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HomeMy WebLinkAbout6312 - COI - Henden Electric - 2024+ �� z a. _ � _. ,� y.� a� A rt # �.i �11 - Et. �. � _ . s.. �. _ _.. ,�.a Certificate Wotder: Named Insured: CITY OF BREMERTON HENDEN ELECTRIC, INC. 345 6TH ST STE 600 26124 CALVARY LN NE BREMERTON, WA USA 983371873 KINGSTON WA 98346-9441 Automobile Liabiti Insurer Name: Allstate Insurance Com an PoliC Number: 648744039 X 1 --Any Auto 2 -Owned Autos Only 3 -Owned Priv. Pass. Autos Only A -- Owned Autos Other Than Priv. Pass, Autos Onl 5 -- Owned Autos Subject to No Fault 6 -Owned Autos Subject to a Compulsory UM Law 7 -- S ecificall Described Autos t3 -Hired Autos Onl 9 - Nonowned Autos Onl Policy effective Date : 01-18 - 2 0 2 3 Policy Expiration Date: 01-18 - 2 0 2 4 Limitsaf $1, 000, 000 Combined Single Limit (each accident) Insurance: BI Per Person BI Per Accident PD Per Accident Description of (7perations/Locations/Vehicles/Endorsements/S cial Provisions Interested PariyType: Additional Insured - A11 Other THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER. IF THIS CERTIFICATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE EITHER BE ENDORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER INSURED STATUS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT POLICY LANGUAGE OR ENDORSEMENT. POLICY(IES) MUST WITH ADDITIONAL INDICATED IN SUCH Producer: CHISHOLM INSURANCE Authorized Representative: Date:l1-22-22 •S'r -: Includes copyrighted material of Insurance Services Office, Inc., with its permission ''�� ' �I �VV A(1L 1011 � _ ,r Aaiditional insured Copy �Alistate. Yai re in good hands. COMMERCIAL AUTO AA CW 231i914 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT Coverage provided under this policy is modified by the attachment of this endorsement If there is any conflict in coverage provisions between this form and any state specific endorsement also attached to this policy, the provisions) of the state specific form shall apply. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Endorsement Effective: 01-18 - 2 02 3 Nameq Insureq: HENDEN ELECTRIC, INC. SCHEDULE or Organization( CITY OF BREMERTON 345 6TH ST STE 600 BREMERTON, WA USA 983371873 ountersigned By: Authorized Representative If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement. SECTION IV —BUSINESS AUTO CONDITIONS,B.General Conditions, 5. Other Insurance is modified by this endorsement, only as it applies to any coverage provided to the person or organization designated in the schedule of this endorsement and only to the extent that such person or organization qualifies as an "insured" under this policy. If the named insured has entered into an agreement with the person or organization designated in the Schedule of this endorsement, which requires that the insurance available to them under this policy be applied on a primary and non-contributory basis, the following provision applies: Any coverage provided under this policy to the person or organization designated in the Schedule of this endorsement is primary, and we will not seek contribution from any other Automobile Liability insurance otherwise available to the designated person or organization. x�;�r .: Includes copyrighted material of Insurance Services Office, Inc., with its permission aorta-3 AA CW 2311914 Allstate Insurance Company Pdditional Insured Copy Page 1 of 1 ®Allstate. You're In good hands. POLICY NUMBER: 648744039 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies persons) or organizations) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: HENDEN ELECTRIC, INC . Endorsement Effective Date: 01-18 - 2 0 2 3 SCHEDULE Name Of Persons) Or Organization(s): CITY OF BREMERTON 345 6TH ST STE 600 BREMERTON, WA USA 983371873 Information required to complete this Schedule, if not shown above, will be shown in the_Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. ��m-i -{ CA 20 481013 ©Insurance Services Office, Inc., 2011 Pclditional Insured Copy Page 1 of 1