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Home My WebLink AboutCAG2019-076 - Insurance Certificate - 2020 to 2021OP lD: SR - ACORD'l--*CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY} 02t19t2020 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 CONSTTTUTE A CONTRACT BETWEEN THE |SSU|NG INSURER(S), AUTHORTZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: lf the certificate holder the terms and conditions of the policy, is an ADDITIONAL INSURED, the policy(ies) must be endorsed. lf SUBROGATION lS WAIVED, subject to 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 Sprague lsrael Giles 1501 Fourth Avenue, Suite 730 Seattle, WA 98101-3225 Robert Karl PHONE lAlC- No. Eltt: JEWIS.l INSURER(S} AFFORDING COVERAGE NAIC # INSURED Jewish Family Service Seattle Association for Jews with Disabilities Home Gare Associates 1601 16th Ave Seattle, WA 981224000 TNSURER A : Philadelphla lndemnlty lns.18058 INSURER B: INSURER C : INSURER D: INSURER E: INSURER F : COVERAGES 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. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSUMNCE 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. INSRIF TYPE OF INSURANCE tNcp POLICY NUMBER LIMITS EACH OCCURRENCE 1,000,000$ $100,000 MED EXP (Anv one Derson)$5,000 PERSONAL & ADV INJURY 1,000,000$ GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG 2,000,000$ A COMI\4ERCIAL GENERAL LIABILITY GEN'L AGGREGATE LIMIT APPLIES PER: X x CLAIIVS-IVADE OCCUR POLICY LOC GENERAL LIABILITY X PHPK2097868 o2t18t2020 0211812021 $ COMBINED SINGLE LIMIT (Ea accid€nt)1,000,000$ BODILY INJURY (Per person)$ BODILY INJURY (Per accident)$ PROPERTY DAMIAGE (PER ACCIDENT)$ Comp Ded $50( A AUTOMOBILE LIABILITY ANY AUTO ALL OWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS X X x PHPK2097868 92t18t2020 02118t2021 Goll Ded 1,00($ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS-l\ilADE AGGREGATE $ $DEDUCTIBLE RETENTION $$ I WCSTATU- I v I T6PV I tiflTs I ,\OTH.FP E.L. EACH ACCIDENT s 1,000,00( E.L. DISEASE - EA EIVIPLOYEE 1,000.00($ A WORKERS COMPENSANON AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER'EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) lf yes, describe under DESCRIPTION OF OPERATIONS below Y/N N/A PHPK2097868 WA STOP GAP 021't8t2020 02t18t2021 E.L. DISEASE. POLICY LIMIT 1.000,00($ A Professional PHPK2097868 o2t18t2020 o2t,t8t202'l Ea. lncid Aggregate 1,000,00( 2,000,00( DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES {Attach ACORD 101, Additional Remarks Schedule, lf more space is required}Certificate holder is additional insured if required bv written contract oragrgement, s.ubject to the General Liability idditionhl insured provision endorsement. CERTIFICATE H TION @ 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.City of Kent Human Services 220 4th Avenue South Kent, WA 98032 t#a.nt AUTHORIZED REPRESENTATIVE ACORD 25 (2009/09) pOLt6y NUMBER; PHPK2097868 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 A. Section ll - Who ls An lnsured is amended to include as an additional insur€d the person(s) or organization(s) shown in the Schedule, but only with respecl to liability for "bodily injury", "properly damage" or "personal and advertising iniury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: t. ln the performance of your ongoing operations; or 2, ln connection with your premises owned by or rented to you. However: 1. The insurance afforded lo such additional insured only applies to the extent permitted by law; and 2. tf 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 whlch you are required by the contract or agreement to provide for such additional insured. COMMERCIAL GENER,AL LIABILITY cG 20 26 04 13 B. Wth respect to the insurance afforded to these additional insureds, the following is added to $ection lll - Limits Of lnsurance: lf coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of lnsurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of lnsurance shown in the Declarations. Name Of Additional lnsured Person(s) Or Organization(s): City of Kent Housing & Human Services lnformation to lete this if shown above will be s Declarations cG 20 26 04 13 @ lnsurance Services Office, lnc., 2012 Page r of r