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HomeMy WebLinkAboutPW14-052 - Insurance Certificate - Environmental Science Associates - 01/01/2015 - 01/01/2016 Liability Coverage - 01/06/2015 rii a_.7 3 E DATE(MM(OD(YWY) A CERTIFICATE OF LIABILITY INSURANCE 1/6/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UP `- H 1 CATE 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- T1�E� ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. t.. f / r) C`Q IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must 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 j certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME: Valerie Porter-Browne _ Woodruff-Sawyer C PHONE 415-391-2141 FAX e,415-989-9923 50 California Street, Floor or 12 E-MAIL San Francisco CA 94111 ADDRESSwporter-Browne@wsandco.com INSURER(S)AFFORDING COVERAGE ' NAIC H INSURERA:Greenwich Insurance Comp By 22322 !, INSURED ENVISCI-01 INSURER B.XL Specialty Insurance Company ,37885 ' Environmental Science Associates INSURERC: 550 Kearny Street, Ste 800 San Francisco CA 94108 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1398331775 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, ILTRi TYPE OF INSURANCE INSD WVD� POLICY NUMBER MM/ODFiOuCJ1'YYY MMDD/1RYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y iGEC001336712 1/112015 1/l/2016 EACH OCCURRENCE '$1,000,000 5AWAED CLAIMS-MADE ❑X OCCUR PREMISES Ea=um .. PREMISES{RENT rcence} $1,000,000 X Contractual Liab MED EXP(Any One person} $10,00t1 X Stop Gap _ PERSONAL_&ADV INJURY $1,000,000 GENT.AGGREGATE LIMIT APPLIES PER. '.. GENERAL AGGREGATE $2,000,000 POLICY n jE(° LOC PRODUCTS-COMPfOR AGG $2,000,000..._ X OTHER: No Deductible $ B AUTOMOBILE LIABILITY 1/l/2015 '1111201fi (Ea acrntleot}I GLIMIT $1,000,000 AEC001336512 ALL AUTOOWNS BODILY INJURY(Per person) $ --- AUTOS OWNED AUTOSULED BODILY INJURY(Par accident) $ NON I PRPEPERT-YbAMAGP X HIRED AUTO B X AUTOS Per accident)_ _ $ X No Ded. -_.. $ A X UMBRELLA LIAR X OCCUR UEC001336612 111/2015 1/1/2016 EACH OCCURRENCE $1,000,WO EXCESS LIAB CLAIMSMADE AGGREGATE $1,000,000 DED I RETENTION$ $ B WORKERS COMPENSATION WECO01337412 /l/2015 1/1/2016 ! X STATUTE OE TL AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y(❑N E.L. ACH ACCIDENT $1,000,000 R/OFFICEMEMBER EXCLUDED? NIA -- (MandatorylnNH) EL DISEASE EA EMPLOYEE $1,000,000 If yes,describe order DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $1,000,000 A Professional Liability ',PECO01336812 1/1/2015 1/l/2016 '..Each Occurrence: $1,000,000 Cov.A.Claims Made ' iAggregate: $2,000,000 Retra Date:10/1189 Retention: $100,000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ' D209696; Kent Meridian Banks Variance. City of Kent is named additional insured perform XIL 2010 07 04(ED.0413)and XIL 2037 07 03 (ED. 0413)attached. I i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Kent ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Kim Kamoto 220 Fourth Avenue South AUTHORIZED REPRESENTATIVE Kent WA 98032 i�oJt>tiit� G-�C/�- Cd`t�mE1 @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ENDORSEMENT#007 This endorsement, effective 12:01 a.m., January 1, 2015 forms a part of Policy No. GEC001336712 issued to ENVIRONMENTAL SCIENCE ASSOCIATES by Greenwich Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. I i ADDITIONAL INSURED—OWNERS, LESSEES OR CONTRACTORS— SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name Of Additional Insured Location(s)Of Covered Operations Persons Or Or anlzation s ; ANY PERSON OR ORGANIZATION THAT YOU Various REQUIRED IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT TO INCLUDE AS AN ADDITIONAL INSURED PROVIDED THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS SUBSEQUENT TO THE EXECUTION OF THE WRITTEN CONTRACT OR WRITTEN AGREEMENT. Information required to complete this Schedule if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or"personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply This insurance does not apply to"bodily injury" or"property damage"occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insureds)at the location of the covered operations has been completed; or I XIL 2010-0704 (Ed. 0413) a 2013, XL America, Inc. Page 1 of 2 All rights reserved. May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission i 2. That portion of "your work" out of which the injury or damage arises has been put to Its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. All other terms and conditions of this policy remain unchanged. i II I i I I i XIL 2010-0704 (Ed. 0413) ©2013, XL America, Inc. Page 2 of 2 j All rights reserved. May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission I i I ENDORSEMENT#005 This endorsement, effective 12:01 a.m., ]anuary 1, 2015 forms a part of Policy No, GECO01336712 Issued to ENVIRONMENTAL SCIENCE ASSOCIATES by Greenwich Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED—OWNERS, LESSEES OR CONTRACTORS—COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name Of Additional insured Location And Description Of Completed Operations Persons Or Organize n s : ANY PERSON OR ORGANIZATION THAT YOU ARE Various REQUIRED IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT TO INCLUDE AS AN ADDITIONAL INSURED PROVIDED THE"BODILY INJURY" OR "PROPERTY DAMAGE"OCCURS SUBSEQUENT TO THE EXECUTION OF THE WRITTEN CONTRACTOR WRITTEN AGREEMENT. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for"bodily injury" or"property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". All other terms and conditions of this policy remain unchanged. XIL 2037-0703 (Ed. 0413) 0 2013, XL America, Inc. Page 1 of 1 All rights reserved. May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission