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HomeMy WebLinkAboutPW16-366 - Insurance Certificate - Kennedy/Jenks Consultants - Liabilty Coverage 10/01/2015-10/01/2016 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYYY) ... 10/1r2016 9d25/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 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 THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)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 certificate holder in lieu of such endorsement(s). CONTACT PRODUCER LOckton Comp anies NAME: 444 W.47th Street,Su1te 900 Kansas Cityy MO 64112-1906E-MAILNo,Ext: arc,No (816)960-90 -M E 00 ADDRESS: INSURER(S)AFFORDING COVERAGE N IC 9 INSURER,A: Zurich American Insurance Company 16535 INSURED KENNEDY/JENKS CONSULTANTS,INC. INSURER C.. Coin yton'Insurance C`om an 19437 1370659 303 SECOND STREET,SUITE 300 SOUTH SAN FRANCISCO CA 94107 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER, 12591 W REVISION NUMBER: XXXXXXX 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. INSR ADDL, SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIGDfYYYY MMIIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIAWLITY Y N 0.,05833581, I0/1f2015 1011/2016 EAC14OCCURRENCE 1 0O0,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea ocrurrence 1 0t)0,000 MEID EXP IAny oneperson) S 5.000 - PERSONAL&ADV INJURY $ 1,000,00() GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 2,000.01.10 POLICY]JECT LOC PRODUCTS-COMPIOP AGG S 2,000,000 OTHER S A. AUTOMOBILE LIABILITY 'Y Y 13AP9326879 10/l/2015 IWI/2016 OMBIaEeDtSINGLELIMII' S I.,000.000 X ANY AUTO BODILY INJURY(Per person) $ XXXXX XX X A i.OSWNED AUTHrCDULED BODILY INJURY(Per accident. S .X:XXXXXX NOWOWNIEO PROPERTY DAMAGE $ XXXXXXX X HIRED AUTOSX AUTOS Per accident 1 S XX.I"S.xxxx. UMBRELLA LIAR OCCUR EACH'OCCURRENCE $ XxxxxxX EXCESS LIAR CLAIMS-MADE NOT APPLICABLE AGGREGATE S X:XXXXXX DED I I RETENTION S S A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY N WC.9326878 I0i I/2015 10/1/2016 X AND OTH- ANY PRC)PRIETORFPARPNERFFXEt:llTIVk� NIA E.l.EACH ACOCENT s 1 r000 000 I. OFFICERIMEMBER EXCLUDEra7 N (Mandatary iA NHI ❑ E.l,DISEASE..EA EMPLOYEE. s 1,()00,000 ARIPTI{3M OF OPERATIONS Eeian mm......� E L..DISEASE-POLICY LIMIT' 1,000,000' 13 i i��r lllSSIONAL N N 02615-1151 10/1/2015 10/102016 $1,000,000 PER CLAIM $1,000,000 ANNUAL AfiGR EG A"i'I'.'. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,may be attached'if more space is required) C13"Y OF KFN"l IS AN ADDITIONAL INNt.R EID WITH RESIIEC l"1 O UE.NFRAI.AND ALITO LIABIL1.9'Y„ WHERE' REQUIRED 13Y WRITJ-1 N CONTRACT. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, 259 1868 AUTHORIZED REPRESENTATIVE CITY OF KENT ATTN:ENGINEERING DEPT. 220-4TH AVENUE SOUTH KENT WA 98023-0000 ACORD 25(2014/01) Q1 8-201+4 ACORD CORPORATION,All rights reserved The ACORD name and logo are registered marks of ACORD ,a� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD ton/zot6 9/25/2015 15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 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 THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. 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 certificate holder in lieu of such endorsement(s). PRODUCER Lockton Com anies NAME: NTACT FAX 444 W.47th Street,Suite 900 Arc No EXt: A/C No): Kansas Cityy MO 64112-1906 E-MAIL (816)960-9000ADDRESS: INSURER(Sl AFFORDING COVERAGE NAIC# INSURER A: Zurich American Insurance Company 16535 INSURED KENNEDYIJENKS CONSULTANTS,INC. INSURER B: Lexington Insurance Cowarly 19437 1357983 303 SECOND STREET,SUITE 300 SOUTH INSURER C: SAN FRANCISCO CA 94107 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 11997945 REVISION NUMBER: XXXXXXX 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. INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDpIYYYY (MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY Y N GL05833581 10/1/2015 10/1/2016 EACH OCCURRENCE S 1,000,000 CLAIMS-MADE D OCCUR PREMISES Ea occurrence 1,000,000 MED EXP(Any oneperson) 5 000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 RPOLICY JEC LOC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER $ AUTOMOBILE LIABILITY EO acBIN cid.D SINGLE LIMIT S XXXXXXX ANY AUTO NOT APPLICABLE BODILY INJURY(Per person) $ XXXXXXX AUT OWNED AUTOSULEO BODILY INJURY(Per accident $ XXXXXXX HIRED AUTOS AUTOS NED PROPERTYr cc tDAMAGE $ XXXXXXX $ UMBRELLA LIAR OCCUR EACH OCCURRENCE S }{}{}{} xxx EXCESS LIAB CLA[MS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ANY PROPRIETORMARTNER/EXECUTIVE NIA NOT APPLICABLE OFFICER/MEMBER EXCLUDEl E.L-EACH ACCIDENT $ XXXXXXXED? (M yyandatory In NH) E.L.DISEASE-EA EMPLOYEE XXXXXXX DESCRION OF rPERATIONS below E.L.DISEASE-POLICY LIMIT t XXXXXXX B PROFESSIONAL N N 026154151 10/1/2015 10/1/2016 $1,000,000 PER CLAIM LIABILITY $1,000,000 ANNUAL AGGREGATE DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CITY OF KENT IS AN ADDITIONAL INSURED WITH RESPECT TO GENERAL LIABILITY,WHERE REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION See Attachment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11997945 AUTHORIZED REPRESENTATIVE CITY OF KENT ATTN:ENGINEERING DEPT. 220-4TH AVENUE SOUTH KENT WA 98023-0000 ACORD 25(2014101) 01 8-2014 ACORD CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLO5833581 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location(s) Of Covered Operations Or Organ ization s : WHERE REQUIRED BY WRITTEN CONTRACT, THE CITY& COUNTY OF HONOLULU. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A.Section 11 -Who Is An Insured is amended to This insurance does not apply to"bodily injury"or include as an additional insured the person(s)or "property damage"occurring after: organization(s)shown in the Schedule, but only with respect to liability for"bodily injury", "property damage" 1.All work, including materials, parts or equipment or"personal and advertising injury"caused, in whole or furnished in connection with such work,on the in part, by: project(other than service, maintenance or repairs)to be performed by or on behalf of the additional 1.Your acts or omissions; or insured(s)at the location of the covered operations has been completed;or 2.The acts or omissions of those acting on your behalf; 2.That portion of"your work"out of which the injury or damage arises has been put to its intended use by any in the performance of your ongoing operations for the person or organization other than another contractor or additional insured(s)at the location(s)designated subcontractor engaged in performing operations for a above. principal as a part of the same project. B.With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: CG 20 10 07 04 © ISO Properties, Inc., 2004 Attachment Code:D480788 Certificate ID : 11997945