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Home My WebLink AboutPA Service Requested and Ins.Mandy Buchholz From: no- rep ly_Service Requests@co.kittitasma.us Sent: Thursday, July 06, 2017 9:05 AM To: Mandy Buchholz Subject: 39984 1 New PAO Request I Special Event Application WestStar Ranch Mandy Buchholz, Thank you for submitting a request. A copy is displayed below. As we continue to work on your request you will receive additional notifications. Please review the issue fields as they may contain a request for something necessary to continue working on the request. Note: This email was sent from an unmonitored account. Please do not reply to this email. To respond, please update your service request on CAMAS using the link below. Request #39984 - Special Event Application WestStar Ranch Initial request: Good Morning Chris! Ins., should be here ANY DAY. Our office received a Special Event application from Scott & Jo Repp, to host the WestStar Open Roping to be held on Wednesday August 30, 2017. 1 plan to place this request on the August 1, 2017 Agenda for the Boards consideration. Please submit your departments recommendations to me no later than July 20, 2017. If there are still outstanding issues, please indicate those in writing as well. For specific questions regarding the event I would ask that you contact the applicant directly. Again, thank you and have a great rest of your week! Status: Open Priority: Soon Update or cancel your request Notice: Email sent to Kittitas County may be subject to public disclosure as required by law DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 7/6/2017 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 holder is an ADDITIONAL INSURED, the policy(ies) 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). PRODUCER CONTA T Leigh Ann Reed NAyIE; Allen Financial Insurance GroupPHONE (602) 992-1570 FAX (602)992-8327 A[C� No, Exll:- Not The Equestrian Group E nAl _leighann@eggroup.com 12424 N. 32nd St., Suite 101 INSURERS AFFORDING COVERAGE NAIC# Phoenix AZ 85032 INSURERA_Capitol Indemnity Coore ration 10328 INSURED INSURER American Cowboy Team Roping Association INsuRERc: 4710 William Avenue _WSURER D: (Winnemucca NV 89445 1inumIF: I n�,..cMA =e rcorIrrrATC KII IIURCD:`T.T 77437n25 RFVISInN NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSUP�NCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ LTR TYPE OF INSURANCE IINSOC�7DL' VLiVn � POLICY NUMBER PO CD)YYYY iMfI7grYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 -EBENX _ nc $ 100,000 A CLAIMS -MADE LX I OCCUR-1DAMAGETO MED EXP (Any one person) S 5,000 PR02466555 12/1/2016 12/1/2017 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG S 2,000,000 X ❑ ARUM POLICY (ECT LOC $ -- OTHER. AUTOMOBILE LIABILITY CO J3IN n13 SINGLE $ BODILY INJURY (Per person) $ _.... _ ANY AUTO ALL OWNED SCHEDULED _ AUTOS AUTOS NON -OWNED HIRED AUTOS I AUTOS BODILY INJURY (Per accident) $ PR OAMAGE $ -iP ' E 1 UMBRELLA LIAR OCCUR EACH OCCURRENCE S AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? Ll (Mandatory In NH) N / A E T -1- STATUTE ER EACH ACCIDENT _ $ _ E L DISEASE - EA EMPLOYE $ Res, d iscrir,e under DESCRY I ION OF OPERATIONS below JE.L. DISEASE -POLICY LIMIT $ I { DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The Certificate Holder is hereby added as additional insured but only in respect to the liability that arises out of the named insured's activities or operations. ACTRA Public Event on 8/30/17 - WestStar Roping CE_RTI€=IGATE MOLDER LArt LLLLR I IV F4 Xittit.aB County Events Center 512 N Poplar St Ellensburg, WA, 98926 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Leighann Reed/AGG1 � 3- 071988-2014 AGORD CORPORATION. All rlgnts reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD I NS025 nm am 1