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HomeMy WebLinkAboutCAG2019-143 - Insurance Certificate - KC Sexual Assault Resource Center - Liability Coverage - 09/30/2018 KINGC-6 `4 f217 CERTIFICATE OF LIABILITY INSURANCE DATE n419'7/2018 V} p9r271ap1 s 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement an this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER 425-885-2283 j�%JAcT Myra Schnarr Redmond General Insurance Agcy I PHONE 425-885-2283 FAx 425-898-4621 PO Box 847 1Ar0.No,EXIT: iAtc.Noy. Redmond,WA 98073-0847gss myra.schnarr@assuredpartners.com Karen Ford _......,.______._ ..... INSURERISi AFFORDING COVERAGE NAIC 0 INSURER A:Philadelphia Indemnity Ins. INSURED King County Sexual Assault INSURER e: Resource Center PO Box 300 INSURERC: Renton,WA 98057 INSURER D: INSURER E t_ d !INSURER F; COVERAGES QERTIEICAIENUMBER: REVISION U BE 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 BF 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. ILTR TYPE OF INSURANCE ADDLlSUBR. POLICY NUMBER ! POLICY EFF I POLICY EXP LIMITS A ` X COMMERCIAL GENERAL LIABILITY EACH gOCURRENt;E. 1,000,000 C'AIMS-h+4oE X DMMAcE0 SC OiERENTED 100,000 tGo2 � _ MLO LXP Any o c�e�san, 5,000 7 'ERSONAL AD1.NJURY._ <_" 1,000,000 GEN L AGGREGAFF.LIV.I-A PLIF = r. GENERA:AG"'RELATE x 2,000,000 X POLICY T ti F 2,000,000 j PRODUCTS-C:OMP�OP ACC, I`: rFlFfz !Emp Ben. I 1,000,000 A AUTOMOBILE LIABILITY i COMBINED SINGLE l.l+v'IT 1,000,000 7 [Ea accjdw tl T ANY ALTO PHPK1860300 09/30/2018 09/3012019' BODILY INJURY(Per perscn; JNNNI-D AUTOS O'N�r a,'OS 1 BOOK Y IN JURY,PC,, Kc.ra"j,. X X NON '{PPPA FCS 01 i INO PERTYaOAMACE }$ A X1 UMBRELLA LIAR XOCG'J 2 EACH OCCURRENCE b 2,000,000 Excessuas CLA;h1a e PHU8641557 09/30/2018'09/30/20191 i AGCI+erATE is 2,000,000 DED , X RETENTIONS 10000 I A WORKERS COMPENSATION PER !AND EMPLOYERS LIABILITY STATIJtF titiY f} L rt,t- q LN nL;i�T1Y�= PHPK1860300 09/30/2018 09/3012019 1,000,000 FF I FR � ,- ;N r A -_ cA ACC DE VT s 1,000 000 Maeda�ry to iv i �WA STOP GAP F L ITISEASE-E, ch r-f "it S iga arc^ [ 1''`-.� - DISEASE.POLICY t if�T S 1,000,000 A Professional PHPK1860300 09/30/2018 09/30/2019'Each Occ 11000,000 1 Liability Aggregate � 2,000,000 DESCRIPTION OF OPERATIONS I LOCAT'.ONS I VEHICLES IACORD 101,Additional Remarks Schedule,may be attached If more space is required) Contract/Prog ram:Coin prehensive Sexual Assault Services Program. City of Kent,Housing and Human Services Division are named as an Additional Insureds as respects contract issued for operations as sexual assault and education service per attached form CIS 20 26 04 13. I I CERTIFICATE D R CE L 10 CITYKKE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. Parks, Recreation&Comm Svcs,- Housing and Human Svcs AUTHORIZED REPRESENTATVE 220-4th Ave South Kent,WA 98032 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Lwl'z 011--Iglj NOTEPAD. HOLDER CODE CITYKKE KINGC-6 PAGE 2 INSUREUS NAME King County Sexual Assault OP ID: CHLO Date 09/2712018 Assault Services Program I i I I G 4 # II i POLICY NUMBER: PHPK1860300 COMMERCIAL GENERAL LIABILITY CG20260413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): 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 B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liab lity for "bodily injury", "property If coverage provided to the additional insured is damage" or "personal and advertising injury" required by a contract or agreement, the most we caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the omissions or the acts or omissions of those acting amount of insurance: on your behalf: 1. Required by the contract or agreement, or 1. In the performance of your ongoing operations, or 2. Available under the applicable Limits of 2. in connection with your premises owned by or Insurance shown in the Declarations; rented to you. whichever is less. However: This endorsement shall not increase the 1. The insurance afforded to such additional applicable L:mits of Insurance shown in the Declarations. insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 26 04 13 O Insurance Services Office. Inc , 2012 Page 3 of 7