISEASE - POLICY UMI i $ B Medical & Accident SPX000002788960 12/31/2016 12/31/2017 ExcessMedical $10,000 $2,500 IExcess 12.01 AM 12:01 AM AD & Specific Loss ($250 Deductible/Claim) DESCRIPTION OF OPERATIONS' LOCATIONS+ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) NAMED AS AN ADDITIONAL INSURED AS RESPECTS THEIR INTEREST IN THE OPERATIONS OF THE CERTIFICATE HOLDER IS 04/01/17 Yakima River Canyon Marthon and Half Marathon INSURED NAMED INSURED. DATE OF EVENT(S): Core Running Club, Att'n: Lenora Dolphin, PO Box 1511, Yakima, WA 98907 RRCA CLUB/EVENT MEMBER: Hard .TE CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 0401/17 Kittitas County THE EXPIRATION DATE fHERI QF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 205 W. 5th ROOM 108 AUTHORIZED REPRESENTATIVE Ellensburg, WA 98926 Terry Diller/MMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 r20T4on