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HomeMy WebLinkAboutCAG2022-085 - Insurance Certificate - Solid Ground Washington - Liability Coverage - 06/01/2022SOLID02 P ID: DATE 05127/2022 Y) 05/27/2022 CERTIFICATE OF LIABILITY INSURANCE 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 CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS 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 endorsements . PRODUCER 206-623-7035 Sprague Israel Giles 151 ourth Avenue, Suite 730 CONTACT John M. Policar NAME: lacC,, No, Ext): 206-623-7035 FAX No):206-682-4993 Seattle, WA 98101-3225 John M. Policar ED AIL E INSURERS AFFORDING COVERAGE NAIC # INSURER A:Philadelphia lndemnit Ins. 18058 INSURED Solid Ground Washington 1501 N. 45th Street Seattle, WA 98103-6708 INSURER B : INSURER C : INSURER D INSURER E : INSURER F : COVFRAt;FR CFRTIFIrATF MIIMRFR• 0G1/14ZWIKt kuleeecD- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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. INSR LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR Liquor Liability X PHPK2419008 INCLUDED 06/01/2022 06/01/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREM E Ea occurrence $ 100,000 X MED EXP An one person)$ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC JECT OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED X SCHEDULED AUTOS ONLY AUTOS HIRED NON-WNED AUTOS ONLY AUTO ONLY $5,000Cornp X $5 000coll PHPK2419008 06/01/2022 06/01/2023 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY Per person)$ X BODILY INJURY Per accident $ X PROPERTY DAMAGE Per accd.M $ X $ UMBRELLA LIAB EXCESS LIAR OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DED I I RETENTION S $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under OF OPERATIONS below N / A PHPK2419008 WA STOP GAP 06/01/2022 06/01/2023 PER X OTH- TAT TE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000DESCRIPTION $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Kent is additional insured if required by written contract or written agreement, sub ect to General Liability blanket additional insured provision endorsement Citv of Kent 226 4th Ave South Kent, WA 98032 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD