Loading...
HomeMy WebLinkAbout6326 - Kitsap County Historical Society_COIDATE (MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE 04/01 /2022 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 SUBROGATIONIS 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 CONTACT PROPEL INSURANCE/PHS NAME: 52701950 PHONE (866)467-8730 FAX (888)443-6112 (A/C, No, Ext): (AIC, No): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio, TX 78251 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL# INSURED INSURERA: Sentinel lnsufanc{e.0(np� yLtd.,, , 11000 KITSAP COUNTY HISTORICAL SOCIETY INSURERB: 280 4TH ST INSURER C BREMERTON WA 98337A813APRINSURER D : ' INSURERE: INSURERF: `' f nM DAr_cc rFRTIFICATF NIIMRFR• RFVISION NIIMRFRO 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, INSR LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF MM! D/YYYY POLICY EXP MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $1 000000 MED EXP (Any one person) $106000 General Liability X A X X 52 SBA AA8188 04/30/2022 04/30/2023 PERSONAL & ADV INJURY $1 000 000 GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 POLICY ❑ JEC LOG PRODUCTS-COMP/OPAGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT accident) $100000000 ANY AUTO BODILY INJURY (Per person) A ALL OWNED SCHEDULED AUTOS AUTOS 52 SBA AA8188 04/30/2022 04/30/2023 BODILY INJURY (Peraccident) PROPERTY DAMAGE (Per accident) X HIRED X NON -OWNED AUTOS AUTOS UMBRELLALIAB OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS- MADE AGGREGATE ED I RETENTION $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY AT ER ANY YIN E.L. EACH ACCIDENT PROPRI ETORIPARTNERIEXECUTIVE OFFICER/MEMBEREXCLUDED? NIA E.L. DISEASE EA EMPLOYEE (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below --riAggregate A EMPLOYMENT PRACTICES LIABILITY 52 SBA AA8188 04/30/2022 04/30/2023 Each Claim Limit Limit $10,000 $10,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 attached to this policy. Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy. City of Bremerton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 345 6TH ST BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED BREMERTON WA 98337-1858 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©198&2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DATE (MMIOD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04/01/2022 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 SUBROGATIONIS WAIVED, subject to the terns 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 ry IA' I PROPEL INSURANCE/PHS NAME: 52813224 PHONE (866)467-8730 FAX No): The (A/C, No, Ext): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio, TX 78251 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURERA: Twin City Fire I,nSUfanfl011 R KITSAP COUNTY HISTORICAL SOCIETY INSURERS: 280 4TH ST BREMERTON WA 98337-1813 INSURERC: APR 1 INSURER D : INSURER E : INSURER F : S rntrconr_�c (`FRTIFIf ATF PIIINIRFR• REVISION NUMBER: V 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DD/Y YYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE❑OCCUR DAMAGE PREMISES RENTED PREMISESS ( Ea occurrence MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG POLICY ❑ PRO- LOC JECT El OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY (Per person) ALLOWNED SCHEDULED BODILY INJURY (Per accident) AUTOS AUTOS HIRED NON -OWNED PROPERTY DAMAGE AUTOS AUTOS (Peraccident) UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- AGGREGATE MADE ED I RETENTION $ WORKERS COMPENSATION PER I OTH- AND EMPLOYERS' LIABILITY STATUTE JER ANY YIN E.L. EACH ACCIDENT PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE -EA EMPLOYEE E.L. DISEASE -POLICY LIMIT (Mandatory in NH) byes, describe under DESCRIPTION OF OPERATIONS below A Directors & Officers Liability 52KM033887521 08/02/2021 08/02/2022 Aggregate $1,0000000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace is required) Those usual to the Insured's Operations. Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 attached to this Policy. Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy. City of Bremerton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 345 6TH 5T BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED BREMERTON WA 98337-1858 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4�7f Cz � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (201 ti/03) The ACORD name and logo are registered marks of ACORD CERTIFICATE F LIABILITY INSURAVC-E DATE (MM/DD/YYYY) conferTHIS 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 SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not a to the certificate holderof - •• PRODUCER• PROPEL INSURANCE/PHS 1 1 PHONEi•• +• i 1 The • • Business Service Center •11 Wiseman • Antonio,San *i • INSURER(S) INSUREb KITSAP COUNTY HISTORICAL SOCIETY 280 4TH ST BREMERTON WA 98337.1813 .c ►ice.. INSURER A : Sentine INSURER B : INSURER C : INSURER D INSURER E ; INSURER F AFFORDING COVERAGE NAICII THIS IS 70 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS•MADE I X OCCUR I�J General Liability DAMAGE TO RENTED PREMISES (Ea occurrence $150005000 X MED EXP (Any one person) _ $100000 A _ X X 52 SBA AA8188 04/30/2022 04/30/2023 PERSONAL & ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ❑ PRO- I X I LOG JECT t� t PRODUCTS - COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a accident)_ $15000,000 ANY AUTO BODILY INJURY (Per person) A ALL OWNED SCHEDULED AUTOS AUTOS 52 SBA AA8188 04/30/2022 04/30/2023 BODILY INJURY (Per accident) X HIRED NOWOWNED AUTOS X AUTOS PROPERTY DAMAGE (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS" MADE AGGREGATE _ DED RETENTION WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY STATUTE ER E.L. EACH ACCIDENT ANY Y/N PROP RIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE -EA EMPLOYEE _.,_..,.---°----,--_-- (Mandatory In NH) It yes, describe under EL. DISEASE - POLICY LIMIT DES RIP ON OF OPERATIONS below A EMPLOYMENT PRACTICES LIABILITY L I _ 52 SBA AA8188 04/30/2022 04/30/2023 I Each Claim Limit Aggregate Limit $10,000 $10,000 DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (ACORD 1010 Additional Remarks Schedule, may be attached If more space Is required) Those usual to the Insured's Operations, Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 attached to this policy. Waiver of Subrogation applies In favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy, City of Bremerton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 345 6TH ST BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED BREMERTON WA 98337-1858 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE DATE (MM/DDIYYYY) 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 AMENDs EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, wt. AOF INSURANCE DOES - CONSTITUTE y. CONTRACT BETWEEN THE ISSUING INSURERi AUTHORIZED REPRESENTATIVE OR PRODUCERAND THE CERTIFICATE HOLDERs IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcyi must be endorsed. If SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy, certain pollcles may require an endorsement. A statement on this certificate does not confer r1i to the certificate holder In fleu of such endorsomenti PROPEL INSURANCEIPHS PHONE (866) 41 FAx 62813224 (AlC, No, Ext): (AI :1 No): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio, TX 78251 ADDRESS: INSURER(S) AFFORDING COVERAGE INsuRED INsuRERA: Twin City Fire Insurance Co KITSAP COUNTY HISTORICAL SOCIETY INSURER B : 280 4TH S'i - ---- --- BREMERTON WA 98337e1813 INSURERC: INSURER D INSURER E INSURER F : rnv� arsee ('POTIViii h1IIMR1=11i REVISION NUMBER: THIS IS 70 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDD/Y YYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR ILL��111 EACH OCCURRENCE DAMAGE TO RENTED PREMISES Ea occurrence MED EXP (Any one person) — PERSONAL & ADV INJURY GENERAL AGGREGATE GEML AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT OTHER: PRODUCTS - COMP/OP AGG A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED NON -OWNED AUTOS AUTOS COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) UMBRELLA LIABE:MLADIME. EXCESS LIABAS• CUR EACH OCCURRENCE AGGREGATE v qEb RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY YIN PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below NIA - PER STATUTE OTH- ER E.L. EACH ACCIDENT _ EL. DISEASE -EA EMPLOYEE ---- E.L. DISEASE - POLICY LIMIT A Directors & Officers Liability :r52KM033887512208/02/2022 08/02/2023 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Those usual to the Insured's Operations, Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 attached to this policy, Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy. City of Bremerton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 345 1 ST BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED BREMERTON WA 98337.1858 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE