HomeMy WebLinkAboutCAG2023-124 - Insurance Certificate - Insurance Certificate - Community Network Council - 7/27/24 ACCOM ® CERTIFICATE OF LIABILITY INSURANCE DATE 08/05/2OSI2OIYYYY)
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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 endorsemen s.
PRODUCER CONTNAMACT Certificate Requests
DML Insurance Services PHONE (206)838-9077 FAX ,(206j838-9076
uva4005 20th Ave W Ste 132 E-MAIL Seattle WA 98199-
carts@dmlinsurance.com
U I G
INSURER .Great American Insurance CO 16691
INSURED INSURER 13,Philadelphia Indemnity Ins Co 18058
Community Network Council INIHIRER C I - -. -
1819 Central Ave.S.Suite 72 INSURER
Kent WA 98032-
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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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 ADDLSUSR POUCYEFF POUCYEXP POLICY NUMBER OMITS
B X COMMERCIAL GENERAL LIABILITY X X PHPK2588387 0712712024 7/27/2025 EACHOCCURReNCE 1,000,000
DAMAGE TO RENTED 100.D00
CLAIMs{dADE OCCUR
X Abusive Conduct Liab MED EXP Lkrty.. man 5,0D0
X Professional Liab PERSONAL 3 ADV INJURY S 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000
X POLICYā¯‘ PRO. LOC PRODUCTS-COMP/OPAGG 2,000,000
ECT
B AUTOMOBILE LIASILRY X X PHPK2588387 D 7/27/2024 /2W2025 COMBINED SINGLE LIMIT S 1,000.000
ANY AUTO BODILY INJURY 1Per person) $
OWNED J( SCHEDULED BODILY INJURY 1PW sWdent) $
AUTOS ONLY AUTOS
Ix
HIRED X MON4SWNEO PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY
$
UMBRELLA UAB OCCUR EACH OCCURRENCE
EXCESS LIAR CLAIMS-MADE AGGREGATE
B WORKERS COMPENSATION PHPK2588387 7/272024 07/27/2025 IFER I X OTH-
AND EMPLOYERS'LWBIUTY
ANY PROPRIETORIPARTNEWEXECUTIVE YI N/A
(Mandatory in N E.L.EACH ACCIDENT 1,000,000
OFFICERIMEMBH) E.L.DISEASE-EA EMPLOYEE
ER EXCLUDED? LJ 1,000,000
It ,dmmm'undar 1,000,000
E. .DISEASE-POLICY LIMIT
A Directors&Officers Liability X X EPPE684580 0712712024 7/27/2025 Limit $1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Senedulo,maybe eesMed If more space Is rapuired)
Below certificate holder is an additional Insured with respect to contract on file.
Coverage is Primary Non-Contributory and Waiver of Subrogation applies to the holder.
CERTIFICATE HOLDER CANCELLATION Al 010631
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
City of Kent ACCORDANCE WITH THE POLICY PROVISIONS.
525 Fourth Avenue North
Kent WA 98032- AUrHORGEO REPRESENTATIVE
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