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HomeMy WebLinkAboutCAG2019-396 - Insurance Certificate - CenturyLink Communications, LLC - 09/01/2020-09/01/2021 Coverage ACUREP CERTIFICATE OF LIABILITY INSURANCE ATE(Mo DD/YYYY) 08/ 2k...-- 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 Marsh USA Inc. NAME: CA License#0437153 IA/C,ON o.Extt: FAX No): 1301 5th Avenue,Suite 1900 E-MAIL Seattle,WA 98101-2682 ADDRESS: Attn:Seattle.certrequest@marsh.com/Fax:212-948-4326 INSURER(S)AFFORDING COVERAGE NAIC# CN102197661-STND-ALL-20-21 INSURER A:Greenwich Insurance Company 22322 INSURED INSURER B:XL Specialty Insurance Co. 37885 CenturyLink,Inc.and all subsidiaries, including but not limited to:Qwest Communications International Inc.;Embarq Corporation; INSURER C:Allianz Underwriters Ins Co 36420 Level 3 Parent,LLC and Level 3 Communications,LLC INSURER D 100 CenturyLink Drive;Mailstop 5TS154 Monroe,LA 71203 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-003510161-24 REVISION NUMBER: 0 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIDD/YYYYI (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY RGD500033308 09/01/2020 09/01/2021 EACH OCCURRENCE $ 3,000,000 CLAIMS-MADE X OCCUR PR S RENTED PREMISES((Ea occurrence) $ 500,000 X CONTRACTUAL LIABILITY MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 15,000,000 X POLICY JECT PRO LOC PRODUCTS-COMP/OP AGG $ 15,000,000 OTHER: $ A AUTOMOBILE UABIUTY RAD500033408 09/01/2020 09/01/2021 COMBINED SINGLE LIMIT $ 2,000,000 (Ea accident) X ANY AUTO 'Auto Physical Damage-Self Insured BODILY INJURY-(Per person) $ X OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ C X UMBRELLA LIAB X OCCUR U5Z000023190001 09/01/2020 09/01/2021 10,000,000 EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION$ $ B WORKERS COMPENSATION RWD500032908(AOS) 09/01/2020 09/01/2021 X PER OTH- B AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE RWR500033008(WI) 09/01/2020 09/01/2021 E.L.EACH ACCIDENT $ 1,000,000 B OFFICER/MEMBER EXCLUDED? N N/A RWE500033108(WA) 09/01/2020 09/01/2021 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 B If yes,describe under RWE500033208(OH) 09/01/2020 09/01/2021 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Technology E&O incl. U5Z000023190001 09/01/2020 09/01/2021 Each Claim/Aggregate 10,000,000 Cyber/Privacy Liability Retention 5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Franchise Agreement.CITY OF KENT is included as Additional Insured on the General,Automobile,and Umbrella Liability Policies if required by written contract or agreement subject to the policy terms and conditions. CERTIFICATE HOLDER CANCELLATION CITY OF KENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn:City Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 220 Fourth Avenue South ACCORDANCE WITH THE POLICY PROVISIONS. Kent,WA 98032 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Katie Stephens CyI { [t 1 -�•- ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 0400-01-00-0002813-0002-0011616 AGENCY CUSTOMER ID: CN102197661 LOC#: Seattle AcoRD ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc. CenturyLink,Inc.and all subsidiaries, including but not limited to:Owest Communications International Inc.;Embarq Corporation; POLICY NUMBER Level 3 Parent,LLC and Level 3 Communications,LLC 100 CenturyLink Drive.Mailstop 5TS154 Monroe,LA 71203 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance GENERAL LIABILITY Automatic Additional Insured's Primary Coverage Additional Insured as respects your interest in the operations of the Named Insured as required by contract or agreement. Coverage provided by the above General Liability policy shall be primary and is limited to liability arising out of Named Insured's ownership and/or operations. Any insurance carried by the additional insured shall not be contributory insurance. Waiver of Transfer of Rights of Recovery Against Others to Us(Waiver of Subrogation)--any person or organization with wtom you have entered into a contract or agreement,or by statute,law or code of ordinance. Separation of Insureds Applies. Insurance covers incidents that occur within 50'of railroad property,any railroad exclusions have been deleted per endorsement CG2417. AUTOMOBILE LIABILITY Any person or organization you are required in a written contract,agreement,statute,law or code of ordinances provided the"bodily injury"or"property damage"occurs subsequent to the executive of the contract,agreement,statute,law or code of ordinances. Lessor-Additional Insured and Loss Payee-All Lessors Waiver of Transfer of Rights of Recovery Against Others to Us(Waiver of Subrogation)—Any person or organization with whom you have waived prior to the"accident"or the"loss" under a contract with that person or organization,or under statute,law or code of ordinances. --------WORKERS'COMPENSATION AND EMPLOYER'S LIABILITY AND EXCESS WORKERS'COMPENSATION AND EMPLOYER'S LIABILITY(OH&WA-SELF-INSURED- $1,000,000 RETENTION) Waiver of Our Right to Recover from others Endorsement—Where required by written agreement signed prior to loss,or required by statute,law or code of ordinances executed prior to loss. EXCESS/UMBRELLA Coverage applies per occurrence.Additional Insured as respects your interest in the operations of the Named Insured as required by contract or agreement.Waiver of Transfer of Rights of Recovery Against Others to Us(Waiver of Subrogation)-Any person or organization with whom you have entered into a contract or agreement,but only to the extent required by such contractor agreement.Separation of Insureds Applies. COMMERCIAL CRIME-FIDELITY BOND Carrier:XL Specialty Insurance Company Policy Number:ELU16972420 Effective Dates:09/01/2020-09/01/2021 Each Occurrence:$15,000,000 U.S.PROPERTY Carrier:Allianz Underwriters Insurance Company Policy Number:U5Z000023190001 Effective Dates:09/01/2020-09/01/2021 Limit:$25,000,000 Deductible:$25,000,000 Property Coverage:"All Risk"of Direct Physical Loss or Damage to All Real and Personal Property,including Boiler&Machinery,Earthquake,Flood and Wind-Replacement Cost Basis,and Business Interruption-Actual Loss Sustained. Loss Payee or mortgagee as required by written contract/loan agreement to the the extent of your insurable interest.Waiver of Subrogation-Any person or organization whom you have entered into a contract or agreement,but only to the extent required by such contract or agreement.Other deductibles may apply as per policy terms and conditions. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 0400-01-00-0002813-0003-0011617 Dear Certificate Holder: As many companies have moved to a remote working environment, mailing Certificates of insurance to a physical address can cause unnecessary delays in providing you proof of insurance. To streamline delivery and in an effort to support our firm's commitment to sustainability,going forward, we would like to distribute your Certificates of Insurance electronically if possible. We are kindly requesting Certificate Holders provide us an email address where we can deliver your COI in the future. Please send your response to: USOperations.email@marsh.com and provide the following information so that we can expedite your COI delivery: « Certificate#(Shown below Insured Name—e.g.:ABC-123456789-01) « E-Mail for future delivery: For undeliverable email addresses,our system is configured to automatically redirect the Certificate for delivery via USPS. Lastly, if you no longer need this COI please respond to USOperations.emailPmarsh_com with the Certificate number and we will inactive the record in our system to avoid future automatic delivery. Thank you. US Operations, Marsh USA, Inc. 0400-01-00-0002813-0004-0011618 0002813 SP 0400 -001-P02814-I CITY OF KENT Attn: City Clerk 220 Fourth Avenue South Kent, WA 98032 •• • 0400-01-00-0002813-0001-0011615