SCFOA HALL of Fame Cruzin to Colby Car Show 3/25/2022

1 ® DATE(MM/DD/YYYY) A o CERTIFICATE OF LIABILITY INSURANCE 12/22/2021 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 have ADDITIONAL INSURED provisions or 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 CONTACT NAME: American Specialty Insurance&Risk Services, Inc. c g I(A/C,No): E-MAIL ADDRESS: 7609 W.Jefferson Blvd.,Suite 100 INSURER( )AFFORDING COVERAGE NAIC#__ Fort Wayne IN 46804 INSURER A: Arch Insurance Company 11150 INSURED INSURER B: National Association of Sports Officials(NASO) INSURER C: 2017 Lathrop Avenue INSURER D: INSURER E: Racine WI 53405 INSURER F: COVERAGES CERTIFICATE NUMBER: 1001941025 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE 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. INSR' ADDLT7SUBR POLICY EFF I POLICY EXP LIMITS LTR I TYPE OF INSURANCE INSD I INVD (Y POLICY NUMBER (MMIDDYYY)I(MMIDONYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I$ 1,000,000 DAMACETO RENTED $ 11000,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) I MED EXP(Any one person) $ Excluded A Y SBCGL0744103 08/01/2021 08/01/2022 p PERSONAL 8,ADV INJURY ,$ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000 PRO- POLICY JECT LOG PRODUCTS-COMP/OP AGG $ 5,000,000 __ X OTHER: OTHER $ AUTOMOBILE LIABILITY '+i OMBIINdEDtSINGLELIMIT $ ANY AUTO i BODILY INJURY(Per person) $ OWNED SCHEDULED i BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS "' HIRED NON-OWNED PROPERTY DAMAGE $ �_ AUTOS ONLY AUTOS ONLY (Per accident) $ s UMBRELLA LIAB OCCUR EACH OCCURRENCE $ I EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION I PER STATUTE I ER i AND EMPLOYERS'LIABILITY Y/N i ;ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICERJMEMBEREXCLUDED7 I(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under I DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) -Coverage applies to SNOHOMISH COUNTY FOOTBALL OFFICIALS ASSOCIATION,209 158TH ST NW,ARLINGTON,WA 98223. -The Certificate Holder shall be an Additional Insured, but only with respect to the operations of the Named Insured,and subject to the provisions and limitations of Form CG 2026 Additional Insured- Designated Person or Organization,but only with respect to CAR SHOW FUNDRAISER from May 28,2022 through May 30,2022. CERTIFICATE HOLDER CANCELLATION City of Everett,its officials,officers,employees,agents,and volunteers 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 ��✓v V y'1 1) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD