Loading...
HomeMy WebLinkAboutImpark cert_ATL_THE CITY OF BREMERTON_5274262_9SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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 THISCERTIFICATE 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION$ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY B 1,000,000 09/29/2022 RM3GL00010-211 RM3WC00007-211 (Retro) 20,000,000 ATL-005274262-10 1,000,000 10,000,000 RM3WC00008-211 (FL) X X 20699 10,000,000 N 09/29/2021 X SIR $250,000 09/29/2021 4 09/29/2022 01/01/2022 A 37540 09/29/2022 RM3CA00012-211 (AOS) Crime C 4,000,000 2,000,000 ACE Property & Casualty Insurance Company 1,000,000 X D 12/21/2021 09/29/2021 5,000,000 09/29/2021 RE: LOT 25-090-100, CITY OF BREMERTON PARKING ENFORCEMENT CITY OF BREMERTON IS INCLUDED AS ADDITIONAL INSURED (EXCEPT WORKERS’ COMPENSATION) WHERE REQUIRED BY WRITTEN CONTRACT. THIS INSURANCE IS PRIMARY AND NON- X 09/29/2021 GEN AGG PER LOC BREMERTON, WA 98337 THE CITY OF BREMERTON Beazley Insurance Company, Inc. 25,000 CONTRIBUTORY OVER ANY EXISTING INSURANCE AND LIMITED TO LIABILITY ARISING OUT OF THE OPERATIONS OF THE NAMED INSURED SUBJECT TO POLICY TERMS AND CONDITIONS. X A A Everest Premier Insurance Company CN129383541-Globa-GAWU-21-23 Limit N/A 09/29/2022 2,000,000 XEUG72543117001 09/29/2022 A RM3CA00011-211 (MA) 4,000,000 10120 1,000,000 1,000,000 01/01/2023 RM3WC00009-211 (AOS) 3031 N. Rocky Point Drive West, Suite 700 Marsh USA, Inc. X Tampa, FL 33607 900 Haddon Avenue, Suite 333 Imperial Parking (U.S.), LLC Collingswood, NJ 08108 X X V1FFC1200401 09/29/2021 345 6TH STREET, SUITE 600 09/29/2021 A 09/29/2022 09/29/2022 Everest National Insurance Co ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: Everest National Indemnity Company� RM3CA00009-211� � $150,000 SIR Per Unit�� 22 $1,000,000 Per Location� Garage Keepers Legal Liability� Tampa RM3CA00010-211� 09/29/2021 -09/29/2022� � ACV or Cost to repair,whichever is less� �� �� Everest National Indemnity Company� Auto Physical Damage and Garagekeepers (AOS) -� Certificate of Liability Insurance CN129383541 $150,000 SIR Per Unit� Auto Physical Damage and Garagekeepers (MA) -� 09/29/2021 -09/29/2022� Garage Keepers Legal Liability� ACV or Cost to repair, whichever is less� Marsh USA, Inc.� 900 Haddon Avenue, Suite 333� Imperial Parking (U.S.), LLC� Collingswood, NJ 08108 $1,000,000 Per Location� 25 �