HomeMy WebLinkAbout6267 - COI - Bremerton Historic Ship Association0
0
0
W
0
N
0
0
0
0
0
0
0
A✓ CERTIFICATE OF LIABILITY
INSURANCE
°Aoz�16�20"3"'
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 endorsements .
PRODUCER
CONTACT
CS&S/PROPEL INSURANCE
RECEIVED
NAME:
PHONE
FAX
A/C, No, Ext :
A/C, No):
PO BOX 958489
EMAIL
Lake Mary, FL 32746-8989 FEB 21 2023
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
1-877-724=2669
Continental CasualtyC
INSURERA: om Company
20443
INSURED City of Bremerton
BREMERTON HISTORIC SHIP ASSOCIATIOQisk Management
INSURERB:
INSURERC:
PO BOX 336
INSURER D:
BREMERTON, WA 98337
INSURER E:
INSURER F:
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, NOTWITHSTANDINGANY 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
LTR
TYPE OF INSURANCE
ADDL
INSD
SUER
WVD
POLICY NUMBER
POLICY EFF
MM/DD
POLICY EXP
MM/DD
LIMITS
A
�/
X
COMMERCIAL GENERAL LIABILITY
Y
3010105003
04/08/23
04/08/24
EACH OCCURRENCE
29000,000
CLAIMS -MADE �X OCCUR
DAMAGE TO RENTED occ
PREMISES Ea urence
1 000 000
MED EXP (Any one person)
10 000
PERSONAL R ADV INJURY
2 9 000 I 000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
410002000
POLICY JEC'T 9 LOC
PRODUCTS - COMP/OP AGG
490001000
OTHER:
3010105003
04/08/23
04/08/24
COMBINED SINGLE LIMIT
(Ea accident)
S
11000,000
A
AUTOMOBILE LIABILITY
ANY AUTO
BODILY INJURY(Per person)
OWNED AUTOS SCHEDULED
ONLY AUTOS
BODILY INJURY(Per accident)
XHIRED AUTOS NON -OWNED
ONLY AUTOS ONLY
PROPERTY DAMAGE
(Per accident)
UMBRELLALIAB
OCCUR
EACH OCCURRENCE
EXCESS LIAB
CLAIMS -MADE
AGGREGATE
DED
RETENTION $
WORKERS COMPENSATION
PER
OTH-
AND EMPLOYERS' LIABILITY Y/N
STATUTE
I
ER
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER(MEMBER EXCLUDED? E
NIA
E.L. EACH ACCIDENT
(Mandatory in NH)
If yes, describe under
E.L. DISEASE - EA EMPLOYEE
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
OTHER
PER
STATUTE
I
OTH-
ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Acord 101, Additional Remarks Schedule, may be attached If more space is required)
Certificate Holder is Named as Additional Insured - Designated
Person or Organization.
Coverage is primary and non-contributory. RE: Tax Lodging Permit
CERTIFICATE HOLDER CANCELLATION
City of Bremerton
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
345 6th St Ste 600
Bremerton, WA 98337
AUTHORIZED REPRESENTATIVE
CDkti0_4tUy-
ACORD 25 (2016103)
O 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD