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HomeMy WebLinkAbout6408 - North Coast Electric Company - COI - 2024..ACO � DATE(2 BDo 2YYY) t� CERTIFICATE OF LIABILITY INSURANCE 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 endorsement(s). Aon Risk Services Northeast, Inc. Stamford CT Office 1600 Summer Street Stamford CT 06907-4907 USA North coast Electric Company 2450 8th Avenue south #200 Seattle WA 98134 usA RA�FC rF rnunt (g66) 283-7122 r-�n 800-363-0105 (A/C. No, Exl); (FUC. NoJ: E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE INsuRERA: Hartford Fire Insurance co. INsuRERB: Hartford Accident &Indemnity company INSURERC; TW'In City Fire Insurance Company INSURERD: ACE Property &Casualty insurance Co. INSURER E: INSURER F: I.Ielf�iu 19682 20699 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 SHOW N MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested lTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR CSES EACH OCCURRENCE $2,000,000 PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $100, 000 PERSONAL & ADV INJURY $2 , 000 , 000 GENERALAGGREGATE $2,000,000 GEN'LAGGREGATELIMITAPPLIESPER: POLICY � PRO- � LOC JECT OTHER: PRODUCTS -COMP/OP AGG $2 , OOO , OOO A AUTOMOBILE LIABILITY X ANY AUTO X OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED AUTOS X NON -OWNED ONLY AUTOS ONLY X Coll Ded 525,000 X Comp Ded 525,000 Y 10 CSE 560203 A05 O1/O1/2023 O1/O1/2024 COMBINED SINGLE LIMIT Ea accident $1, 000, 000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE Peraccidenl D X UMBRELLALIAB EXCESS LIAB X OCCUR CLAIMS -MADE XOOG46663044 01 Ol 2023 01/Ol 2024 EACH OCCURRENCE $1,000,000 AGGREGATE $1, OOO, 000 DED X RETENTION 325,000 B D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR /PARTNER /EXECUTIVE oFFICERIMEMBERExcLUDED4 � (Mandatory in NH) II yes, describe under DESCRIPTION OF OPERATIONS below N/A Y Y lOWNS602OO AOS Stopgap 1 nC . l n l i ml t lOWBR560201 WI, MA Ol Ol 2023 Ol/01/2023 Ol Ol 2024 Ol/Ol/2024 X PER STATUTE ORH- E.L. EACH ACCIDENT $1, OOO , OOO E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1, OOO, 000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Addilfonal Remarks Schedule, may be attached if more space is required) RE: City of Bremerton Low Flow Punlps vFD's, City of Bremerton, 345 6th Street, Suite 100, Bremerton, wA 98337-1891 is included as Additional Insured in accordance with the policy provisions of the general Liability policy. A waiver of Subrogation is granted in favor of city of Bremerton in accordance with the policy provisions of the General Liability, Automobile Liability and workers' compensation policies, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Clty Of BrenlertOn AUTHORIZED REPRESENTATIVE 345 6th Street, suite 100 Bremerton wA 98337-1891 USA s� rn L d w c a� a d O 2 N N r 0 0 t` rn O Z !� V .� d U a N b 0 m 0 0 rn 0 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Policy Number: 10 wN s6o2oo Endorsement Number: 57 Effective Date:ol/01/2023 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: SONEPAR USA HOLDINGS, INC. 4400 LEEDS AVENUE, STE 500 CHARLESTON, SC 29405 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE ANY PERSON OR ORGANIZATION FROM WHOM YOU ARE REQUIRED BY CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. Authorized Representative Form WC 00 03 13 Printed in U.S.A. Process Date: Policy Expiration Date: Sonepar Holdings USA, Inc. Policy Number: 10 CSE S60203 Policy Period: 01/01/2023 - 01/01/2024 � � � � � � � � This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. Any person or organization whom you are required by contract to name as additional insured is an "insured" for LIABILITY COVERAGE but only to the extent that person or organization qualifies as an "insured" under the WHO IS AN INSURED provision of Section II -LIABILITY COVERAGE. B. For any person or organization for whom you are required by contract to provide a waiver of subrogation, the Loss Condition -TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is applicable. ;�' Form HA 99 13 01 87 Printed in U.S.A. POLIC7 RUTIBER:1 CSE S60208 COMMERCIAL GENERALLIABILITY CG t 04 12 19 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, WAIVER A^,R ... TRANSFER r:A,,,..R OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS Name Of Persons) Or Organization(s): BLANKET AS REQUIRED BY WRITTEN CONTRACT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery against the person(s) or organizations) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 04 12 19 ©Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: io csE s6o208 COMMERCIAL GENERAL LIABILITY CG20261219 �' u N • � � � � � � This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons) Or Organization(s): Any person or organization whom you become obligated to include as an additional insured as a result of any contract or agreement you have entered into. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to include as an additional insured the persons) or organizations) 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 omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. N s 0 m s 0 0 0 0 0 0 0 0 CG 20 26 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 .ACC ® DAT'(2 M�DOD2 YYY) � CERTIFICATE OF LIABILITY INSURANCE 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 endorsement(s). PRODUCER Aon Rislc Services Northeast, inc. stalnford CT office 1600 summer street Stamford cT 06907-4907 USA INSURED North Coast Electric Company 2450 8th Avenue south #200 Seattle wA 98134 USA JAN 0 5 2023 «� ci il3[�1�.11l J� I:l �:� PrIONr (866) 283-7122 rAx <800) 363-0105 E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC # INSURER A: Allied World NatlOndl Assurance Company 10690 INSURER B: HdrtfOrd Fire insurance co. 19682 INsuRER c: Hartford Accident &indemnity Company 22357 INSURER D: TWin City Fire insurance Company 29459 INSURERE: ACE Property &Casualty Insurance Co. 20699 INSURERE: Great Northern Insurance Co. 20303 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. 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY CSEs EACH OCCURRENCE $2 , 000 , 000 CLAIMS�MADE ❑X OCCUR PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $100, 000 PERSONAL& ADVINJURY $2,000,000 GENERAL AGGREGATE $2 , OOO, 000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2,000,000 POLICY PRO � LOC JECT OTHER: B AUTOMOBILE LIABILITY Y 10 CSE 560203 A05 Ol/Ol/2023 Ol/Ol/2024 COMBINED SINGLE LIMIT Ea accident $1, OOO, 000 X ANYAUTO BODILY INJURY (Per person) X OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED AUTOS X NON -OWNED ONLY AUTOS ONLY BODILY INJURY (Per accident) PROPERTY DAMAGE Peraccidenl E X UMBRELLALIAB X OCCUR XOOG46663044 Ol Ol/2023 Ol/Ol/2024 EACH OCCURRENCE $1,000,000 AGGREGATE $1, 000, 000 EXCESS LIAB CLAIMS -MADE DED X RETENTION 325,000 C D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N oFFICER/MEMBERExcLUDED7 � (Mandatory in NH) N/A Y Y lOWN560200 AOS lOWBR560201 WI & MA Ol 01 2023 01/Ol/2023 Ol Ol 2024 Ol/Ol/2024 X PER STATUTE ORH- E.L. EACH ACCIDENT $1, 000, 000 E.L. DISEASE -EA EMPLOYEE $1, 000 , 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1, 000 , 000 F E&0-MPL-Primary 99508230 Professional claims Made Ol/01/2023 Ol/Ol/2024 Each Claim Deductible $1,000,000 $100,000 DESCRIPTION OFOPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: City of Bremerton Low Flow Pumps vFD's. City of Bremerton, 345 6th Street, suite 100, Bremerton, wA 98337-1891 is included as Additional insured in accordance with the policy provisions of the general Liability policy. General Liability evidenced herein is Non-contributory to other insurance available to an Additional insured, but only in accordance with the policy's provisions. A waiver of su rogation is granted in favor of City of Rrenlerton in accordance with the policy provisions of the General Liability, Automobile Liability and workers' Compensation policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. '� I Clty Of BrelllertOn AUTHORIZED REPRESENTATIVE —'l 345 6th Street, Suite 100 Bremerton wA 98337-1891 USA s N N w c d v L N a 0 2 0 N r t` 0 0 n O Z Y U N U N 0 0 M 0 0 rn 0 0 0 0 0 0 ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition (2) You have agreed in writing in a contract or and supersedes any provision to the contrary: agreement that this insurance would be Primary And Noncontributory Insurance primary and would not seek contribution from This insurance is primary to and will not seek any other insurance available to the additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 12 19 ©Insurance Services Office, Inc., 2018 Page 1 of 1 ■ Policy Number: Io wN s6o2oo Endorsement Number: 57 Effective Date:ol/oI/2o23 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: SONEPAR USA HOLDINGS, INC. 4400 LEEDS AVENUE, STE 500 CHARLESTON, SC 29405 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE ANY PERSON OR ORGANIZATION FROM WHOM YOU ARE REQUIRED BY CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. Countersigned by Form WC 00 03 13 Printed in U.S.A. Process Date: �t�e�rtiJ . � � /I<? �t.r;!.Lc c'2'-yet-' Authorized Representative Policy Expiration Date: r S .X� 0 0 0 0 0 rn 0 m 0 0 0 0 Sonepar Holdings USA, Inc. Policy Number: 10 CSE S60203 Policy Period: 01 /01 /2023 - 01 /01 /2024 This endorsement modifies insurance provided under the following: A. Any person or organization whom you are required by contract to name as additional insured is an "insured" for LIABILITY COVERAGE but only to the extent that person or organization qualifies as an "insured" under the WHO IS AN INSURED provision of Section II -LIABILITY COVERAGE. B. For any person or organization for whom you are required by contract to provide a waiver of subrogation, the Loss Condition -TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is applicable. Form HA 99 13 ®1 87 Printed in U.S.A. �• : 1 CSE S60208 BAJZMX (. THIS ENDORSEMENT CHANGES POLICY.PLEASEREAD IT CAREFULLY. WAIVER OF TRANSFER 1 OF OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Persons) Or Organization(s): BLANKET AS REQUIRED BY WRITTEN CONTRACT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions. We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against I such person(s) or organization(s) prior to loss. This ;r, t endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 04 12 19 ©Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: 10 CSE S60208 COMMERCIAL GENERAL LIABILITY CG 20 26 12 19 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. A This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Name Of Additional Insured Persons) Or Organization(s): Any person or organization whom you become obligated to include as an additional insured as a result of any contract or agreement you have entered into. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the persons) or additional insureds, the following is added to organization(s) shown in the Schedule, but only with Section III - Limits Of Insurance: respect to liability for "bodily injury", "property If coverage provided to the additional insured is damage or personal and advertising injury required by a contract or agreement, the most we caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the omissions or the acts or omissions of those acting amount of insurance: on your behalf: I. Required by the contract or agreement; or 1. or the performance of your ongoing operations; 2. Available under the applicable limits of 2. In connection with your premises owned by or insurance; rented to you, whichever is less, However: This endorsement shall not increase the applicable 1. The insurance afforded to such additional limits of insurance, insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured, CG 20 26 12 19 ©Insurance Services Office, Inc., 2018 Page 1 of 1