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HomeMy WebLinkAboutPK18-260 - Insurance Certificate - YMCA of Greater Seattle - 10/01/23-10/1/2024 77/2/2024 E(MM/DDYYY) ACC" CERTIFICATE OF LIABILITY INSURANCE /Y 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: Elise Beaudoin Marsh &McLennan (CLW) PHONE FAX 101 N Starcrest Dr AIC No Ext: 727-523-86665 AIC No):727-449-1267 Clearwater FL 33765 ADDRESS: elise.beaudoin@marshmma.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Great American Insurance Company 16691 INSURED YMCASEAT INSURER B:Great American Alliance Insurance Co. 26832 YMCA of Greater Seattle 909 4th Avenue INSURER C:Great American Assurance Company 26344 Seattle WA 98104 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:927842782 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 /Y LIMITS LTR INSD WVD POLICY NUMBER MM/DDYYY IY MM/DDYYY C X COMMERCIAL GENERAL LIABILITY Y Y PAC31324670502 10/1/2023 10/1/2024 EACH OCCURRENCE $1,000,000 Fv� DAMAGE TO CLAIMS-MADE OCCUR PREMISES (E.occur ante) $1,000,000 X 25,000 MED EXP(Any one person) $20,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY❑ PRO- � JECT LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: BI/PD Deductible $$25,000 A AUTOMOBILE LIABILITY CAP313246805 10/1/2023 10/1/2024 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident L $ B X UMBRELLA LIAB X OCCUR UMB313246905 10/1/2023 10/1/2024 EACH OCCURRENCE $15,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $15,000,000 DED X RETENTION$n $ C WORKERS COMPENSATION PAC31324670502 10/1/2023 10/1/2024 PER AND EMPLOYERS'LIABILITY Y/N STATUTE ERH Stop Gap-WA/WY ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Abuse&Molestation PAC31324670502 10/1/2023 10/1/2024 Aggregate/Occurrence 3MM/1 MM C Professional Liability PAC31324670502 10/1/2023 10/1/2024 Aggregate/Occurrence 3MM/1MM Deductible/Occurrence $25,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:All Operations City of Kent is an additional insured on a primary and non-contributory basis with respect to general liability when required by written contract per the attached policy forms. Waiver of subrogation applies when required by written contract per the attached policy forms.Notice of Cancellation applies per the policy provisions. 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 Ave. S. AUTHORIZED REPRESENTATIVE Kent WA 98032 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD