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HomeMy WebLinkAboutCAG2023-514 - Insurance Certificate - PerCise MRM, LLC - Liability Coverage - 09/30/2023 FORCAME-01 SBERGUM ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/29/2024 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 Samantha Bergum NAME: Solutions Insurance Agencies PHONE FAX 215 N Central Ave (A/C,No,Ext): A/C,No): Suite 6 AbDR'E ,sbergum@solutionsagencies.com Duluth, MN 55807 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Massachusetts Bay Insurance Company 22306 INSURED INSURER B:The Hanover Insurance Company 22292 FORCE America,Inc.;Varitech Industries,Inc. PreCise MRM, LLC; FAH Alexandria INSURER C:Hanover American Insurance 36064 Atlanta Powertrain; Chris Norring INSURERD: 501 East Cliff Road Burnsville, MN 55337 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MM DD MM DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR ZDXD37230406 9/30/2023 9/30/2024 DAMAGE TO RENTED 100,000 PREMISES Ea occurren X XCU Coverage MED EXP(Any oneperson) $ 10,000 X Contractual Liabilit PERSONAL&ADV INJURY $ 1,000,000 I'OTHER: L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRCO-- �X LOC PRODUCTS-COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY EOMBINED SINGLE LIMIT 1�000,000 X ANY AUTO ADXD35333706 9/30/2023 9/30/2024 BODILY INJURY Perperson) OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED IX NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY APer accident $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE UHXD37230506 9/30/2023 9/30/2024 AGGREGATE $ 5,000,000 DED I X I RETENTION$ 0 $ C WORKERS COMPENSATION X PER TAT TE X ERH AND EMPLOYERS'LIABILITY Y/N WDXD35254806 9/30/2023 9/30/2024 500,000 ANY OFFICER/MEMBER ER EXCLUDED?ECUTIVE a N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Kent-IT Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y p ACCORDANCE WITH THE POLICY PROVISIONS. 220 4th Ave S Kent,WA 98032 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD