Loading...
HomeMy WebLinkAbout6221 - Seton ConstructionDATE (MM/DDNYYY) A� " CERTIFICATE OF LIABILITY INSURANCE 2/19/2021 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 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 Kuresman Insurance 9321 Bayshore Dr. NW STE ill Silverdale INSURED Seton Construction, Inc. PO BOX 1376 WA 98383- APR � 6 2021 Trina Maher D. (360)692-6131 trinam@kuresmanins.com TY PORT HADLOCK WA 98339 ,fgremerton INSURERF: COVERAGES CERTIFICATE NMA4@9730 REVISION NUMBER: (360)692-6197 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 LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR EACH OCCURRENCE $ 11000,000 DAMAA PREMISES Ea occurrence PREMISES (Ea � 1,000,000 X LOGGERS BROAD FORM X Y BKS58922092 10/30/2020 10/30/2021 MED EXP(Any one person) $ 15,000 PERSONAL BADVINJURY $ 11000,000 GEN'LAGGREGATE LIMITAPPLIES PER: X POLICY a JET a LOC GENERAL AGGREGATE $ 21000,000 PRODUCTS - COMP/OPAGG $ 21000,000 Package Modification Factor 1 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1 , 000 , 000 X BODILY INJURY (Per person) $ B ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS X Y HA058922092 10/30/2020 10/30/2021 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIREDAUTOS AUTOS BACEE $ X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 5,0001000 B EXCESS LIAB CLAIMS -MADE AGGREGATE $ 51000,000 DED X RETENTION $ 10,000 US058922092 10/30/2020 10/30/2021 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER STATUTE X OTH- ER A ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA BKS58922092 10/30/2020 10/30/2021 E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - FA EMPLOYEE $ 11000,000 E.L. DISEASE- POLICY LIMIT $ 21000,000 B INLAND MARINE BM055431387 1/24/2021 1/24/2022 EQUIPMENTRENTED $500,000 DEDUCTIBLE $1 , O 00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: MARINA SQUARE THE CITY, ITS OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS SHALL BE NAMED AS ADDITIONAL INSURED AS RESPECTS WORK PERFORMED BY OR ON BEHALF OF THE CONTRACTOR FOR GENERAL LIABILITY BY WRITTEN AGREEMENT PER CG8810. INSURANCE IS PRIMARY AND NON CONTRIBUTORY WITH A WAIVER OF SUBROGATION FOR GENERAL LIABILITY BY WRITTEN CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF BREMERTON THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: RISK MANAGEMENT 345 6TH ST, STE 100 BREMERTON, WA 98337 AUTHORIZED REPRESENTATIVE Mark Maberry/MWM /` q 1 e ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (zolaol) 01111_1►1 16IJ :__ll'i� AGREEMENT PER CG8810. SEVERABILITY OF INTEREST APPLIES. [�7�1i�lu.ii:1 COPYRIGHT 2000, AMS SERVICES INC.