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HomeMy WebLinkAbout5471 insuranceSODUR-1 DATE (MMIDD/YYYY) coRO' CERTIFICATE OF LIABILITY INSURANCE 06/16/2021 L-Iaswo, Lsms,,, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATEDOESNOTAFFIRMATIVELYORNEGATIVELYAMEND, 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 ends) orsement(. r 303 951 5050 I NAMEACT Glenn J. Sudol PRODUCER FAX _. . 303-951-5060 Outdoor lnsurance Grou p,lnc. 1371 Hecla Drive Ste E Louisville, CO 80027 Glenn J. Sudol Urban Forestry, LLC AcFarland 1910 E. 4th Ave. a, WA 98506 RECEIVE® JUN 28 ?.021 City of Bremerton Risk Management 303- 951-5050 rnichelle@oigcorp. com 7 Ins OVERAGES ctrc I IrwF+t IYurYro r.. THIS IS TO CERTIFY THAT THE POLICIES OF IINSURANCE L^S ^ED B!E^OW HAVE BEEN ISSU pD TO OR nINSURED NAMED ABOVN FOR THE POLICY PERT INDICATED, NO?WITH ...P. P.RY RECU.R MEI„ TERM OR r0ND.TION OF AN CONTRACT OR .HER DOCUMENT TH RESPECT T.. W.HICH HIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSANDCONDITIONSOFSUCHPOLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED GY PAID POLICY EI MSLIMITS 3R ADDL SUB POLICY NUMBER TYPEOFINSURANCE1,000,0 X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED 1 OO,a CLAIMS - MADE X OCCUR X X PPK2287002 07101/2021 07/01/2022 P E E Eaoccu a ce $ 5,( E& O $1 MI1 M MED EXP An one arson $ 1, 000,( EN' L AGGREGATE LIMIT APPLIES PER: X 1 POLICY PRO LOC JECTAUTOMOBILE LIABILITY ANY AUTO OWNED AUTOSONLYHIRED AUTOSONLY A I X I UMBRELLA LIAB SCHEDULED AUTOS NON - OWNED AUTOS ONLY EXCESS LIAB CLAIMS -MADE DED X RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE N I A Mandatory rnNH) EXCLUDED? If yes, describe under___ 2434 0710112021 07/01/2022 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) It is understood and agreed that the Certificate Holder is named as the AdditionalInsured, but only with respect to it's liability arising out of theactivitiesoftheNamedInsured. Waiver of subrogation applies, the insurance is primary & non-contributory Needs Al Endo & other forms City of Bremerton Attn Risk Management 345 6th Street Ste 100 Bremerton, WA 98337 2, 000,000 LIMIT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THEEXPIRATIONDATETHEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. RIZED REPRESENTATIVE AUTHO2016/ 03) ACORD25 ( 1988- 2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PPI<2287002 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. i I 1 • 1 nI I i This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or O Gity of Bremerton Information required to complete this Schedule, if not shown Section II —Who Is An Insured is amended to in- clude as an additional insured the persons) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. will be shown in the Declarations. CG 20 26 07 04 ©ISO Properties, Inc., 2004 Page 1 of 1 PI-GL-005 (07/12) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Effective Date: 07/01/2017 Name of Person or Organization (Additional Insured): CITY OF BREMERTON BREMERTON PARKS & RECREATION SECTION II —WHO IS AN INSURED is amended to include as an additional insured the persons) or organizations) shown in the endorsement Schedule, but only with respect to liability for "bodily injury," property damage" or "personal and advertising injury" arising out of or relating to your negligence in the performance of "your work" for such person(s) or organization(s) that occurs on or after the effective date shown in the endorsement Schedule. This insurance is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or "occurrence" we cover for this Additional Insured. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III —LIMITS OF INSURANCE. All other terms, conditions, and exclusions under the policy are applicable to this endorsement and remain unchanged. Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission.