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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 holier is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on <br /> this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). <br /> PROBER NAME–* <br /> Margaret Mayers <br /> Insurance Management Group PHONE <br /> Ext_ (260)338-2925 (765)664-0761 <br /> 12730 Coldwater Roaders <br /> ADDRESS: mma msmloom Y @- 9 <br /> Suite 103 <br /> INSURER(S)AFFWMDING COVERAGE NAIC aY <br /> Fort Wayne IN 46845 WSURERA_ National Casualty Company 11991 <br /> INSURED RNSuwR g.. Nationwide Life Insuranoe Company 66869 <br /> Road Runners Club of Amedca12021 and its Member Clubs INSURER C <br /> 1501 Lee Highway <br /> INSURER D <br /> Suite 140 INSURER E: <br /> Arlington VA 22209 INSURER F. <br /> COVERAGES CERTIFICATE NUMBER: 2021$1M A.I. REVISION NUMBER. <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 WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_ <br /> LTR TYPE OF DURANCE (NSD WYD POLICY NUMBER POSY POLICY EXP <br /> LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000.000 <br /> C:I.AIMSMADE ®OCCUR PREMISES Ea accaere— $ 500,000 <br /> Legal Liability to MED EXP(Any one person) $ 5,000 <br /> A Participant$1,000,000 KRB 12/31/2020 12131!2()21 PERSONAL&AoV INJURY $ 1,000,000 <br /> CEMLAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 5,000,000 <br /> POLICY F-1 PR <br /> JECT F-1 LOC PRODUCTS-COMP/OPAGG S 1,000,000 <br /> OTHER- Per Event Basis Abuse and Molestation $ 500,000 <br /> AUTOMOBILE IJABILITY COMIED SINGLE LIMIT $ 1.000,000 <br /> ANYAUTO BODILY INJURY(Per person) $ <br /> A OWNED <br /> Y SCHEDULED KROOODO008622000 12131/2020 12131/2021 swtLYINimyweraaIdent) s <br /> AUTOS ONLAUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY AUTOS ONLY er accident $ <br /> $ <br /> UMBRELLA UAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR HCLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LWBILITY YIN STATUTE ER <br /> ANY PROPRIETOWPARTNERIEXECUTNE <br /> ElNIA E.L.EACH ACCIDENT $ <br /> OFFlCERfifEMBER EXCLUDED? <br /> (Mandatary in W E.L DISEASE-EA EMPLOYEE $ <br /> N yes.describe under <br /> DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ <br /> Excess Medical&Accident Excess Medical $10,000 <br /> B ($250 DeducliblelClaim) BAXOM31541900 12131/2024 12/3112021 AD&Specific Loss $2,500 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 181,Addtimral Remarks Schaduls,may be attached if mom space is required) <br /> CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED AS RESPECTS TO THEIR INTEREST IN THE OPERATIONS OF THE NAMED <br /> INSURED. DATE OF EVENT(St IWMI 32nd Annual Shoreline Classic INSURED RRCA CLUB/EVENT MEMBER: Decatur Running Club,Attn: <br /> John Pranschke,PO Bax 3397,Decatur,IL 62524 <br /> Processed by MMM <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> 09/19/21 City of Decatur ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 1 Gary K <br /> A <br /> Anderson Plaza <br /> Decatur <br /> Decatur IL 62523 Ahauf <br />