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DATE (MMIDDIYYYY) <br />AC�RU® CERTIFICATE OF LIABILITY INSURANCE 2/17/2017 <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: If the certificate holdor is an ADDITIONAL INSURED, the pDlicOes) must be endorsed. If SUBROGATION IS 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). cornCr g <br />PRODUCER NA"'" Mar aret Mayers _ ...- <br />PHONE (260)467-5689 ...1F..(z6o)467-5691 - <br />S7 Insurance - Fort Wayne Office (HI�,.Na, Factl: -rat - <br />Wrau marg-rat. mayers8starfinancial.com <br />2130 East Dupont Road asllsFrEss:.w <br />. r.,Qe.ne i NA)C u <br />Fort Wayno IN 46825 INSURER A National Casual <br />INSURED INSUF,r,fd R Nat..3.OnwIde Life <br />Road Runners Club of America/2017 and Its IH9ilHER c <br />Member Clubs °' <br />1501 Lee Highway, Suite 140 <br />IlrSt)RE�E=-. <br />- <br />Arlington VA 22209 <br />INSURERF_ <br />REVISION NUMBER: <br />COVERAGES CERTIFICATE NUMBER2017 $2M A. I. <br />TO THE INSURED NAMED ABOVE FOR THE POLICY <br />PERIOD <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED <br />OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT <br />DESCRIBED HEREIN IS SUBJECT TO ALL <br />THE TERMS, <br />MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES <br />CERTIFICATE <br />POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />_. J <br />EXCLUSIONS AND CONDITIONS OF SUCH <br />I'DUCY EFF <br />1?OLICY EXP LIMITS <br />lHSft TYPE OF INSURANCE POLICY h1U1ABElt <br />MMJDDlYV <br />1,0410D+xYYY <br />2,000,000 <br />LSF <br />EACHOGGIiRRf_TECE. <br />S <br />X COMMERCIAL GENERAL LIABILITY <br />i;'I(AfAG�1 <br />$ <br />500,000 <br />1 CLAIMS -MADE ❑X OCCUR <br />"E}$4a4J <br />5,000 <br />A -_ <br />KR00000006655400 <br />12/31/2016 <br />12/31/2017 MED EXP One parson) <br />,1 <br />_ <br />3L <br />14egaI 7,iabil3U[ is <br />12 : 01 AM <br />12: 01 AM PVI SpNAL & ADV INJURY <br />S <br />2 , 0001000 <br />pa=w* G2 OQ�Oy QOb <br />f ^ <br />GENERAL AGGREGATE <br />$ <br />Unlimited <br />._ <br />GENT AGGREGATE LIMIT APPLIES PER: <br />❑ Abuse & Molestation <br />X LOC <br />PRODUCTS-COMPIOP AGG <br />$ <br />2 , 000 , 0 00 <br />500 000 <br />POLICY <br />Agrgregal_5 $5,000,000 <br />O ERI <br />Abuse and Molestabon <br />{7 $IN LE <br />$ <br />$ <br />, <br />2,000,000 <br />� 1 � <br />AUTOMOBILE LIABILITY <br />_ <br />BODILY INJURY (Per person) <br />E <br />A _ <br />ANY AUTO _ <br />112/31/2016 12/31/2017 BODILY INJURY (pGracadeM) <br />8 <br />ALL OWNED <br />SCHEDULED gR00000006655400 <br />AUTOS PROPERTY DAM�E <br />$ <br />AUTOS <br />_ <br />X <br />NON -OWNED <br />12:01 AM 12:01 AMBO_....... <br />X <br />HIRED AUTOS <br />AUTOS <br />E <br />EAC pC(x1pRENGE <br />$ <br />UMBRELLA LIAR OCCUR-T�� <br />AGGREGATE <br />$ <br />-_... <br />.............—.. <br />EXCESS LIAR CLAIMS -MADE <br />.....,--- -.... --.. <br />$ <br />DED RETENTION$ <br />wGRKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />E L EACH ACCIDENT _ <br />S <br />ANY YROPHlFJ0R)PARI'NCPJEKC.C,UTIVE j .._i NIA <br />OFFICERIML=MBER EXCLUDED? ` 1 <br />E L- DISEASE - EA EMPLOYE <br />$ <br />(Mandatary in NH) <br />If yds, describe under <br />DES <br />E.L DISEASE - POLICY UMI i <br />$ <br />B Medical & Accident SPX000002788960 <br />12/31/2016 <br />12/31/2017 ExcessMedical <br />$10,000 <br />$2,500 <br />IExcess <br />12.01 AM <br />12:01 AM AD & Specific Loss <br />($250 Deductible/Claim) <br />DESCRIPTION OF OPERATIONS' LOCATIONS+ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) <br />NAMED AS AN ADDITIONAL INSURED AS RESPECTS THEIR INTEREST IN THE OPERATIONS OF THE <br />CERTIFICATE HOLDER IS <br />04/01/17 Yakima River Canyon Marthon and Half Marathon <br />INSURED <br />NAMED INSURED. DATE OF EVENT(S): <br />Core Running Club, Att'n: Lenora Dolphin, PO Box 1511, Yakima, <br />WA 98907 <br />RRCA CLUB/EVENT MEMBER: Hard <br />.TE <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />0401/17 Kittitas County THE EXPIRATION DATE fHERI QF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />205 W. 5th <br />ROOM 108 AUTHORIZED REPRESENTATIVE <br />Ellensburg, WA 98926 <br />Terry Diller/MMA <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />INS025 r20T4on <br />