HomeMy WebLinkAboutCAG2021-520 - Insurance Certificate - Curtis Blue Line - Liability Coverage - 04/01/2022COVERAGES
CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE NUMBER:sEA-00382214+01 REVISION NUMBER: 1
DATE (MM/DD/YYYY)
ut06t2022
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 CONSTTTUTE A CONTRACT BETWEEN THE |SSUING TNSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
lf SUBROGATION lS 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
MARSH RISK & INSURANCE SERVICES
FOUR EMBARCADERO CENTER, SUITE 1,100
CALIFORNIA LICENSE NO, 0437153
sAN FRANCTSCo, CA 94111
Attn: sanf rancisco.certs@marsh.com
cN101 797553--FG AWU-22-23 GAW
PHONE
INSURER{SI AFFORDING COVERAGE NAIC #
rNsuRER a : Gemini lnsurance Co 10833
INSURED
L. N. Curtis and Sons, lnc.
Attn: John Viboch, CFO
185 Lennon Lane, Suite 1 10
Walnut Creek, CA 94598
TNSURER B: Great Northern lnsurance Companv 20303
rNsuRER c : Slarr lndemnitv & Liabilitv ComDanv 38318
INSURER D:
INSURER E
INSIIRFR F :
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH 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.
INSRITR TYPE OF INSURANCE POLICY NUMBER
POLICY EFFIMM'DN'YYYYI POLIGY EXP
IMM'NN/YYYVT LIMITS
A X COMMERCIAL GENERAL LIABILITY
CLAIMS.MADE OCCUR
X Firearms Tactical
General Liability
GEN'L AGGREGATE LIMIT APPLIES PER:
X
'o.,." l-l !g"o; l-l '.o.
X
vrGP021092 04t01t2022 04t01n023 EACH OCCURRENCE $1,000,000
UAMAUE IUKENIEU
PRFMISFS rFe n.^' 'rran^al 50,000
MED EXP (Anv one person)$Excluded
PERSONAL & ADV INJURY 1,000,000
GENERAL AGGREGATE $2,000,000
PRODUCTS - COMP/OP AGG $2,000,000
$
B AUTOMOBILE LIABILITY
ANY AUTO
O\ANED
AUTOS ONLY
HIRED
AUTOS ONLY
SCHEDULED
AUTOS
NON.O\^JNED
AUTOS ONLY
/35EJ643 04t01t2022 04t01t2023 $2,000,000
BODILY INJURY (Psr person)
BOOILY INJURY (Per accident)$
$
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS.MADE
EACH OCCURRENCE D
AGGREGATE $
nFn RETENTION $$
c WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRI ETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
lf yes, describe undar
DESCRIPTION OF OPERATIONS below
/N
N/A
1UUUUU456/wultzuzz 04lu'U2023 X PERSTATI ITF OTH-FP
E.L. EACH ACCIDENT 1,000,000$
E.L. DISEASE - EA EMPLOYEE 1,000,000
E.L. DISEASE - POLICY LIMIT $1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addltlonal Romarks Schedule, may be attached if more 6pace iE requirud)
arising out of the operations of the named insured and where required by Mitten contract.
CANCELLATION
@ 1988-2016 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Kent
Police 0epartunent
220 Fourth Avenue South
Kent, WA 98032
1lhtul Rat & loa'naw Set*cet
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
oiQo*CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY}
Mt06t2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF TNSURANCE DOES NOT CONSTTTUTE A CONTRACT BETWEEN THE |SSU|NG INSURER(S), AUTHORTZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
MARSH RISK & INSURANCE SERVICES
FOUR EMBARCADERO CENTER, SUITE 11OO
CALIFORNIA LICENSE NO. 0437153
sAN FRANCTSCo, CA 94111
Attn: sanfrancisco.certs@marsh.com; Fax: 21 2-948-0398
cN 1 01 79755$STND-GAWU-22-23
P IONEtn N^ FYtl.FAXlAr(: N^1.
.MAIL
DDRESS:
INSURERISI AFFORDING COVERAGE NAIC f
rNsuRER A : Starr lndemnity & Liabilitv Company 38318
INSURED
L. N. Curtis and Sons, lnc.
Attn: John Viboch, CFO
185 Lennon Lane, Suite 110
Walnut Creek, CA 94598
tNsuRER B: Great Northern lnsurance Comnanv 20303
INSURER G : N/A N/A
INSURER D:
INSURER E :
INSURER F :
GOVERAGES CERTIFICATE NUMBER:sEA-003530843-1 0 N 3
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH 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.
POLICY EFFtMMtnnHvvtINSRlTRTYPE OF INSURANCE tNcn pot tcY NilMnFR POLICY EXP,MMrnnwwl LIMITS
EACH OCCURRENCE $1,000,000
DAMAGE IOf<ENIbL)
PREMISES lEa occur.encel 1,000,000$
MED EXP (Anv one oerson)10,000$
PERSONAL & ADV INJURY 1,000,000$
GENERAL AGGREGATE 10,000,000$
PRODUCTS - COMP/OP AGG 2,000,000$
A COMMERCIAL GENERAL LIABILITY
$0 Liability Deductible
X
LIMIT
PRO-
JECT
X
X
X
CLAIMS-MADE OCCUR
PER:
LOC
1 00030556921 1 Mt01t2022 04t01t2023
Per Location Aggregate 2,000,000
$2,000,000
BODILY INJURY (Per person)$
BODILY INJURY (Per accident)$
$
B AUTOMOBILE LIABILITY
ANY AUTO
O\^AED
AUTOS ONLY
HIRED
AUTOS ONLY AUTOS ONLY
SCHEDULED
AUTOS
NON.O\AJNEDXX
X $0 Liability Deduciible
73583643 94tu1t2022 04t01t2023
COMP/COLL DEDS:1,000$
EACH OCCURRENCEUMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS-MAt)E AGGREGATE $
DF f)RFTFNTION S $
X PEI(
STATIJTF
(JtH-
FR
E.L. EACH ACCIDENT 1,000,000
E.L. DISEASE - EA EMPLOYEE 1,000,000$
A WORKERS COMPENSATION
ANO EMPLOYERS' LIABILITY
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
lf yes, describe under
DESCRIPTION OF OPERATIONS b€low
N/A
'1000004587 v4tvUzuzt t)4tultzQzJ
E-L. DISEASE - POLICY LIMIT 1,000,000$
OESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD l0l, Additional Remarks Schedule, may b6 aftach6d lf more spaco is roquiJed)
arising out of the operations of the named insured and where required by written contract.
TE HOLDER
@ 1988-2016 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of AGORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEO BEFORE
THE EXPIRATION DATE THEREOF, NOTIGE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Kent
Police Department
220 Fourth Avenue South
Kent, WA 98032
?tlni4l Rt4A & laanwaa Sewat
AUTHORIZEO REPRESENTATIVE
ACORD 25 (20r6/03)