HomeMy WebLinkAboutLW15-177 - Insurance Certificate - Kent School District - Certificate of Insurance - 09/01/2014 KBntSD165
Schools Insurance Association of Washington
CERTIFICATE OF INSURANCE Issue Date: 07/09/2015
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES
NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE MEMORANDUM OF COVERAGE(MOC)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 cerlillcate[,doer is an ADDITIONAL INSURED.the MOC must be endorsetl. a SUBROGAI ION IS WAIVED,subject to the terms and conditions of the MOG.oadain coverage may
require an endorsement. Astatement on this ce,6geate does net writer rights to the wnificate holdar in lieu cfsuch endorsement s'.
PRODUCER COMPANIES AFFORDING COVERAGE
Clear Risk Solutions GENERAL LIABILITY
SAW/Munich Re
451 Diamond Drive Torus Specialty Insurance Company
Ephrata, WA 98823 AUTOMOBILE LIABILITY
Phone 509-754-2027 Fax 509-754-3406 SIAW/Munich Re
Torus Specialty Insurance Company
INSURED PROPERTY
Kent School District#415 SIAW/Munich Re,of al.
12033 SE 256th Street D-700
Kent, WA 98031-6643 CRIME I PUBLIC EMPLOYEE DISHONESTY
SIAW/Munich Re
COVERAGES
THIS IS TO CERTIFY THAf THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTI IE COVERAGE PERIOD INDICATED,NOTWITHSTANDING ANY
RFQUIREMFM,TERM OR CONDITION OF CONTRACT OROTHER OCCUMENT WITH RESPECTTO WIL CHTHIS CERTIFICATE MAY BE ISSUED OR MAYPERTAJN.THE INSURANCEAFFORDED BYTHE
MOO DESCRIBED HEREIN IS SUBJECT TOALL THETERMS,EXCLUSIONS AND CONDRIONS OF SUCH MOO.UMITS SHOWNMAY HNVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE MOC NUMBER MOC EFF MOC EXP DESCRIPTION LIMITS
DATE DATE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY SIAW141534025 09/01/2014 09/01/2015 GENERAL AGGREGATE $31,000,000
OCCURRENCE FORM PRODUCT-COMP/OP ASS $31,000,000
PERSONAL&ADV,INJURY $25.000,000
EACH OCCURRENCE $25.000,000
LIABILITY IS SUBJECT TO A 100,000 SIR PAYABLE FROM PROGRAM FUNDS ANNUAL PROGRAM AGGREGATE $150,000,000
AUTOMOBILE LIABILITY
ANY AUTO SIAW141534025 09/01/2014 09/01/2015 COMBINED SINGLE LIMIT $25,000,000
LIABILITY IS SUBJECT TO A 100,000 SIR PAYABLE FROM PROGRAM FUNDS ANNUAL PROGRAM AGGREGATE NONE
PROPERTY
SIAW141534025 09/01/2014 09/01/2015 ALL RISK PER OCC EXCL EQ&FL $150,000,000
EARTHQUAKE PER OCC EXCLUDED
FLOOD PER OGG(Lx-,IFZA&V,,MIeh..t S1MM) EXCLUDED
PROPERTY IS SUBJECT TO Aue.001 SIR PAYABLE FROM PROGRAM FUNDS ANNUAL PROGRAM AGGREGATE NONE
CRIMEIPUBLIC EMPLOYEE DISHONESTY
CRIME st)�ECTTOA$250 too`Ra4t Msln SIAW141534025 09YO112014 09/01/2015 PER LOSS $1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I SPECIAL ITEMS
Regarding participation in parade. City of Kent, Kent Cornucopia Days,and Kent Lions Club&Foundation are named as
Additiona Insured regarding this event only and is subject to coverage terms,conditions,and exclusions. Additional Insured
endorsement Is attached.
CANCELLATION '..
SHOULD ANY OF THE ABOVE DESCRIBED COVERAGE BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE PROVISIONS OF THE MOC.
CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE
City of Kent I(1 II/�/ C1YY11Q��
220 Fourth Ave S
Kent, WA 98032
2986995
I
ADDITIONAL INSURED ENDORSEMENT
THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE
FOLLOWING:
GENERAL LIABILITY COVERAGE PART
How Coverage is Changed
It is agreed that the interest of any Additional Insured is recognized as their
interests may appear, providing the certificate of insurance that this is
attached to has been issued and is on file with the Company.
The Limits of Insurance applicable to the additional Insured are those
specified in either the:
1. Written contract or written agreement; or
2. Declarations for this policy,whichever is less.
These Limits of Insurance are inclusive and not in addition to the Limits of
Insurance shown in the Declarations.
Additional Insured:
City of Kent
220 Fourth Ave S
Kent,wA 98032
Regarding participation in parade. City of Kent, Kent Cornucopia Days,and Kent Lions Club&Foundation are named as
Additional Insured regarding this event only and is subject to coverage terms,conditions,and exclusions. Additional Insured
endorsement is attached.
Other terms:
All other terms of your Memorandum of Coverage remain the same.
2986996