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HomeMy WebLinkAboutCAG2024-041 - Insurance Certificate - Institute for Applied Technology - East Hill North Community Park - 4/8/24 INSTFOR-43 DODAKELL CERTIFICATE OF LIABILITY INSURANCE DATE 4110/2024 ) 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). CONTACT PRODUCER NAME: Hub International Northwest LLC PHONE FAX 340 NW 5th Street (A/C,No,Ext):(541)757-1323 (A/C,No):(541)757-1328 Corvallis,OR 97330 nI DRIEss:Dayna.odakelI@hubinter aational.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Philadelphia Indemnity Insurance ompany 18058 INSURED INSURER B:SAIF Corporation 36196 Institute For Applied Ecology INSURER C:Scottsdale Indemnity Company 15580 4950 SW HOut St. INSURER D Corvallis,OR 97333 INSURER E 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE IN D D POLICY NUMBER MIDD M/DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE [X] PREMISESS OCCUR X X PHPK2535519 4/8/2024 4/8/2025 DAMAGE (Ea occurrence RENTED 1p$ 5,000 MED EXP An one person) $ ,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY 7 PRO X LOC PRODUCTS-COMP/OP AGO $ 3,000,000 OTHER JECT. ABUSE OR MOLEST $ 100,000 COMBINED SINGLE LIMIT 1,000,000 A AUTOMOBILE LIABILITY Ea accident $ ANY AUTO PHPK2535519 4/8/2024 4/8/2025 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ �( HIRED X NON-OWNED PeOracad.rt DAMAGE $ AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ B WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN 964112 5/1/2024 5/1/2025 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C General Liability CPS7860589 9/7/2023 9/7/2024 One Occurence/AGG 1,000,000 B Worker's Compensatio 964112 5/1/2024 5/1/2025 ACC/EMPL/LIMIT 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Liquor Liability as provided on the Liquor Liability Coverage Form(attached) Professional Liability Policy#PHPK2535519 4/8/2024-4/8/2025 Limit$1,000,000 Occurrence-$2,000,000 Aggregate Project:East Hill North Park Community Park-Vegetative Survey and Site Restoration. Certificate Holder is Additional Insured per written contract and Waiver of Subrogation applies. Policy provides 45 day cancellation notice. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent WA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y , ACCORDANCE WITH THE POLICY PROVISIONS. 220 Fourth Avenue South 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