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12/06/2006 wED 16: 45 FAX 209 468 6339 Dialysis Unit 0003/004 <br /> American Specialty 12/23/2005 12 :57 PM PAGE 2/002 Fax server <br /> CERTIFICATE OF INSURANCE 12123/2005 <br /> PRODUCER Brown&Brown Insurance of Georgia THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> 1117 Perime or Center West,#N-400 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Atlanta.GA.0338 HOLDER THIS CERTIFICATE DOES NOT AMEND,MEND,OR <br /> ALTER THE COVERAGE AFFORDED 9Y THE POLICY BELOW. <br /> INSURED INSURERS AFFORDING COVERAGE <br /> INS.A: :a la[ndernnity Insuraneff COMPAny <br /> USA Track&Field,Inc. INS.B: <br /> I RCA Dame,Suite 140 INS C'. <br /> Indianapolis,IN 46225.0120 <br /> LARRY FRANK CERT NUMBER:1000375367 <br /> 3808 FALMOUTH COURT EVENT CODE:06-38-006 <br /> STOCKTON,CA 95219 <br /> COVERAGES <br /> THIS I$TO CERTIFY THAT-HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE 189UED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITION OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INS INSURANCE POLICY POLICY <br /> LTR TYPE POt1CY NUMBER EFFECTIVE EXPIRATION LIMITS <br /> GL FrHPK1499A6 12!3112005 1=1/2006 an Occurrence 11000,000 <br /> - 100.000 <br /> A Damageto remises en o4 s <br /> (Any One remies <br /> 12:01 a.m. 12:01 a.m, a npense Limit(Any OnePerson) u <br /> Personal and a Sing injury <br /> Cuenerg AqqreqaW---F@-f ftled <br /> Froducts-Gompieted Upemborn Agwegata <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSI-MENT/SPECIAL PROVISIONS <br /> The Certificcalsholder is only an Additional Insured with respect to Wilily caused by the negligent acts or omissionlS of[he Named Insured as respects to the CALIFORNIA-10 on <br /> January 00,2006. <br /> Coverage applies to USA Tra:k&Fuld sanctioned overdo and regislered pracliccs,ncWng any directly rulalud OCkvlties,such as event set-up Arid leer-down,perdiripant check-in and <br /> award ceremorsea. <br /> CERTIFICATE HOLDER CANCELLATION <br /> COUNTY OF SAN JOAQUIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED <br /> ATTN;.JOHN WOFILA BF-FOrtl1THE EXPIRATION DATETHEREOF,THE ISSUING <br /> PO BOX 1810 COMPANY WILL ENDEAVOR YO MAIL 30 DAYS WRITTEN NOTICE <br /> 7n TI•IL-CERTIFICATE HOLDER,BUT FAILURE TO MAIL SUCH <br /> STOCKTON,CA 95201 NOTICE SHALL IMPOSE NO OL1I,ICATION OR LIABILITY OF ANY <br /> KIND UPON THE COMPANY,ITS ACCMTS OR REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br />