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HomeMy WebLinkAboutL15-059 - Insurance Certificate - Verizon Wireless - 6/30/24 CERTIFICATE OF LIABILITY INSURANCE r ATE(/18/20YYYY) ACdFtL�® 061 e/zoza ��. 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). CONTACT a PRODUCER NAME; Aon Risk services Northeast, Inc. PH (866) 283-7122 FAX (800) 363-0105 W New York NY Office (WC.No.Ext): (A/C.No.): One Liberty Plaza ADDRESS: 2 AIL 165 Broadway, Suite 3201 New York NY 10006 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Liberty Mutual Fire Ins CO 23035 Verizon Communications Inc. INSURERB: 1095 Avenue of the Americas New York NY 10036 USA INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570106446511 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. Limits shown are as requested TNSRLTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY TB EACH OCCURRENCE $5,000,000 CLAIMS-MADE ❑X OCCUR PREMISES Ea occurrence) $5,000,000 X Standard Contractual Liability MED EXP(Any one person) $10,000 X XCU Coverage is Included PERSONAL&ADV INJURY $5,000,000 T GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $S,000,OOO v X POLICY ❑PRO ❑LOC PRODUCTS-COMP/OPAGG $5,000,000 a JECT 0 OTHER: n Ln A AUTOMOBILE LIABILITY AS2-691-550588-124 06/30/2024 06/30/2025 COMBINED SINGLE LIMIT $5,000,000 AOS Ea accident A AS2-691-550588-134 06/30/2024 06/30/2025 BODILY INJURY(Per person) C X ANYAUTO Z SCHEDULED NH - Primary BODILY INJURY(Per accident) OWNED AUTOS TL2-691-550588-184 06/30/2024 06/30/2025 PROPERTY DAMAGE c> A AUTOS ONLY HIRED AUTOS NON-OWNED NH - Excess Per accident) ONLY AUTOS ONLY H I 1 N UMBRELLA LIAB OCCUR EACH OCCURRENCE U EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION WORKERS COMPENSATION AND PER STATUTE ORH- EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If yes,describe under E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below _ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Named Insured includes: verizon wireless(VAw), LLC dba verizon wireless, Address: 180 washington valley Road, Bedminster, NJ 07921. RE: site Name: Ramsay, site Address: 400 W. Gowe St., Kent, wA 98032. City of Kent is included as an Additional Insured with respect to the General Liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE v EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. g L City Of Kent AUTHORIZED REPRESENTATIVE �y o ! 220 4th Avenue south ate•-- C� Kent WA 98032 USA /rl,4/J�//+,e�_vj�r C�GfPl6 t��e./iLlXGIEPQ C e./IBGL li=o 0 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Policy Number T132-691-550588-144 COMMERCIAL GENERAL LIABILITY CG 20 2612 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: - COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization whom you become obligated to include as an additional insured as a result of any contract or agreement you have entered into. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury", "property If coverage provided to the additional insured is damage or personal and advertising injury required by a contract or agreement, the most we caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the omissions or the acts or omissions of those acting amount of insurance: on your behalf: 1. In the performance of your ongoing operations; 1. Required by the contract or agreement; or or 2. Available under the applicable limits of 2. In connection with your premises owned by or insurance; rented to you. whichever is less. However: This endorsement shall not increase the 1. The insurance afforded to such additional applicable limits of insurance. insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 26 12 19 U Insurance Services Office, Inc., 2018 Page 1 of 1