HomeMy WebLinkAboutCAG2021-108 - Insurance Certificate - Kent Youth and Family Services - Non Profit Insurance Program Certificate of Coverage - 06/01/2022Non Profit lnsurance Program
Certificate of Coverage
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER'
NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF COVERAGE DOES NOT
BETWEEN THE tSSUtNG TNSURER(S), AUTHORTZED REPRESENTATTVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
THIS CERTIFICATE DOES
CONSTITUE A CONTRACT
PRODUCER COI'PANIES AFFORDING COVERAGE
Clear Risk Solutions
451 Diamond Drive
Ephrata, WA 98823
GENERAL LIABILITY
American Alternative lnsurance Corporation, et al.
AUTOMOBILE LIABILITY
American Alternative lnsurance Corporation, et al.
PROPERTY
American Alternative lnsurance Corporation, et al.
MISCELLANEOUS PROFESSIONAL LIABILITY
Princeton Excess and Surplus Lines lnsurance Company
INSURED
Kent Youth and Family Services
232 South Second Avenue #201
Kent, WA 98032
GOVERAGES
IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. lf SUBROGRATION lS 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).
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE
INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF CONTRACT OR
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES
INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
OTHER DOCUMENT WITH RESPECT TO WHICH THIS
DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIMTION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE
WITH THE POLICY
CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE
City of Kent
220 4th Ave S
Kent, WA 98032
TYPE OF INSURANCE POLICY NUMBER POLICY EFF
DATE
POLICY EXP
DATE
DESCRIPTION LIMITS
GENERAL LIABILITY
tLtw N1 -A2-RL-000001 3-3 61112023 PER
OCCURRENCE FORM
INCLUDES STOP GAP
PER MEMBER AGGREGATE
PRODUCT-COMP/OP
PERSONAL & ADV. INJURY
ANNUAL POOL AGGREGATE
$10,000,000
$5,000,000
$5,000,000
$50,000,000Ltry IS SUBJECT TO A $25O,OOO SIR PAYABLE FROM PROGMM FUNDS)
AUTOMOBILE LIABILITY
N1-A2-RL-00000 61112022 61112023 LIMIT
(LIABILITY IS SUBJECT TO A $25O,OOO SIR PAYABLE FROM PROGRAM FUNDS)ANNUAL POOL AGGREGATE NONE
PROPERTY
3-1 3 ALL RISK PER OCC
(PROPERry IS SUBJECT TO A $25O,OOO SIR PAYABLE FROM PROGRAM FUNDS)
EARTHQUAKE PER OCC
FLOOD PER OCC
ANNIJAL POOL AGGREGATE
Excluded
$1,000,000
NONE
MISCELLANEOUS PROFESSIONAL
N1-A3-RL-0000060-1 3 6t1t2023 PER CLATM $5,000,000
IS SUBJECT TO A SIR PAYABLE PROGRAM
DESCRIPTION OF OPERATIONS
'
LOCATIONS
'
VEHICLES / SPECIAL ITEMS
Regarding funding received. The City of Kent, its elected, and appointed officials are named as Additionallnsured regarding lhis funding only and are subject to policy terms,
conditions, and exclusions. Additionallnsured endorsement is attached.
AMERICAN ALTERNATIVE
INSURANCE COMPANY
ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION
(GENERAL LIABILITY)
THIS ENDORSEMENT CHANGES THE POLIGY. PLEASE READ IT CAREFULLY
This endorsement modifies insurance provided under the following:
GENERAL LIABILITY 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 lnsured): As Per Schedule on file with Clear Risk Solutions, Undenivriting Adminishator
City of Kent
220 4th Ave S
Kent, WA 98032
Regarding funding received. The City of Kent, its elected, and appointed officials are named as Additionallnsured
reglrdinglhis tunding only and are subject to policy terms, conditions, and exclusions. Additionallnsured
endorsement is attached.
A. With respects to the General Liability Coverage Part only, the definition of lnsured in the Liability Conditions, Definitions and Exclusions
section of this policy is amended to include as an tnsured the Person or Organization shown in the above Schedule. Such Person or
OrganizationisanlnsuredonlywithrespecttoliabilityforBodilylnjury,PropertyDamage,or Personal andAdvertisinglnjury
caused in whole or in part by your acts or omissions orthe acts or omissions of those acting on your behalf:
1. In performance of your ongoing operations; or
2. ln connection with your premises owned or rented to you.
B. The Limits of lnsurance applicable to the additional lnsured are those specified in either the:
1. Written contract or written agreement; or
2. Declarations for this policy,
whichever is less. These Limits of lnsurance are inclusive and not in addition to the Limits Of lnsurance shown in the Declarations'
All other terms and conditions remain unchanged.
Named lnsured
Non Profit lnsurance Program (NPIP)
Policy Number
N1-A2-RL-0000013-13
Endorsement Effective
6t112022
lncludes copyrighted material of the lnsurance Services Office, lnc., with its permission