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DATE(MMIDDIYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 01/07/13 <br /> PRODUCER HCM Insurance Brokers THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 1407 Foothill Blvd 1=228 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR <br /> La Verne,CA 91750 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Phone (866)866-7090 Fax (866)496-5968 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED Federation of Independent Assn for Cycling INSURER A: Lexington Insurance Company <br /> INSURER B_ Houston Casualty Company <br /> and American Bicycle Racing INSURER C: <br /> P.O. Box 487 INSURER D: <br /> Tinley Park. IL 60477-0487 INSURER E: <br /> COVERAGES INSURER F: <br /> THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> LTR INSRD DATE(MM/DD)YY) DATE(MWDDIYY) <br /> GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br /> V COMMERCIAL GENERAL LIABILITYDAMAGE TO RENTED <br /> 075-715813 01101113 01/01/14 PREMISES(Ea occurence) $300,000 <br /> MED EXP(Any one person) <br /> CLAIMS MADE d OCCUR --- - -- - - <br /> A PERSONAL&ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1,000,000 <br /> POLICY PROJECT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 <br /> ANY AUTO 075-715813 01/01/13 01/01/14 (Ea accident) <br /> ALL OWNED AUTOS <br /> BODILY INJURY <br /> A SCHEDULED AUTOS (Per person) <br /> V HIRED AUTOS BODILY INJURY <br /> J NON OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT <br /> ANY AUTO OTHER THAN EA ACC <br /> AUTO ONLY: AGG <br /> EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE <br /> OCCUR CLAIMS MADE AGGREGATE <br /> DEDUCTIBLE <br /> RETENTION $ <br /> WORKERS COMPENSATION AND WC STATU- OTH- <br /> EMPLOYERS'LIABILITY TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT <br /> OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE <br /> If yes,describe under <br /> SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT <br /> OTHER <br /> B EXCESS MEDICAL 13/7002371 01/01/13 01/01/14 PER PERSON $10.000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> Additional named insured: P.A.C.E.R.S. <br /> Event: Woodbridge Road TT <br /> Event Date, March 23, 2013 <br /> Certificate holder is named as additional insured. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> The County of San Joaquin, 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO <br /> State of California THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY <br /> 1810 E. Hazelton Ave. OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. <br /> Stockton,CA 95201 AUTHORIZED REPRESENTATIVE <br /> ACORD 26(2001/08)QF O ACORD CORPORATION 1988 <br />