HomeMy WebLinkAboutIT13-155 - Insurance Certificate - Verizon Wireless - Property Insurance 12/31/2020 - 12/31/2021CERTIFICATE OF PROPERTY INSURANCE
o
c)
€)
ffi
F\
Flooco
h
oo
oF\
h
duto
=fz
ut
kIl!
tr
UJo
:
-*.diE
E
=Jgs-iEJic
Ffl#tJ
DATE (MM/DDIYYYY)
ot/20/202L
THIS CERTIFICATE I s lssuE D AS A MATTER OF NFORMATION ONLY AND CONFE RS NO RIGHTS UPON THE CERTI FI CATE HOLDER.THIS
CERTI FICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR AUTER THE COVE RAGE AFFORDED BY THE POL|CIES B ELOW
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE TSSUTNG TNSURER(S), AUTHORTZED REPRESENTATTVE
OR PRODUCER, AND THE CERTIFICATE HOLDER.
PRODUCER
Aon Risk Services Northeast, Inc
New York NY Office
One Libertv Plaza
165 eroadwly, suite 3201
NEW YOTK NY 10006 USA
No.
(866) 783-7L22 (800) 363-010s
570090027366
INSURER(S) AFFORDING COVERAGE NAIC #
INSURED
cellco Partnership dba verizon Wjreless
L095 evenue of the Americas
NCW YOrK NY 10036 USA
TNSURERA: GUideone National Insurance company t4L67
INSURER B:
INSURER D:
INSURER E:
INSURER F:
LOCATION OF PREMISES/ DESCRIPTION OF PROPEnTY (Attach ACORD 101, Addltionat Remarks schodute, it more spacs ts rcquir€d)
RE: site Name: sEA 4 corners, Location code: L02484 contract No. 79134, site Address: 26800 Maple valley Black oiamond RoadSE, Map'le valley, WA 98038.
THlslSTocEHTlFYTHATTHEPoLlclEsoFlNsuRANcELlsTEDBELowHAvEBEENlsSuEDTo
INDICATED, NOTWTHSTANDING ANY REQUIFEMENT, 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 SU BJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR TYPE OF INSUFANC€POLICY NUMBER POLICY EFFECTIVE
DATE (MM/DD/YYYY)
POLICY EXPIRATION
DATE (MM/DO/YYYY)COVERED PROPERTY LIMITS
A X PROPERTY
CAUSES OF LOSS DEDUCTIBLES
uvYUuu+bb lt/ 1L/ tu2l BUILDING
PERSONAL PROPERTY
BUSINESS INCOME
EXTRA EXPENSE
RENTAL VALUE
BLANKET BUILDING
BLANKET PERS PROP
BLANKET BLDG & PP
BASIC BUILDING
BROAD
UONIENIS
X SPECIAL
EABTHQUAKE
WIND X $1 0,000,000
FLOOD
Blkt PP Ded
INLAND MARINE
CAUSES OF LOSS
NAMED PERILS
TYPE OF POLICY
POLICY NUMBER
CRIME
TYPE OF POLICY
BOILEB & MACHINERY/
EOUIPMENT BREAKDOWN
SPECIAL CONDITIONS / OTHEF COVEFAGES (ACORD 101, Additional Femarks Schedute,may bs anacnod ta more space ts requtred)all nisk Property subject to policy terms, conditions and exclusions. waiver of subrogation applies to the property policy asrequired by written contract.
CERTIFICATE HOLDER
c
NN
@
ooo
@
oo
No
N
oo
oo
[ffi
city of KentAttn: cjty clerk
220 Fourth Avenue
KENI WA 98403 USA
E
TE:t'-trE
-
@ 1995.2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCBIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WTH THE POLICY
PROVTSIONS.
.&g^/%rf^tfu-%
ACORD 24(2016t03)
Aon Cllenl Servirsr
4Ouedook Foint
Linoolnshirs" ll 60069
MDG2021 00001850 01
rl,lltlrtrl,,,rt,,tl,liltlhllttililhillhl,t,lltilllllu,lhrtl
City Of Kent
Attn: City Clerk
220 Fourlh Avenue
Kent WA 98403
{%,*
ffi /
g,ts,w,At
tffi
ffi
(L
@N@
oo
e@
8
No
o
ooe
a