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HomeMy WebLinkAbout6234 - Art Anderson Associates - COI - 2024DATE (MM/DD/YYYY) oRo® CERTIFICATE OF LIABILITY INSURANCE � 12/27/2023 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 endOrsei 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 Leyalle Harris Brown &Brown of Washington, InC. 2106 Pacific Ave, Ste 501 Tacoma WA 98402 PHONE (A/C, No Ext : FAX AIC, No E-MAIL Le alle.Harris bbrown.com ADDRESS: y INSURER($) AFFORDING COVERAGE NAIC N INSURERA: Western National Assurance Company 24465 INSURED Art Anderson Associates, Inc. 830 Pacific Ave, Suite 200 Bremerton WA 98337 INSURER B : Western National Mutual Insurance Company 15377 INSURERC: Admiral Insurance Company INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 23/24 r 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. INSR LTR TYPE OF INSURANCE ADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 190001000 CLAIMS -MADE � OCCUR DAMAGE TO TED PREMISES (Ea occurrence) $ 50,000 MED EXP (Any one person) $ 51000 PERSONAL 8 ADV INJURY $ 0 A CPP 1330301 00 12/26/2023 12/26/2024 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000,000 PRO- POLICY ❑ PRO ❑ LOC JLCT PRODUCTS - COMPIOPAGG $ 21000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 11000,000 X BODILY INJURY (Per person) $ ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS CPP132857200 12/26/2023 12/26/2024 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PIP -Basic $ 10,000 X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 51000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE LIMB 1055083 00 12/26/2023F12/26/2024 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERJMEMBER EXCLUDED? NIA CPP 1330301 00 12I26I2023 E.L. EACH ACCIDENT $ (Mandatory In NH) E.L. DISEASE . EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below I I I I E.L. DISEASE - POLICY LIMIT $ C E0000018730-12 12/26/2023 12/26/2024 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project ##4556; BPD Practice Range Classroom c 4. f dEIPED j(C\.. V L� City of Bremerton is additional insured per attached. Waiver of subrogation applies per attached. JAN C► 2U2j City of Bremerton Attornpyls Office CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Bremerton ACCORDANCE WITH THE POLICY PROVISIONS, 345 6th Street, Ste 100 AUTHORIZED REPRESENTATIVE Bremerton WA 98337 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD For copies of the endorsements, email Leyalle Harris at the above address. DATE (MM/DDIYYYY) oizo® CERTIFICATE OF LIABILITY INSURANCE 12/27/2023 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 riahts to the certificate holder in lieu of such endorsement(s), PRODUCER Brown &Brown of Washington, Inc. 2106 Pacific Ave, Ste 501 Tacoma INSURED Art Anderson Associates, Inc. 830 Pacific Ave, Suite 200 WA 98402 curvlAcl LeyalleHarris NAME: PHONE FAX (AIC, No, Ext): (A/C, No): EMAIL Le alle.Harris bbrown.com ADDRESS: y INSURER(S) AFFORDING COVERAGE NAIC # INsuRERA: Western National Assurance Company 24465 INsu RER B : Western National Mutual Insurance Company 15377 INsuRER C : Admiral Insurance Company INSURER D : INSURER E : Bremerton � WA 98337 I INSURER F : I I COVERAGES CERTIFICATE NUMBER: 23/24 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. INSR LTR TYPE OF INSURANCE ADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 CLAIMS -MADE FX OCCUR DAMAGE TO RLTLD PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ 51000 PERSONAL&ADV INJURY $ 0 A Y Y CPP 133030100 12/26/2023 12/26/2024 GEN'LAGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 21000,000 POLICY El PRO ❑ LOC JECT PRODUCTS -COMP/OPAGG $ 21000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 11000,000 X ANY AUTO BODILY INJURY (Per person) $ B OWNED SCHEDULED AUTOS ONLY AUTOS CPP132857200 12/26/2023 12/26/2024 BODILY INJURY (Per accident) $ XHIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ PIP -Basic $ 10,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 51000,000 RDED AGGREGATE $ 51000,000 A XCESS LIAR CLAIMS -MADE UMB 1055083 00 12/26/2023 12/26/2024 X RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER STATUTE OTH- ER A ANY PROPRIETOR/PARTNEWEXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA CPP 1330301 00 12/26/2023 12/26/2024 E.L. EACH ACCIDENT $ (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS bolow E.L. DISEASE - POLICY LIMIT $ C E0000018730-12 12/26/2023 12/26/2024 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Bremerton is additional insured per attached AHBP8084. Waiver of subrogation applies per BP0497. RECEIVED JAN 0 8 102'N City of Bremerton CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Bremerton ACCORDANCE WITH THE POLICY PROVISIONS, 345 6th Street, Ste 100 AUTHORIZED REPRESENTATIVE Bremerton WA 98337 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD For copies of tl�e endorsements, email Leyalle Harris at the above address.