HomeMy WebLinkAboutCAG2021-522 - Insurance Certificate - Institute for Community Leadership - Non Profit Insurance Program Certificate of Coverage - 06/01/2022Non. Frofit lnsurance Frogram
Gertificate of Goverage
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AiID CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS GERTIFICATE DOES
THIS CERTIFICATE OF CO'\€RAGE DOES NOT CONE]ITUE A CONTRACT
NOT AMEND, EXTEND OR ALTER THE
BETII'JEEN THE ISSUING INSURER(S)'
COVERAGEAFFORDED BYTHE POLICIES BELOW.
AUTHORIZED REPRESENTAT]VE OR PRODUCER'AND THE CERTIFICATE HOLDER.
is an musl l€rms
the policy, certain coveftUe may requke an endorsemenl. A statemenl on lhis doss nol conler rights to th6 certilicate holder in lieu of such endorEement(s).
THIS lS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
TERM OR CONDffION OF CONTRACT OR OTHER DOCUMENT WTTH RESPECT TO WHICH THISINDICATED, NOT WITHSTANDING
CERTIFICATE MAY BE ISSUED OR
ANY
MAY
REOUIREMENT,
PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDFIONS OF SUCH POL'CIES. LIMITS SHOWN MAY HAVE BEEN REDUCED EY PAID CLAIMS.
CAI{CELLATIOI{
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXFIRATION DATE THEREOF, NOTICE WILL BE DELMERED IN ACCORDANCE
FRObUCER CONPAilIES AFFORDD{G COVERASE
Clear Risk Sdutions
451 Dhmond Ddve
Ephrata, wA98823
OEIIERAL LIABf,ITY
Ameriean Alternellvt lnsurance Gorporetion' ci al.
AUTOHOBILE LIABILITY
American Allernatlv. lnsuranca CorForadoB, ot al.
PROPERTY
American Alternalivc lnsurancc Corporation, of al.
IIISCELLAT{EOUS PROFESSIOT{AL LIABIUTY
Prlnccton Exces$ and Sutplue Llnes lnsurance Gompany
lnstitute fd Cqnmunlty Leader€hip
24833 18oth Avenue SE
tGnt, WA 98{X2
POLICY,EG
OA'IE
rflrr€DESCFpllollpoucv.Nurlsh
PER MEMBERAGGREGATE
PRODUCT.COMP/OP
PERSONAL & ADV. INJURY
ANNUAL POOL AGGREGATE
12023
ts suBJEcT To A $250,000 SIR PAYABLE FROM PROGRAM FUNDS)
$,l,o0o,ooo
92i000,000
$2,000,000
OCCURRENCE FORM
INCLUDES STOP GAP
Atf,.roflbg'LELIAEL,fiY
ANNUAL POOL AGGREGATE
Ecl&
NONE
6t112022
3
(PRoPERTY IS SUBJECT TO A $25O,OOO SIR FAYABLE FROM PROGRAM FUNDS)
{LIABILITY IS SUBJECT TO A $25O.OOO SIR PAYABLE FROM PROGRAM FUNDS)
EARTHOUME PER OCE
FLOOD PER OCC
ANNUAL POOL AGGREGATE
Excluded
Excluded
NONE
SUBJECT TO
CLAIM
PROGRAM
I
2021-2OZZCDBG-CV Grant. The City ot Kert is named as Additionsl lnsured regarding this grant only and is subjectto po$cy terms, conditions, and exclusions.
lnsured €ndorsement is anached,
Resarding
Additional
#
CERNHC.ATTHOLOGR AT'I}IOMED REPNE8EI*TA?ilE
Attn: Din€h Wlson
City of K€nt
220 4th Ave. South
Kent, WA 98032
./") /' -'/'r y.,J o,_,/-VI- ,,' l)^-<L-.'' C-"-'-
AMERICAN ALTERNATIVE
INSURANCE COMFANY
ADDITIONAL INSURED- DESIGNATED PERSON OR ORGANIZATION
(GENERAL LlABlLlrYl
TI{IS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
Thls endorsement modilies insurance provided under the following:
GENERAL LIABILITY COVERAGE PART
This endorsement changes the policy efieclive on the inceplion date ofthe policy unless another dale is lndlcated above.
Schedule
Person or Organization {Additional lnsured): As Per Schedule on file with Clear Risk Solutions, Underurlting Administrator
Attni Dinah Wilson
City of Kent
2204fr1 Ave. Soulh
Kent, WA 98032
Regarding 2021-2022 CDBGCV Grant. The City of Kent is named as Additional lnsured regarding this grant only and
is subiect to policy t€rmE, conditions, and exc,lusions. Additional lnsured endorsement is attached,
A. \4lrth respects lo lhe Geneml Llability Coverage Parl only, the dellnltion of lnsured ln the Uabillty Conditions, Definitions and Exdusioris
section of lhls policy is amended to indude as an lnsurcd the Person or Organization shown in the above Schedule. Sucft Person or
OrganlzaffonisanlhsuredonlywithrespecttoliabilltyforBodllylnlury,PropertyDarnage,or ParaonalandAdvertlsinglntury
caused in wtlde or in part by your acts or omlssions or th6 acts or omissions of those acling on your behalf
1. ln performance of your ongoing operations; or
2. ln connectlon with your premlses owned or r€nt6d to you.
B. The Limits df lnsurance applicable to the additional lnsured are thee specilied in either the:
1. Wdtten conlracl or written agreement; or
2. Dedarations forthis policy,
whicfiever is less. These Limlts of lnsuranse arc inclusive and not in addition to the Llmlts Of lnsurance shown in the D6dara{ons.
All orlhertenns and conditione remain undtanged,
Named lnsured
Non Profit lnsurance Program (NPIP)
Pollcy Number
N'-A2-RL-0000013-13
Endorsement Effeclive
6t1t2022
lncludes copyrighted material of lhe lnsurance Services Office, lnc., with ite permission