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Home My WebLink AboutCAG2021-220 - Insurance Certificate - Glover EmpowerMentoring Program - Non Profit Insurance Program - 06/01/2021Issue Date 5/27/2021 Cert #:0000037075 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUE 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 be endorsed. If SUBROGRATION IS WAIVED, subject to the terms and conditions of the policy, certain coverage may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER COMPANIES AFFORDING COVERAGE Clear Risk Solutions 451 Diamond Drive Ephrata, WA 98823 GENERAL LIABILITY American Alternative Insurance Corporation, et al. AUTOMOBILE LIABILITY American Alternative Insurance Corporation, et al. INSURED PROPERTY American Alternative Insurance Corporation, et al. Glover Empower Mentoring Program 827 N Central Ave, B-109 Kent, WA 98032 MISCELLANEOUS PROFESSIONAL LIABILITY Princeton Excess and Surplus Lines Insurance Company COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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. TYPE OF INSURANCE POLICY NUMBER POLICY EFF DATE POLICY EXP DATE DESCRIPTION LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY N1-A2-RL-0000013-12 6/1/2021 6/1/2022 PER OCCURRENCE $3,000,000 OCCURRENCE FORM PER MEMBER AGGREGATE $6,000,000 INCLUDES STOP GAP PRODUCT-COMP/OP $3,000,000 PERSONAL & ADV. INJURY $3,000,000 (LIABILITY IS SUBJECT TO A $150,000 SIR PAYABLE FROM PROGRAM FUNDS)ANNUAL POOL AGGREGATE $50,000,000 AUTOMOBILE LIABILITY ANY AUTO N1-A2-RL-0000013-12 6/1/2021 6/1/2022 COMBINED SINGLE LIMIT $3,000,000 (LIABILITY IS SUBJECT TO A $150,000 SIR PAYABLE FROM PROGRAM FUNDS)ANNUAL POOL AGGREGATE NONE PROPERTY N1-A2-RL-0000013-12 6/1/2021 6/1/2022 ALL RISK PER OCC EXCL EQ & FL $75,000,000 EARTHQUAKE PER OCC Excluded FLOOD PER OCC Excluded (PROPERTY IS SUBJECT TO A $150,000 SIR PAYABLE FROM PROGRAM FUNDS)ANNUAL POOL AGGREGATE NONE MISCELLANEOUS PROFESSIONAL LIABILITY N1-A3-RL-0000060-12 6/1/2021 6/1/2022 PER CLAIM $3,000,000 (LIABILITY IS SUBJECT TO A $150,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $40,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / SPECIAL ITEMS Regarding Consultant Services Agreement. City of Kent is named as Additional Insured regarding this agreement only and is subject to policy terms, conditions, and exclusions. Additional Insured endorsement is attached. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE City of Kent 220 4th Ave S Kent, WA 98032 Non Profit Insurance Program Certificate of Coverage AMERICAN ALTERNATIVE INSURANCE COMPANY ADDITIONAL INSURED – DESIGNATED PERSON OR ORGANIZATION (GENERAL LIABILITY) Named Insured Non Profi t Insurance Program (NPIP) Policy Number N1-A2-RL-0000013-12 Endorsement Effective 6/1/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement modifies insurance provided under the following: GENERAL LIABILIT Y COVERAGE PART This endorsement changes the policy effective on the inception date of the policy unless another date is indicated above. Schedule Person or Organization (Additional Insured): As Per Schedule on file with Clear Risk Solutions, Underwriting Administrator City of Kent 220 4th Ave S Kent, WA 98032 Regarding Consultant Services Agreement. City of Kent is named as Additional Insured regarding this agreement only and is subject to policy terms, conditions, and exclusions. Additional Insured endorsement is attached. A. With respects to the General Liability Coverage Part only, the definition of Insured in the Liability Conditions, Definitions and Exclusions section of this policy is amended to include as an Insured the Person or Organization shown in the above Schedule. Such Person or Organization is an Insured 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.In performance of your ongoing operations; or 2.In connection with your premises owned or rented to you. B.The Limits of Insurance applicable to the additional Insured are those specified in either the: 1.Written contract or written agreement; or 2.Declarations for this policy, whichever is less. The se Limits of Insurance are inclusive and not in addition to the Limits Of Insurance shown in the Declarations. All other terms and conditions remain unchanged. Includes copyrighted material of the Insurance Services Office, Inc., with its permission