HomeMy WebLinkAboutCAG2023-208 - Insurance Certificate - Communities in Schools of Kent (CISK) - Liability Coverage - 06/01/2023 Issue Date 5/23/2023 Cert#:0000040407
Non Profit Insurance Program
Certificate of Coverage
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVEYS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES
NOTAMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW.THIS CERTIFICATE OF COVERAGE 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 be endorsed If SUBROGRATION IS 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).
PRODUCER COMPANIES AFFORDING COVERAGE
Clear Risk Solutions GENERAL LIABILITY
451 Diamond Drive American Alternative Insurance Corporation,et al.
Ephrata,WA 98823
AUTOMOBILE LIABILITY
American Alternative Insurance Corporation,et al.
INSURED PROPERTY
American Alternative Insurance Corporation,et al.
Communities in Schools of Kent
MISCELLANEOUS PROFESSIONAL LIABILITY
PO Box 62 Princeton Excess and Surplus Lines Insurance Company
Kent,WA 98035
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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.
TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP DESCRIPTION LIMITS
DATE DATE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY N1-A2-RL-0000013-14 6/1/2023 6/1/2024 PER OCCURRENCE $1,000,000
OCCURRENCE FORM PER MEMBER AGGREGATE $2,000,000
INCLUDES STOP GAP PRODUCT-COMP/OP $1,000,000
PERSONAL&ADV.INJURY $1,000,000
(LIABILITY IS SUBJECT TO A$350,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $50,000,000
AUTOMOBILE LIABILITY
ANY AUTO N1-A2-RL-0000013-14 6/1/2023 6/1/2024 COMBINED SINGLE LIMIT $1,000,000
(LIABILITY IS SUBJECT TO A$350,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
PROPERTY
N1-A2-RL-0000013-14 6/1/2023 6/1/2024 ALL RISK PER OCC EXCL EQ&FL $75,000,000
EARTHQUAKE PER OCC Excluded
FLOOD PER OCC Excluded
(PROPERTY IS SUBJECT TO A$350,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
MISCELLANEOUS PROFESSIONAL LIABILITY
N1-A3-RL-0000060-14 6/1/2023 6/1/2024 PER CLAIM $1,000,000
(LIABILITY IS SUBJECT TO A$350,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $40,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Regarding the Consultant Services Agreement between the City of Kent and Communities in Schools of Kent.City of Kent is named as Additional Insured regarding the
services in this agreement only,and is subject to policy terms,conditions,and exclusions.Additional Insured endorsement is attached.
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.
CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE /f
City of Kent Z'
220 Furth Ave South
Kent,WA 98032
AMERICAN ALTERNATIVE
INSURANCE COMPANY
ADDITIONAL INSURED—DESIGNATED PERSON OR ORGANIZATION
(GENERAL LIABILITY)
Named Insured
Non Profit Insurance Program (NPIP)
Policy Number Endorsement Effective
N 1-A2-RL-0000013-14 6/1/2023
THIS ENDORSEMENT CHANGES THE POLICY. 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 Insured): As Per Schedule on file with Clear Risk Solutions,Underwriting Administrator
City of Kent
220 Furth Ave South
Kent,WA 98032
Regarding the Consultant Services Agreement between the City of Kent and Communities in Schools of Kent.City of
Kent is named as Additional Insured regarding the services in this agreement only,and is subject to policy terms,
conditions,and exclusions.Additional Insured endorsement is attached.
A. With respects to the General Liability Coverage Part only,the definition of Insured in the Liability Conditions,Definitions and Exclusions
section of this policy is amended to include as an Insured the Person or Organization shown in the above Schedule.Such Person or
Organization is an Insured only with respect to liability for Bodily Injury,Property Damage,or Personal and Advertising Injury
caused in whole or in part by your acts or omissions or the acts or omissions of those acting on your behalf:
1. In performance of your ongoing operations;or
2. In connection with your premises owned or rented to you.
B. The Limits of Insurance applicable to the additional Insured are those specified in either the:
1. Written contractor written agreement;or
2. Declarations for this policy,
whichever is less.These Limits of Insurance are inclusive and not in addition to the Limits Of Insurance shown in the Declarations.
All other terms and conditions remain unchanged.
Form:RL 212410 21
Includes copyrighted material of the Insurance Services Office, Inc.,with its permission