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HomeMy WebLinkAboutL17-081 - Insurance Certificate - Sprint Corporation - Liability Coverage 04/2019-04/01/2020 __ 1 ACOR"' CERTIFICATE OF LIABILITY INSURANCE F DATE(MM/DD/YYYY) 6.111 411/2020 1 3/26/2019 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 on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTCT PRODUCER Lockton Companies NAME: 444 W.47th Street,Suite 900 PHONE Ext: FAX A/c,No Kansas City MO 64112-1906 E-MAIL (816)960-9000 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: Continental Casualty Compariv 20443 INSURED SPRINT CORPORATION INSURER B: American Casualty Company of Readin ,PA 20427 14971 6480 SPRINT PARKWAY INSURER C: Transportation Insurance Company 20494 OVERLAND PARK KS 66251 I?ER D: Starr Indemnitv&Liability Company 3R3I8 INSURER E: INSURER F: COVERAGES SPRC003 CERTIFICATE NUMBER: 14637079 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 SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY y Y GL5082521363 4/1/2019 4/1/2020 EACH OCCURRENCE 2 0 00 000 CLAIMS-MADE 0 OCCUR DAMAGE AMAGPREMI ETOEa oNTEccu ante 250,000 X CONTRACTUAL LIAR. MED EXP(Any oneperson) XXXXXXX X *TENANTS LEGAL LIAB PERSONAL&ADV INJURY $ 2 O0O 0OO GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 X' POLICY❑JEC ❑LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY N N BUA5082521329 4/1/2019 4/1/2020 COMBINED SINGLE LIMIT ,4 Ea BIKED $ 2 000 OOO X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED AAUTOS ONLY AUTOS BODILY BODILY INJURY(Per accident $ X'X'XXXXX AUTOS ONLY AUTOS ONLY PROPER,r centDAMAGE $ XXXXXXX Gara ekee ers $ Included D X' UMBRELLA LIAB X OCCUR N N 1000706013191 4/1/2019 4/1/2020 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION PER OTH- C AND EMPLOYERS'LIABILITY N WC5082521282(RETRO) 4/1/2019 4/1/2020 X STATUTE ER B Y/N WC508.2521296(DEDUCTIBLE) 4/1/2019 4/1/2020 e L.EACH ACCIDENT ANYPROPRIMBER/PARTNDED9 PROPRIETOR/PARTNER/EXECUTIVE � WC5082521279(CA) 4/1/2019 4/1/2020 B OFFICER/MEMBER EXCLUDED? N/A $ 1,000,000 C (Mandatory in NH) GAP5082521315(STOP GAP) 1 4/1/2019 4/I/2020 E.L.DISEASE-EAEMPLOYEE $ 1.000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 000 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) *FIRE DAMAGE IS INCLUDED IN BROADER TENANT'S LEGAL LIABILITY FORM WITH LIMITS OF$1,000,000 PER OCCURRENCE. CITY OF KENT IS AN ADDITIONAL INSURED WHERE REQUIRED BY CONTRACT AND SUBJECT TO POLICY TERMS AND CONDITIONS. RE: INSTALLATION,OPERATION&MAINTENANCE OF TELECOMMUNICATIONS EQUIPMENT. LEASED LOCATION:-Site ID:SE52XC354 23825 98TH AVE SOUTH KENT WA PVM P S t C01 OVI, 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. 14637079 AUTHORIZED REPRESENTATIVE CITY OF KENT ATTN:MICHELLE NOVAK 220 FOURTH 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 l.11 -681 SHOULD ANY OF THE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MAIL WRITTEN NOTICE IN ACCORDANCE WITH THE POLICY PROVISIONS TO THE CERTIFICATE HOLDER NAMED WITHIN THE STATED TIME FRAMES OF 30 DAYS, EXCEPT FOR REASON OF NON-PAYMENT OF PREMIUM AT 10 DAYS. FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Miscellaneous Attachment: M463964 Master ID: 14971, Certificate ID: 14637079