HomeMy WebLinkAboutCAG1987-0120 - Insurance Certificate - US Sprint Communications - Certificate of Liability Insurance 04/01/1996-04/01/1999 e< ,., o °°;,, g,°M ; , s 82701r?r
FROGUCER'° ° °71E °M° THIS CERTIFIG C CC10
Lockton Companies ONLY AND CC CQPY ���G'vGD ICERRT FICATTIu
HOLDEXTENP 0 Box 419351 ALTER THEHIS CO B 11 1997 CEES BELOW;
Kansas City Mo 64141.6351 C( FE
(913) 676.9000
COMPAN Attorney
A YCONTINENT Ken'[ (AY
INSURED 5290 COMPANYWSPORT)
SPRINT COMMUNICATIONS COMPANY.L.P. B
D/B/A LONG DISTANCE U S.A.
P.0 BOX 11315 COMPANY
KANSAS CITY MO 64112 C
COMPANY
D
�aV:u4—e e�B,B°F,P `Z.cc*�,E`,h$,s,.o
$,&$,3,dy4,y..II.,$c,;$,
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
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MWDD/YY) DATE(MMIDD/YY)
GENERAL LIABILITY GENERAL AGGREGATE $
A COMMERCIAL GENERAL LIABILITY GL157347417 04/01/96 04/01/99 PRODUCTS COMP/OP AGO $ °
CLAIMS MADE aOCCUR'I PERSONAL&ADV INJURY $
OWNER S B CONTRACTORS PROTI EACH OCCURRENCE $ '
FIRE DAMAGE(Any one hre) $ '
AAAAAAAAMED EXP(Any one peson) $ 1
AUTONY AUTO ABILITY BUA 157347434 (ADS) 04/01/96 04/01/99 COMBINED SINGLE LIMIT $ 2,000,000
A ALL OWNED AUTOS BUA 157347420 (TX) BODILY INJURY $ XXXXXXXXXXX
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY $ XXXXXXXXXXX
NON OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
GARAGE LIABILITY AUTOONLY EAACCIDENT $
ANY AUTO NOT APPLICABLE OTHER THAN AUTO ONLY
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $ xxxn=,
UMBRELLA FORM NOT APPLICABLE AGGREGATE $
OTHER THAN UMBRELLA FORM $
WORKERS COMPENSATION AND WC STATU OTH --�-nmnt
EMPLOYERS'LIABILITY EL EACH ACCIDENT $ 00 nn,Vol
A *WC157347272 04/01/96 04/01/99
THE PROPRIETOR/ INCL EL DISEASE POLICY LIMIT $
PARTNERS/EXECUTIVE DO—DD(
OFFICERS ARE EXCL EL DISEASE EA EMPLOYEE $
OTHER SARE75 ABOVE
B *WORK COMP. WC157347448 04/01/96 04/01/99
DES(RIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
CERTIFICATE HOLDER IS ADDITIONAL INSURED AS RESPECTS LIABILITY COVERAGE. ONLY AS REQUIRED BY
CONTRACT PLEASE SEE ATTACHED.
a�..ft ��i°e$.e°eiereo°s°aoay;`a,°°^..3'�
212438 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF KENT, WASHINGTON EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
AM: TOM BRUBAKER- ASST CITY AM. 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT
220 4TH AVENUE SOUTH
KENT, WA 98032.5895 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS R REPRESENTATIVES
AUTHORIZED REPRESENTATIVE
1
POLICY NUMBER GL 1 57347417 COMMERCIAL GENERAL LIABILITY
MDT. NO. P-5
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED-
STATE OR POLITICAL SUBDIVISIONS-PERMITS
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
State or Political Subdivision-
ALL STATE OR POLITICAL SUBDIVISIONS
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement )
WHO IS AN INSURED (Section It) is amended to include as an insured any state or political subdivision shown in
the Schedule, subject to the following provisions
1 This insurance applies only with respect to operations performed by you or on your behalf for which the state
or political subdivision has issued a permit
2 This insurance does not apply to
a. "Bodily injury," "property damage," "personal injury" or "advertising injury" arising out of operations
performed for the state or municipality, or
b. "Bodily injury" or "property damage" included within the "products-completed operations hazard "
CG 20 12 1185 Copyright, Insurance Services Office, Inc , 1984 ❑