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HomeMy WebLinkAboutCAG2019-389 - Insurance Certificate - Robert Half International - Liability Coverage - 06/01/2023 DATE IY(MM/DDYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 5/25/2023 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 endorsement(s). PRODUCER CONTACT NAME: Robert Half Certificates Arthur J. Gallagher Risk Management Services, LLC aHONNo Ext: 818-539-1463 A/C No):818-539-1801 500 N. Brand Boulevard E-MAIL Suite 100 ADDRESS: roberthalf certificates@ajg.com Glendale CA 91203 INSURER(S)AFFORDING COVERAGE NAIC# License#:OD69293 INSURERA: Federal Insurance Company 20281 INSURED ROBEHAL-03 INSURER B:Safety National Casualty Corporation 15105 Robert Half International Inc 2613 Camino Ramon INSURERC: San Ramon, CA 94583 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:871927356 REVISION NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP IY LIMITS LTR INSD WVD POLICY NUMBER MM/DDYYY IY MM/DDYYY A X COMMERCIAL GENERAL LIABILITY Y 35796687 6/1/2023 6/1/2024 EACH OCCURRENCE $2,000,000 CLAIMS-MADE � OCCUR PREMISES(Ea occur DAMAGE TO ante $2,000,000 X Stop Gap Em.Liab MED EXP(Any one person) $10,000 X in OH,WA,WY,ND PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY❑ JECT PRO- ❑ LOC PRODUCTS-COMP/OP AGG $2,000,000 X OTHER: Employer Liability $1,000,000 A AUTOMOBILE LIABILITY Y 73233217 6/1/2023 6/1/2024 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Comp/Coll.Ded: $1,000/$1,000 A X UMBRELLA LIAB X OCCUR 79217107 6/1/2023 6/1/2024 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$n 1 $ B WORKERS COMPENSATION See Attached Supplemental 6/1/2023 6/1/2024 X STATUTE PER OERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Kent are deemed Additional Insured on the above referenced General Liability and Auto Liability on a primary and non-contributory basis as required by written contract for liability arising out of Named Insureds'acts or omissions. Please refer to attached Chubb General Liability form 80-02-2367 for scope of Additional Insured status.Should the General Liability policy be cancelled before the expiration date thereof,the issuing company will mail thirty(30)days written notice to the Certificate Holder. CERTIFICATE HOLDER CANCELLATION 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 220 4th Ave S.,4th Floor AUTHORIZED REPRESENTATIVE Kent WA 98032 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 2023-2024 RHI Workers Compensation Policy Numbers Policy# States Eff. Date Exp. Date Issuing Company NAIC# Robert Half International Inc.and Protiviti Inc. AOS:AK,AZ,AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, LDS4064812 MN, MS, MO, MT, NE, 6/1/2023 6/1/2024 Safety National Casualty Corp 15105 NV, NH, NJ, NM, NY, NC, OK, OR, PA RI, SC, SD,TN,TX, UT,VT,VA, WV,WY PS 4064813 WI 6/1/2023 6/1/2024 Safety National Casualty Corp 15105 Liability Insurance Endorsement Policy Period JUKE 1,2023 TO JUNE 1,2024 Effective Date JUNE 1,2023 Policy Number 3579-66-87 SFO Insured ROBERT HALF INTERNATIONAL,INC Name of Company FEDERAL INSURANCE COMPANY Date Issued JUNE 1,2023 This Endorsement applies to the following forms: GENERAL LIABILITY Under Who Is An Insured,the following provision is added. Who Is An Insured Additional Insured- Persons or organizations shown in the Schedule are insureds;but they are insureds only if you are Scheduled Person obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by Or Organization this policy. However,the person or organization is an insured only: • if and then only to the extent the person or organization is described in the Schedule; • to the extent such contract or agreement requires the person or organization to be afforded status as an insured; • for activities that did not occur,in whole or in part,before the execution of the contract or agreement;and • with respect to damages,loss,cost or expense for injury or damage to which this insurance applies. No person or organization is an insured under this provision: • that is more specifically identified under any other provision of the Who Is An Insured section(regardless of any limitation applicable thereto). • with respect to any assumption of liability(of another person or organization)by them in a contract or agreement.This limitation does not apply to the liability for damages,loss,cost or expense for injury or damage,to which this insurance applies,that the person or organization would have in the absence of such contract or agreement. Liability Insurance continued Form 80-02-2367(Rev. 5-07) Endorsement Page 1 Liability Endorsement (continued) Under Conditions,the following provision is added to the condition titled Other Insurance. Conditions Other Insurance— If you are obligated,pursuant to a contract or agreement,to provide the person or organization Primary, Noncontributory shown in the Schedule with primary insurance such as is afforded by this policy,then in such case Insurance— Scheduled this insurance is primary and we will not seek contribution from insurance available to such person Person Or Organization or organization. Schedule PERSONS OR ORGANIZATIONS THAT YOU ARE OBLIGATED,PURSUANT TO WRITTEN CONTRACT OR AGREEMENT BETWEEN YOU AND SUCH PERSON OR ORGANIZATION,TO PROVIDE WITH SUCH INSURANCE AS IS AFFORDED BY THIS POLICY;BUT THEY ARE INSUREDS ONLY IF AND TO THE MINIMUM EXTENT THAT SUCH CONTRACT OR AGREEMENT REQUIRES THE PERSON OR ORGANIZATION TO BE AFFORDED STATUS AS AN INSURED. HOWEVER,NO PERSON OR ORGANIZATION IS AN INSURED UNDER THIS PROVISION WHO IS MORE SPECIFICALLY DESCRIBED UNDER ANY OTHER PROVISION OF THE WHO IS INSURED SECTION OF THIS POLICY(REGARDLESS OF ANY LIMITATION APPLICABLE THERETO). All other terms and conditions remain unchanged. Authorized Representative Liability Insurance last page Form 80-02-2367(Rev. 5-07) Endorsement Page 2 COMMERCIAL AUTOMOBILE — BLANKET ADDITIONAL INSURED — POLICY EXCERPT Insured Robert Half International, Inc Policy Number 7323-32-17 Policy Effective June 1, 2023 —June 1, 2024; 12:01 am Standard Time Form Number 16-02-0292 (rev. 11-16) BUSINESS AUTO COVERAGE FORM This endorsement modifies the Business Auto Coverage Form. 2. BROAD FORM INSURED D. Persons And Organizations As Insureds Under A Written Insured Contract Paragraph A.1 —WHO IS AN INSURED—of SECTION II — LIABILITY COVERAGE is amended to add the following: f. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed under an express provision in a written "insured contract", written agreement or a written permit issued to you by a governmental or public authority to add such person or organization to this policy as an "insured". However, such person or organization is an "insured" only: (1)with respect to the operation, maintenance or use of a covered "auto"; and (2)for"bodily injury" or"property damage" caused by an "accident'which takes place after: (a)You executed the "insured contract'or written agreement; or (b)The permit has been issued to you.