HomeMy WebLinkAboutPW15-059 - Insurance Certificate - Verizon - 12/31/2021-12/31/2022 Coverage - 01/04/2022DATE (MM/DDIYYYY)
0t/04/2022
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE
OR PRODUCER, AND THE CERTIFICATE HOLDER.
ONLY
NEGATIVELY
HOLDER.CATE THISNOUPONRIGHTSCERTITHEFICONFERSANDASAOFMATTERNFORMATIONlsCERTIFICATEISSUEDTHISESELOWBBYAFFORDEDTHEPOLtCINDEXTEALTERORCOVERAGETHEORNOTDOESRMATIVELYAMEND,AFFICERTIFICATE BEPRESENTATIVEAUTHORIZEDTHEISSUINGABETWEENCONTRACTrNsuRER(S),
(800) 363-010s(866) 283-7L22No.
5 70000027366
NAIC #TNSURER(S) AFFORDING COVERAGE
PRODUCER
Aon Risk Services Northeast, Inc
New York tlY office
one Liberty Plaza
165 Broadway, suite 3201
New York NY 10006 usA
t4167tNsuRERAr cuideone National lnsurance
INSUREB B:
INSURER D:
INSUBER Er
INSURER F:
INSUBED
cellco Partnership dba verizon trtireless
1095 Avenue of the americas
r'rew York NY 10036 USA
corners, Location code: 102484 contract No. 79134, Site Address: 26800 uaple va1'ley elack oiamond noad
8038.
mors spaca 13 requlred)DESCRIPTION OF PBOPERTYLOCATION
RE: SitE NAME: SEA 4
se, uaple va11ey, wn 9
THISWHICHTOWITHRESPECTERDOCUMENTOFCONTRACTANYOTHOBORTERMCONDITIONANYNOTWITHSTANDINGREOUIREMENTINDICATED,ALLTO THEDESCRIBEDPOLICIESEINHERSUBJECT TERMS,tsBYAFFOFDEDTHEtssuMAYORTHEINSURANCEMAYCERTIFICATEBEPERTAIN,
BYREDUCED CLAIMS.PAIDSHOWNLIMITSHAVEMAYBEENCONDITIONSANDSUCHOFPOLtCIES.EXCLUSIONS
COVEFED PROPERTY LIMITSPOLICY EFFECTIVE
(MM/DD/YYYY)
POLICY
POLICY NUMBERINSR
LTR
TYPE OF INSUFANCE
DEDUCTIBLESCAUSES OF LOSS
PROPERTY
BASIC BUILDING
BROAD
X SPECIAL
EARTHOUAKE X
WIND
FLOOD
Blkt PP Ded
RENTAL VALUE
PROPERTY
INCOME
EXPENSE
BUILDING
PERS PROP
BLDG & PP
TYPE OF POLICY
POLICY NUMBER
CAUSES OF LOSS
INLAND MARINE
NAMED PEFILS
TYPE OF POLICY
CRIME
BOILEB & MACHINERY /
EQUIPMENT BREAKDOWN
All Risk Property subject to policy terms, conditions and exclusions
required by written contract.
more Space
waiver of subrogation applies to the Property po1-icy as
may101,
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CERTIFICATE OF PROPERTY INSURANCE
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ffi citv of KentAttir: city clerk
220 Fourth Avenue
Kent wA 98403 usA
LLATION
@ 1995-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks ot ACORD
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEFEOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WTH THE POLICY
PROVTSIONS.
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ACORD 24 (2016/03)
o.fu\-"ADDITIONAL REMARKS SCHEDULE
AGENCY CUSTOMER ID:
LOC #:
s 7000002 7 366
Rage _ of _
AGENCY
non nisk Services Northeast, Inc,NAMED INSUFED
cel I co Partnershi p dba veri zon wi rel essPOLICY NUMBER
See certificate Number: 570091070431
CARBIER
see centificate Number; 57009102043i.
NAIC CODE
EFFECTIVE DATE;
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS ASCHEDULE TO ACORD FORM,
FORM NUMBEB: ACORD 24 FORM TTTLE: Certificate of Property lnsurance
erimary nddendum
erimary nddendum
u/w co. - policv NumberRarticipation %-
't deone NA t 'l ona I I n 5 u ran c e company 099002 3 5 9
20%
ll'l i ed worl d Assurance company Ltd. - p000040021
.3300%
t Insurance Company - ppR373455020
*Markel Bermuda Limited - N4KLBSPPR000O6O
3.t250%
nelvetia swiss rnsurance company in t-iechtenstein t-imited - prNAM2L4526
2.5%
0.4
client rreaty (AcT) - prNAM2l_4526
412%
'l lgi:itgg by ("),.Aon Risk.solutions.(u,s; is authorized to generate and distribute certificates in annlslratlve capac'lty as evldence of insurance where required-by clients of the Insured,
rticipation % shown l?_?.7:1?9?Y of thg primary layer. 62.6038/"% of the primary iayer is d.irectly placedrough exchange rndemnity company New :ei-sey.
ACORD 101 (2008/01)
The ACORD name and togo are registered marks ol ACOFD
@ 2008 ACORD CORPORATION. All rights reserved.
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Aon Risk Services
PQ Box 1447
Lincolnshire, lL 60069
MDG2022 00003767 01
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ffi:,,'# citv of KentHffi Atth: City Clerk
220 Fourth Avenue
Kent WA 98403
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