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HomeMy WebLinkAboutCAG2020-174 - Insurance Certificate - Valley Cities - 06/30/2020-06/30/2021 CoverageClient#:709605 VALLECIT ACORD,. CERTIFICATE OF LIABILITY INSURANCE COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: DATE (MM/DD/YYYY) 6t17t2020 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 ISSUING TNSURER(S), AUTHORTZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, lf SUBROGATION lS WAIVED, subject to the terms and conditions the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI lnsurance Services NW HC 601 Union Street, Suite 1000 Seattle, WA 98101 206 441-6300 1fi8.",F.. =,u, 206 441-6300 610-362-8530 INSURER(S} AFFORDING COVERAGE NAIC # 1N5URER A : Philadelphia lndemnity lnsurance Co.1 8058 INSURED Valley Cities Counseling & Consultation 325 W Gowe St Kent, WA 98032 INSURER B INSURER C INSURER D INSURER E : INSURER F : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVEBEEN ISSUED TOTHE INSURED NAMEDABOVE FORTHE POLICYPERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITIONOF ANY CONTRACTOR 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 cLAll\ils. INSRLTR TYPE OF INSURANCE INSP WN POLICY NUMBER tsoLtuY Et-t-(MM/DD/YYYYI POLICY EXP(MM/DD/YYYY}LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS.MADE OCCUR X Retro 01/28/1987 X WA Stop Gap GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC OTHER: X PHPK2143303 061301202'l EACH OCCURRENCE $1,000.000 DAMAGE TO RENTEDPRtrMlsFs /F, 6^."rran^a\$1,000.000 MED EXP (Anv one Derson)$20,000 PERSONAL & ADV INJURY $ 1.000.000 GENERAL AGGREGATE $ 3.000.000 PRODUCTS - COI\4PIOP AGG s3.000.000 WA Stop Gap $$1M/$1M/$1M A AUTOMOBILE LIABILITY ANYAUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON-OWNED AUTOS ONLYX PHPK2143303 06/30/2020 06t30t2021 COMBINEIJ SINGLE LIMIT s1.000.000 BODILY INJURY (Per person)$ BODILY INJURY (Per accident)$ $ $ A X UMBRELLA LIAB EXCESS LIAB x OCCUR CLAII\4S.MADE PHUB725836 Retro 01/2811987 0613012020 06t30t2021 EACH OCCURRENCE $5.000.000 AGGREGATE $5.000.000 DED X nerer'rrror.r s10.000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORY'O*'*CRYCXE"'''U= J4 oFFICERyMENIBER EXCLUDFD? L l(Mandatory in NH) lf yes, describe under DESCRIPTION OF OPERATIONS below N/A I PER I qrATr rrF OTH-FA E.L. EACH ACCIDENT $ E.L. DISEASE - EA EI,4PLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Professional Liab Claims-Made Retro 01/28/1987 PHPK2143303 )6130t2020 06130t2021 $1,000,000 Per lncident $3,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is additional insured as respects their interest in the operations of the Named lnsured. Evidence of lnsurance for Professional Liability. TE ACORD 25 (2016/03) #s29062549/M 1 of 1 29062340 @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BXHJT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE W|LL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Gity of Kent 220 4th Ave S Kent, WA 98032-0000 i ,{4F"c-4* AUTHORIZED REPRESENTATIVE 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 POLICY NUMBER: PHPK2143303 A. Section ll - Who ls An lnsured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. 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 to such additional insured only applies to the extent permitted by law;and 2. lf 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 whiclr you are required by the contract or agreement to provide for such additional insured. COMMERGIAL GENERAL LIABILITY cG 20 26 04 13 B. With respect to the insurance afforded to these additional insureds, the following is added to Section 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 Insured Person(s) Or Organization(s): City of Kent lnformation uired to com this Schedule if not shown will be shown in the Declarations cG 20 26 04 13 @ lnsurance Services Office, lnc.,2012 Page14 of 81