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HomeMy WebLinkAboutCAG2024-142 - Insurance Certificate - Solid Ground Washington - CDBG Funded Rental Assistance - 6/1/24 SOLID02 OP ID:SK A�oizo CERTIFICATE OF LIABILITY INSURANCE DATE 05/31/2024Y) 0513112024 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 endorsements. 206-623-7035 coNTACT John M. Policar PRODUCER NAME: Sprague Israel Giles PHONE 206-623-7035 FAX 206-682-4993 151 ourth Avenue,Suite 730 (A/c,No,EXt): (A/C,No): Seattle,WA 98101-3225 ADDRE : John M.Policar INSURERS AFFORDING COVERAGE NAIC# INSURER A:Philadelphia Indemnity Ins. 18058 INSURED INSURER B: Solid Ground Washington 1501 N.45th Street INSURER C: Seattle,WA 98103-6708 INSURER D: — — 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 7XPHPK12569606-012 POLICY NUMBER POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000,OOU CLAIMS-MADE OCCUR 06/01/2024 06/01/2025 pREMIsEs�aoccurrDence $ 100,000 MED EXP An one person) $ 5'000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 2,000,000 POLICY PRO ❑ LOC PRODUCTS-COMP/OP AGG $ JECT OTHER: COMBINED SINGLE LIMIT 1�000,000 A AUTOMOBILE LIABILITY Ea accident $ X ANY AUTO PHPK2669506-012 06/01/2024 06/01/2025 BODILY INJURY Perperson) $ OWNED SCHEDULED BODILY INJURY Per accident $ X AUTOS ONLY rx AUTOSXHIRED NON-OWNED PROPERTYDAMAGEAUTOSONLY AUTO Peraccident SONLY $ X $5,000comp $5 000coll $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ A WORKERS COMPENSATION STATUTE X OR H- ANDEMPLOYERS'LIABILITYYIN PHPK2659506-012 06/01/2024 06/01/20251,000,000 E.L.EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVE $ N/A OFFICER/MEMBER EXCLUDED? WA STOP GAP 1,000,000 (Mandatory in NH) E.L..DISEASE-EP.EMPLOYEE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Kent is additional insured if required by written contract or RECEIVED written agreement,subject to General Liability blanket additional insured provision endorsement. J U N O 1 2024 Human Resources 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 4th Ave South AUTHORIZED REPRESENTATIVE Kent,WA 98032 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD