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HomeMy WebLinkAboutGRA2019-030 - Insurance Certificate - YWCA of Seattle - Liability Coverage - 09/30/20219 DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE I 10/04/2019 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). PRODUCER CONTACT a) Aon Risk Insurance services West, Inc. PHONE FAX D Seattle WA Office OVC,No.Ez1): (206) 749-4800 JAIL No-)- (206) 749-4660 1420 Fifth Avenue E-MAIL suite 1200 ADDRESS: _ Seattle WA 98101-4030 USA INSURER(S)AFFORDING COVERAGE NAIC# ....... INSURED INSURERA: Philadelphia indemnity Insurance Company 18058 YOunQ women's Christian Association INSURER B: Seattle/King & Snohomish Cty. 1118 Fifth Avenue INSURER C: Seattle WA 98101-3001 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570078741514 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 Limits shown are as requested IN TYPE OF INSURANCE I POLICY NUMBER Lt P LIMITS LS ID U D POLICY F P C YYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY PHPK 1 EACH OCCURRENCE $1,000,000 CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $100'000 X Stop Gap Coverage Included MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1.000.000 GENIAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $3,000,000 HPOLICY PRO ❑X LOC PRODUCTS-COMP/OPAGG $3,000,000 OTHER: STOP GAP Limit $1,000,000 0 A PHPK2041712 09/30/2019 09/30/2020 COMBINED SINGLE LIMITL0 AUTOMOBILE LIABILITY $1,OOO,OOO Ea accident) X ANYAUTO BODILY INJURY(Per person) Z OWNED SCHEDULED BODILY INJURY(Per accident) 0) AUTOS ONLY AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE ONLY AUTOS ONLY Per accident) LM X Comp Ded:$500 X Coll Ded:$1,000 A JUXIBIRES LA LIAB X OCCUR PHUB694832 09/3012019 D9/30/2020 EACH OCCURRENCE $10,000,000 V CS LIAB CLAIMS-MADE AGGREGATE $10,000,000 X RETENTION$10,000 WORKERS COMPENSATION AND PER OTH- EMPLOYERS'LIABILITY Y/N STATUTE IER ANY PROPRIETOR/PARTNER EXECUTIVE ❑ EL EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Anita Vista Transitional Housing Program. The City, its elected and/or appointed officials, its employees and agents and King County are included as Additional insured in accordance with the policy provisions of the General Liability policy. �W_l.f -IF CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE �i EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE - POLICY PROVISIONS. #� l City of Kent AUTHORIZED REPRESENTATIVE Human Services Coordinator ATTN: Dinah Wilson ( K 4 Avenue S. t o�n Kent WA t WA 98032 USA ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD