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HomeMy WebLinkAbout20220729_5869 Pro-Pipe insurance exp 2023-0801INSR ADDLSUBRLTRINSRWVD DATE (MM/DD/YYYY) PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED $PREMISES (Ea occurrence)CLAIMS-MADE OCCUR MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ PRO- OTHER: LOCJECT COMBINED SINGLE LIMIT $(Ea accident) BODILY INJURY (Per person)$ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS AUTOS ONLYHIRED PROPERTY DAMAGE $AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below POLICY NON-OWNED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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 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. 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 any rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) ACORDTM CERTIFICATE OF LIABILITY INSURANCE Steadfast Insurance Company American Guarantee Insurance Company Zurich American Insurance Company Travelers Casualty & Surety Co. of Amer 7/29/2022 USI Insurance Services, LLC-CL 2400 East Commercial Blvd. Suite 600 Fort Lauderdale, FL 33308 Jennifer Warrington 954 607-4000 jennifer.warrington@usi.com Pro-Pipe Inc. 47 Discovery #250 Irvine, CA 92618 26387 35521 16535 31194 A X X X Pollution X X X Q2055400202 08/01/2022 08/01/2023 2,000,000 100,000 5,000 2,000,000 4,000,000 4,000,000 B X X X X X X BAP2055400102 08/01/2022 08/01/2023 2,000,000 B X X Q2055400002 08/01/2022 08/01/2023 10,000,000 10,000,000 C N X WC293704903 08/01/2022 08/01/2023 X 1,000,000 1,000,000 1,000,000 A D Professional Liab Inland Marine Q2055400202 QT6306T179634TIL 08/01/2022 08/01/2022 08/01/2023 08/01/2023 2,000,000 each 2,000,000 agg Scheduled/Rented/Leased RE: City of Bremerton 2022 Sanitary and Storm Sewer Cleaning and Video Inspection, Branch #69. The General liability policy includes an automatic Additional Insured endorsement that provides Additional Insured status to The City of Bremerton, its officials, employees, agents and volunteers, only when there is a written contract that requires such status, and only with regard to work performed by or on behalf of the (See Attached Descriptions) City of Bremerton Attn: Risk Management 345 6th Street, Suite 100 Bremerton, WA 98337 1 of 2 #S36881501/M36880182 NATIOUND1Client#: 1982221 DGSZP 1 of 2 #S36881501/M36880182 SAGITTA 25.3 (2016/03) DESCRIPTIONS (Continued from Page 1) named insured. The General liability policy contains a special endorsement with Primary and Noncontributory wording, when required by written contract. The General liability policy provide a Blanket Waiver of Subrogation when required by written contract, except as prohibited by law. 2 of 2 #S36881501/M36880182