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HomeMy WebLinkAboutCAG2023-661 - Insurance Certificate - Gordon Thomas Honeywell Governmental Affairs, LLC - Lobbyist - 11/20/24 StateFarm STATE FARM FIRE AND CASUALTY COMPANY AMENDED DEC 3 2024 Li A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS P BFoomrngfan IL 6i70 2915 Policy Number 98-GY-1097-9 Addl Insured-Section II Only Policy Period Effective Date Expiration Data M-15-216B-FBE1 F U 12 Months NOV 20 2024 NIM 20 2025 001400 3123 The oli��y period begins and ends at 12:01 am standard CITY OF KENT time at fie premises location. 220 4TH AVE S ,•• KENT WA 18012-5838 Named Insured GORDON THOMAS HONEYWELL GOVERNMENTAL AFFAIRS LLC nllllni�ill��llll�ll'I"I!II�I�I�II'Il'I'I��Illllln�illl�ll�l� 0 0 �s Office Policy Automatic Renewal-If the policy period is shown as 12 months,this policy will be renewed automatically subjectto the premiums,rules and forms in effectfor each succeeding policy period. If this policy is terminated,we will give you and the Mortgagee/Lienholder written notice in compliance with the policy provisions or as required by law. Entity: LLC Reason for Declarations: Your policy is amended DEC 3 2024 ADDITIONAL INSURED ADDED PREMIUM ADJUSTMENT FORM CMP-4860 ADDED Endorsement Premium None Discounts Applied: Renewal Year Years in Business Enclosed Building Protective Devices Claim Record Prepared P re 2024 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 SE SE P27 20 Includes copyrighted material of Insurance Services office,Inc.,with its permission. 009053 290 Al Continued on Reverse Side of Page Page 1 of 6 N 530-500 a2 05-37-2011(003 I DECLARATIONS(CONTINUED) Office Policy for CITY OF KENT Policy Number 98-GY-1097-9 SECTION I- PROPERTY SCHEDULE Location Location of Limit of Insurance* Limit of Insurance* Seasonal Number Described Increase- Premises Coverage A- Coverage B- Business Buildings Business Personal Personal Property Property 001 1201 PACIFIC AVE STE 2100 No Coverage $ 62,700 25% TACOMA WA 98402-4314 * As of the effective date of this policy, the Limit of Insurance as shown includes any increase in the limit due to Inflation Coverage. SECTION I - INFLATION COVERAGE INDEXES) Cov A- Inflation Coverage Index: N/A Cov B - Consumer Price Index: 314.8 SECTION I- DEDUCTIBLES Basic Deductible $1,000 Special Deductibles: Money and Securities $250 Employee Dishonesty $250 Equipment Breakdown $1,000 Other deductibles may apply - refer to policy. Prepared SEP 27 2024 Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 009053 Continued on Next Page Page 2 of 6 StateFarm • • . DECLARATIONS(CONTINUED) Office Policy for CITY OF KENT Policy Number 98-GY-1097-9 SECTION i EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE- EACH DESCRIBED PREMISES The coverages and corresponding limits shown below apply separately to each described premises shown in these Declarations, unless indicated by"See Schedule." If a coverage does not have a corresponding limit shown below, �o but has"Included" indicated, please refer to that policy provision for an explanation of that coverage. LIMIT OF COVERAGE INSURANCE Accounts Receivable On Premises $50,000 Off Premises $15,000 Arson Reward $5,000 Back-Up Of Sewer Or Drain $15,000 Collapse Included Damage To Non-Owned Buildings From Theft, Burglary Or Robbery Coverage B Limit Debris Removal 25%of covered loss Equipment Breakdown Included Fire Department Service Charge $5,000 Fire Extinguisher Systems Recharge Expense $5,000 Forgery Or Alteration $10,000 Glass Expenses Included Increased Cost Of Construction And Demolition Costs (applies only when buildings are 10% insured on a replacement cost basis) Money And Securities (Off Premises) $5,000 Money And Securities (On Premises) $10,000 Money Orders And Counterfeit Money $1,000 Newly Acquired Business Personal Property(applies only if this policy provides $100,000 Coverage B - Business Personal Property) Newly Acquired Or Constructed Buildings (applies only if this policy provides $250,000 Coverage A- Buildings) Prepared SEP re 2024 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 Includes copyrighted ri hted material of Insurance Services Office,Inc.,with its permission. CMP-4000 009054 290 Continued on Reverse Side of Page Page 3 of 6 N DECLARATIONS(CONTINUED) Office Policy for CITY OF KENT Policy Number 98-GY-1097-9 Ordinance Or Law- Equipment Coverage Included Outdoor Property $5,000 Personal Effects (applies only to those premises provided Coverage B - Business $5,000 Personal Property) Personal Property Off Premises $15,000 Pollutant Clean Up And Removal $10,000 Preservation Of Property 30 Days Property Of Others (applies only to those premises provided Coverage B - Business $2,500 Personal Property) Signs $2,500 Unauthorized Business Card Use $5,000 Valuable Papers And Records On Premises $50,000 Off Premises $15,000 Water Damage, Other Liquids, Powder Or Molten Material Damage Included SECTION I- EXTENSIONS OE COVERAGE- LIMIT OF INSURANCE PER POLICY The coverages and corresponding limits shown below are the most we will pay regardless of the number of described premises shown in these Declarations. LIMIT OF COVERAGE INSURANCE Dependent Property- Loss Of Income $5,000 Employee Dishonesty $10,000 Utility Interruption - Loss Of Income $10,000 Loss Of Income And Extra Expense Actual Loss Sustained- 12 Months Prepared SEP 27 2024 O Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 009054 Continued on Next Page Page 4 of 6 StateFarm U • W . DECLARATIONS(CONTINUED) Office Policy for CITY OF KENT Policy Number 98-GY-1097-9 SECTION II LIABILITY g LIMIT OF g COVERAGE INSURANCE Coverage L- Business Liability $1,000,000 Coverage M - Medical Expenses (Any One Person) $5,000 Damage To Premises Rented To You $300,000 LIMIT OF AGGREGATE LIMITS INSURANCE Products/Completed Operations Aggregate $2,000,000 General Aggregate $2,000,000 Each paid claim for Liability Coverage reduces the amount of insurance we provide during the applicable annual period. Please refer to Section II - Liability in the Coverage Form and any attached endorsements. Your policy consists of these Declarations, the BUSINESSOWNERS COVERAGE FORM shown below, and any other forms and endorsements that apply, including those shown below as well as those issued subsequent to the issuance of this policy. FORMS AND ENDORSEMENTS CMP-4102 Businessowners Coverage Form CMP-4860 "AI Design Person Org CMP-4247.2 Amendatory Endorsement FE-6999.3 Terrorism Insurance Cov Notice CMP-4706 Back-Up of Sewer or Drain CMP-4721 Ex Personal Advertising Injury CMP-4779 Employers Liability CMP-4788 Addl Insd Mgrs Lessor of Prem CMP-4819.1 Unauthorized Business Card Use CMP-4704.1 Dependent Prop Loss of Income CMP-4710 Employee Dishonesty CMP-4709 Money and Securities CMP-4703.1 Utility Interruption Loss Incm Prepared P re 2024 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 SE SE P27 20 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 009055 290 Continued on Reverse Side of Page Page 5 of 6 N DECLARATIONS(CONTINUED) Office Policy for CITY OF KENT Policy Number 98-GY-1097-9 CMP-4705.2 Loss of Income & Extra Expnse CMP-4765.1 Excl Empl Non-Owned Auto Liab CMP-4572 Amendment of Premium Cond CMP-4561.4 Policy Endorsement CMP-4787 Waiver of Trans Rgt of Recov CMP-4785 Addl Ins Owners Lessee Blkt CMP-4802 Addl Insd Lessor of Leased Eqp CMP-4786 Addl Insd Owners Lessee Sched FE-3661 Actual Cash Value Endorsement FD-6007 Inland Marine Attach Dec * New Form Attached This policy is issued by the State Farm Fire and Casualty Company. Participating Policy You are entitled to participate in a distribution of the earnings of the company as determined by our Board of Directors in accordance with the Company's Articles of Incorporation, as amended. In Witness Whereof,the State Farm Fire and Casualty Company has caused this policy to be signed by its President and Secretary at Bloomington, Illinois. Secretary President Prepared SEP 27 2024 O Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 009055 290 Page 6 of 6 N StateFarm STATE FARM FIRE AND CASUALTY COMPANY 11 • A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS P Box 2915 Policy Number 98-GY-1097-9 e�oomrrlgfon IL 6 1 702-29 15 Named Insured Policy Period Effective Date Exppiration Date M-15-216E-FBE1 F U 12 Months NOV 20 2024 TV 20 2025 The poli y period begins and ends at 12:01 am standard GORDON THOMAS HONEYWELL time aotl a premises location. GOVERNMENTAL AFFAIRS LLC 0 0 0 0 v ra �o ATTACHING INLAND MARINE Automatic Renewal- If the policy period is shown as 12 months,this policy will be renewed automatically subjectto the premiums,rules and forms in effectfor each succeeding policy period.If this policy is terminated,we will give you and the Mortgagee/Lienholder written notice in compliance with the policy provisions or as required by law. Annual Policy Premium Included The above Premium Amount is included in the Policy Premium shown on the Declarations. Your policy consists of these Declarations,the INLAND MARINE CONDITIONS shown below,and any other forms and endorsements that apply,including those shown below as well as those issued subsequentto the issuance of this policy. Forms,Options,and Endorsements FE-8724 Inland Marine Conditions FE-8744.1 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared C�7 SEP 2 2024 Copyright,State Farm Mutual Auto mobile Insurance Company,2008 FD-6007 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 009056 530-666 u.2 65-31-2611(o1f3232c1 98-GY-1097-9 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF DEDUCTIBLE ANNUAL NUMBER COVERAGE INSURANCE AMOUNT PREMIUM - FE-8744.1 Inland Marine Computer Prop S 25, 000 S 500 Included Loss of Income and Extra Expense 5 25 ,000 Included Prepared OTHER LIMITS AND EXCLUSIONS MAY APPLY- REFER TO YOUR POLICY SEP 27 2024 O Copyright,State Farm Mutual Automobile Insurance Company,2008 FD-6007 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 009056 530-686 a2 05-31 Un1(0132330