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HomeMy WebLinkAboutCAG2023-156 - Insurance Certificate - KPg Psomas, Inc - Naden Ave Interurban Trail Improvements - 04/01/2024 73/19/2024 (MM/DDYYY) A�" CERTIFICATE OF LIABILITY INSURANCE IY 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: Sharon Brubaker Greyling Ins. Brokerage/EPIC PHONE FAX 3780 Mansell Road, Suite 370 A/C No Ext: 770.756.6599 A/C No):770.756.6599 Alpharetta GA 30022 ADRIESS: greylingcerts@greyling.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: National Union Fire Ins Co of Pittsburg19445 INSURED INSURER B:Travelers Property Casualty Co of Amer 25674 KPG Psomas Inc. 3131 Elliott Avenue INSURERC: Suite 400 INSURER D: Seattle WA 98121-0000 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:767071289 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 GL5268212 4/1/2024 4/1/2025 EACH OCCURRENCE $2,000,000 CLAIMS-MADE OCCUR DAMAGE TO PREM IS RENTED (Ea occurrence $500,000 MED EXP(Any one person) $25,000 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY jE LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER: $ A AUTOMOBILE LIABILITY CA4489706 4/1/2024 4/1/2025 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident B X UMBRELLA LIAB X OCCUR CUP7X223161 4/1/2024 4/1/2025 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED X RETENTION$In nnn $ A WORKERS COMPENSATION WC015893764(AOS) 4/1/2024 4/1/2025 X STATUTE OERH A AND EMPLOYERS'LIABILITY Y/N WC015893765(CA) 4/1/2024 4/1/2025 ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $2,000,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $2,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 9KEN010100;4Naden Ave.Trail Improvement.City of Kent and KPG Psomas, Inc.are named as Additional Insureds with respects to General&Automobile Liability where required by written contract.The above referenced liability policies with the exception of professional liability are primary&non contributory where required by written contract.Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof,we will endeavor to provide 30 days'written notice(except 10 days for nonpayment of premium)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 Fourth Avenue South; Kent WA 98032-0000 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD