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Home My WebLink AboutCAG2021-185 - Insurance Certificate - Puget Sound Regional Fire Authority - Certificate of Coverage - 12/01/2021CIAW 2021-2022 Page 1 Issue Date: 11/23/2021 Cert#: 0000000586 CITIES INSURANCE ASSOCIATION OF WASHINGTON CERTIFICATE OF COVERAGE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE MEMORANDUM OF COVERAGE (MOC) BELOW. THIS CERTIFICATE OF COVERAGE 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 COVERED PARTY, THE MOC MUST BE ENDORSED. IF SUBROGATION IS WAIVED, SUBJECT TO THE TERMS AND CONDITIONS OF THE MOC, 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 Phone: (509) 754-2027 Fax: (509) 754-3406 COVERED MEMBER Puget Sound Regional Fire Authority 24611 - 116th Avenue SE Kent, WA 98030 GENERAL LIABILITY CIAW / Old Republic Specialty Insurance Underwriters AUTOMOBILE LIABILITY CIAW / Old Republic Specialty Insurance Underwriters PROPERTY CIAW / Old Republic Specialty Insurance Underwriters et al. CRIME / PUBLIC EMPLOYEE DISHONESTY CIAW / Old Republic Specialty Insurance Underwriters COVERAGES THIS IS TO CERTIFY THAT THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE COVERED MEMBER 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 COVERAGE AFFORDED BY THE MOC DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MOC. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF COVERAGE MOC NUMBER MOC EFF DATE MOC EXP DATE DESCRIPTION LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM CIAW212247269 12/1/2021 12/1/2022 GENERAL AGGREGATE $25,000,000 PRODUCT-CO MP/OP AGG $25,000,000 PERSONAL & ADV. INJURY $15,000,000 INCLUDES STOP GAP EACH OCCURRENCE $15,000,000 (LIABILITY IS SUBJECT TO A $500,000 SIR PAYABLE FROM PROGRAM FUNDS)ANNUAL PROGRAM AGGREGATE $50,000,000 AUTOMOBILE LIABILITY ANY AUTO CIAW212247269 12/1/2021 12/1/2022 COMBINED SINGLE LIMIT $15,000,000 (LIABILITY IS SUBJECT TO A $500,000 SIR PAYABLE FROM PROGRAM FUNDS)ANNUAL PROGRAM AGGREGATE NONE PROPERTY CIAW212247269 12/1/2021 12/1/2022 ALL RISK PER OCC EXCL EQ & FL $100,000,000 EARTHQUAKE PER OCC $15,000,000 FLOOD PER OCC (except FZ A&V, which is $1MM) $15,000,000 (PROPERTY IS SUBJECT TO A $500,000 SIR PAYABLE FROM PROGRAM FUNDS)ANNUAL PROGRAM AGGREGATE NONE CRIME/PUBLIC EMPLOYEE DISHONESTY CIAW212247269 12/1/2021 12/1/2022 PER LOSS $1,000,000 (CRIME IS SUBJECT TO A $25,000 SIR PAYABLE FROM PROGRAM FUNDS) DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / SPECIAL ITEMS Regarding Emergency Management Performance Grant, Grant Agreement Number E18-099. City of Kent is named as Additional Covered Party regarding this Agreement only and is subject to coverage terms, conditions, and exclusions. Additional Covered Party endorsement is attached. The MOC is primary and non-contributory. Waiver of Tranfer Subrogation is attached. Seperation of Named Insured endorsement is included in the policy. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED COVERAGE BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE MOC PROVISIONS. CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE City of Kent 220 Fourth Avenue South Kent, WA 98032 CIAW 2021-2022 Page 2 WAIVER OF TRANSFER OF RIGHTS AND RECOVERY AGAINST OTHERS TO US THIS ENDORSEMENT MODIFIES COVERAGE PROVIDED UNDER THE FOLLOWING: GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of Kent 220 Fourth Avenue South Kent, WA 98032 Any person or organization as shown in the Schedule above, for whom we make a payment under this coverage, must transfer their right to recovery against any other party. After a Claim they must do everything necessary to secure, and nothing to impair these rights. However, we will waive our right of recovery against any person or organization as shown in the Schedule above with respect to which the Covered Party has waived its right of recovery prior to the Occurrence, Accident, or Wrongful Act in a Covered Contract. All other terms and conditions remain unchanged. CIAW 2021-2022 Page 3 ADDITIONAL COVERED PARTY ENDORSEMENT THIS ENDORSEMENT MODIFIES COVERAGE PROVIDED UNDER THE FOLLOWING: GENERAL LIABILITY COVERAGE PART How coverage is changed: It is agreed that the interest of any Additional Covered Party is recognized as their interests may appear, providing the certificate of coverage that this is attached to has been issued and is on file with the Company. The Limits of Coverage applicable to the Additional Covered Party are those specified in either the: 1. Written contract or written agreement; or 2. Declarations for this MOC, whichever is less. These Limits of Coverage are inclusive and not in addition to the Limits of Coverage shown in the Declarations. All other terms and conditions remain unchanged. Additional Covered Party: City of Kent 220 Fourth Avenue South Kent, WA 98032 Regarding Emergency Management Performance Grant, Grant Agreement Number E18-099. City of Kent is named as Additional Covered Party regarding this Agreement only and is subject to coverage terms, conditions, and exclusions. Additional Covered Party endorsement is attached. The MOC is primary and non- contributory. Waiver of Tranfer Subrogation is attached. Seperation of Named Insured endorsement is included in the policy.