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HomeMy WebLinkAbout6061 DocuSign Envelope ID: BF1773D5-7F28-4BBE-9FED-0843BCE0B739 PROFESSIONAL SERVI ES AGREEMENT Insurance Broker ge Services The City of Bremerton("City")and Brown Brown Insurance("Consultant"),referred to herein individually as a "Party" and collectively as the "Parties", enter into the following Professional Services Agreement("Agreement")fo insurance brokerage services: I. Scope: The Consultant agrees to perform t e services more specifically described in the Scope of Work, including any attachments there•, attached hereto as Exhibit A, which is incorporated by reference herein. The Scope of Welk may be modified only pursuant to Section VII.H of this Agreement. If the Scope of Work pro ides for unspecified additional services, such services shall only be performed upon the express itten request of the City. Consultant further represents that the services furnished under this Agr-ement will be performed in accordance with generally accepted professional practices in effect athe time such services are performed. II. Term: The City and the Consultant agree hat work will begin on March 1, 2020, and continue for a three-year period unless terminated e. Tier as provided in Section IX. III. Compensation: In consideration of the sery ces provided pursuant to this Agreement,the City shall pay Consultant an amount not to exceed$,5,000 per year. Any and all commissions received by Cons ltant from insurance companies for business placed on behalf of the City will be accounted for, disclosed to the City, and credited to City's account within 30 days of their receipt by Consul . t. The term "commission" shall not mean contingent or volume bonuses shared by the insur. ce carriers or wholesalers on Consultant's overall book of business. IV. Relationship of Parties: Consultant repres nts that it is skilled in the matters addressed in the Scope of Work and is performing independeni functions and responsibilities within its field of expertise. Consultant and its personnel are indep-ndent Consultants and not employees of the City. Consultant and its personnel have no autho ty to bind the City or to control the City's employees and other Consultants. None of the be efits provided by the City to its employees, including,but not limited to, compensation, insuran•e, and unemployment insurance are available from the City to the employees, agents, represent.tives, or sub-consultants of the Consultant. Consultant will be solely and entirely responsible for its acts and for the acts of Consultant's agents, employees, representatives and sub-consultants duri g the performance of this Agreement. As an independent Consultant, Consultant i. responsible for its own management. The City's administration and enforcement of this A_ -ement shall not be deemed an exercise of managerial control over Consultant or its personnel. As an independent Consultant, Consultant s responsible for payment of all taxes and licensing fees necessary to perform its obligations nder this Agreement. These taxes and fees include but are not limited to State industrial insuran'e,Business&Occupation, State professional licensing, and City business licensing. If any tax-s or fees due the City have been declared Page 1 of: Bremerton/Brown&Brown Insurance Brokerage Services Rev.07/2018 Docusign Envelope ID: BF1773D5-7F28-4BBE-9FED-0843BCE0B739 delinquent,the City may withhold the delinquent amount,plus any additional charges arising from the delinquency, from any payments due Consultant V. Indemnification: Consultant shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmles. from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the performance of this Agreement except for that portion of the injuries and damages caused by the City's sole negligence. The City's review or acceptance of any of th- work when completed shall not be grounds to avoid any of these covenants of indemnification. The provisions of this section shall survive th- expiration or termination of this Agreement. VI. Insurance: The Consultant shall procure an, maintain for the duration of the Agreement, insurance that is sufficient to protect the Consultan 's business against all applicable risks. The Consultant shall provide a Certificate of Insurance e idencing: 1. Commercial General Liability ins rance written on an occurrence basis with limits no less than$1,000,000 combi ed single limit per occurrence and$2,000,000 general aggregate for personal idury, bodily injury and property damage. Coverage shall include but no be limited to: blanket contractual; products/completed operations/broas form property damage; explosion, collapse and underground(XCU) if applicabl:; 2. Automobile Liability insurance wi ill limits no less than $1,000,000 combined single limit per accident for bodily in ury and property damage; 3. Excess Liability insurance with emits not less than $1,000,000 limit per occurrence and aggregate; 4. Professional Liability insurance w h limits no less than $5,000,000 limit per occurrence/claim; and 5. Workers Compensation insuranc: as statutorily required by the Industrial Insurance Act of the State of Washi gton, Title 51, Revised Code of Washington and employer's liability with limits not less than$1,000,000. Any payment of deductible or self-insured r;tention shall be the sole responsibility of the Consultant. All required policies shall be provided on an "occurrence" basis except professional liability insurance, which may be provided on a"cla ms-made" basis. The City shall be named as an additional i sured on the Commercial General Liability insurance policy, as respects work performed by or on behalf of the Consultant and a copy of an endorsement that is acceptable to the City,which n. es the City as an additional insured shall be attached to the Certificate of Insurance. The C ty further reserves the right to reject any unacceptable policies and/or endorsements. Page 2 of 9 Bremerton/Brown&Brown Insurance Brokerage Services Rev.07/2018 DocuSign Envelope ID: BF1773D5-7F28-4BBE-9FED-0843BCE0B739 The Consultant's Commercial General Liabil ty insurance shall contain a clause stating that coverage shall apply separately to each insured ag.inst whom claim is made or suit is brought, except with respects to the limits of the insurer's lia.ility. The Consultant's insurance shall be primary .nd non-contributory insurance as respects the City and shall contain a waiver of subrogation ag:inst the City for claims arising out of any operations, liabilities and obligations to which c.verage applies. It shall be an affirmative obligation upon Consultant to advise the City's Rik Manager by fax at (360) 473-5161, or by certified mail, return receipt requested to City of remerton, Attn: Risk Management, 345 6th Street, Suite 100, Bremerton, WA 98337 within i o days of the cancellation, suspension or substantive change of any insurance policy set out erein, and failure to do so shall be construed to be a breach of this Agreement. The City also reserves its unqualified right to require at any time and for any reason, proof of coverage in the form of a duplicate of the insuranc=policy with all endorsements as evidence of coverage. VII. General Conditions: A. Reports and Information: Consult.' t shall maintain the usual written records customary in the business of an insurance broker o include, but not be limited to, records of policies,premium audits,loss date,and other pertine t correspondence which affects the coverage hereunder. These records shall be maintained for a inimum of seven(7)years subsequent to the termination of this Agreement. B. Ownershi• and Use of Records and I ocuments: Any reports, studies, conclusions and summaries prepared by the Consultant shall b,come the property of the City. All written information submitted by the City to the Consultant n connection with the services performed by the Consultant under this Agreement will be safe_ arded by the Consultant to at least the same extent as the Consultant safeguards like informa ion relating to its own business. If such information is publicly available or is already in Consultant's possession or known to it, or is rightfully obtained by the Consultant from third part es, Consultant shall bear no responsibility for its disclosure, inadvertent or otherwise. All data, documents and files created by Co sultant under this Agreement may be stored at Consultant's office in Tacoma, Washington. Con.ultant shall make such data, documents, and files available to the City upon its request at all seasonable times for the purpose of editing, modifying and updating as necessary until such 'me as the City is capable of storing such information in the City's offices. Duplicate copies o this information shall be provided to the City upon its request. All documents, including all reports, drawin:;s, specifications, computer software or other items prepared or furnished by Consultant pursuant o this Agreement, are instruments of service with respect to the project and are the property oft e City. Any reuse by the City for other than the specific purpose intended will be at City's sole r sk. Page 3 of 9 Bremerton/Brown&Brown Insurance Brokerage Services Rev.07/2018 DocuSign Envelope ID: BF1773D5-7F28-4BBE-9FED-0843BCE0B739 C. Use of Photographs and Images. Consultant shall not use or distribute photographs or images depicting City officials, personnel, property, or equipment whether prepared by Consultant or provided by City without prior writen consent of the City. The City will not unreasonably withhold its consent. D. Work Performed at Consultant's R_sk: Consultant shall take all precautions necessary and shall be responsible for the safety of is employees, agents, and sub-consultants in the performance of the work hereunder and shall uti ize all protection necessary for that purpose. All work shall be done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to materials,tools,or other articles used or held for use in connection with the work. E. Place of Work: The Consultant shall perform the work authorized under this Agreement at its offices in Tacoma, Washington. Meetings with the City staff as described in Exhibit A, Scope of Work, shall take place at the City's offices, or at locations mutually agreed upon by the Parties. F. Entire Agreement: This Agreement and its Exhibits constitutes the entire agreement between the Parties, and the Parties acknowledge that there are no other agreements, written or oral,that have not been set forth in the text of this Agreement. G. Severability: Should any part of this Agreement be found void,the balance of the Agreement shall remain in full force and effect. H. Modification: This Agreement may only be modified by written instrument signed by both Parties. I. Written Notices: All communication' regarding this Agreement shall be sent to the parties at the addresses listed below by registered o first-class mail, or by personal service, and shall be deemed sufficiently given if sent to the add essee at the address stated in this Agreement or such other address as may be hereafter specified i writing. Notices to be sent to: I otices to be sent to: CITY: ONSULTANT: City of Bremerton I:rown&Brown Insurance Attn: Melisa Vaal Folmer •ttn: Kim Wilson 345 6th Street, Suite 100 ►106 Pacific Avenue, Suite 501 Bremerton, WA 98337-1891 acoma, WA 98402 J. Waiver: Failure to enforce any provi.ion of this Agreement shall not be deemed a waiver of that provision. Waiver of any right or po er arising out of this Agreement shall not be deemed waiver of any other right or power. K. Non-Waiver of Breach: The failure s i the City to insist upon strict performance of any of the covenants and agreements contained here n, or to exercise any option herein conferred Page 4 of Bremerton/Brown&Brown Insurance Brokerage Services Rev.07/2018 DocuSign Envelope ID: BF1773D5-7F28-4BBE-9FED-0843BCE0B739 in one or more instances shall not be construed to be. waiver or relinquishment of said covenants, agreements or options, and the same shall be and re ain in full force and effect. L. Compliance with Laws: Consultant s all comply with all applicable Federal, State, and local laws in performing its obligations under th s Agreement. M. Choice of Law and Venue: This Ag eement shall be interpreted according to the laws of the State of Washington. Any judicial a,tion to resolve disputes arising out of this Agreement shall be brought in Kitsap County Super or Court. N. Attorneys' Fees: In the event of litig.tion to enforce any of the terms or provisions herein, each Party shall pay all its own costs and attorney's fees. O. Assignment: Any assignment of th s agreement by the Contractor without the written consent of the City shall be void. VIII. Nondiscrimination: Consultant shall not d scriminate in employment or services to the public on the basis of race, color, national origin, s x, religion, age, marital status, disability, or sexual orientation except for employment actions ba.ed on bona fide occupational qualification. IX. Termination: This Agreement may be to inated, at will, by either Party with 90 days' notice to the other Party. This Agreement may be i mediately terminated for cause by a Party if the other Party substantially fails to perform through o fault of the terminating Party,and the non- performing Party does not commence correction of I e failure of performance within five days of the terminating Party's sending notice to the non-pe orming Party. A. Rights Upon Termination: In the e -nt of termination, the City shall pay for all services performed by the Consultant to the effectiv- date of termination, as described on a final invoice submitted to the City. After termination, th; City may take possession of all records and data within the Consultant's possession pertaining tip this project which may be used by the City without restriction. Any such use not related to the project which Consultant was contracted to perform shall be without liability or legal exposure t s the Consultant. [SIGNATURES ON EXT PAGE] Page 5 of Bremerton/Brown&Brown Insurance Brokerage Services Rev.07/2018 DocuSign Envelope ID: BF1773D5-7F28-4BBE-9FED-0843BCE0B739 IN WITNESS WHEREOF,the parties below have executed this Agreement. CITY: CONSULTANT: CITY OF BREMERTON BROWN& BROWN INSURANCE ,—DocuSigned by: By: IA-toW ` By: 61111 0-nbcbIA. Greg 1.1. eeler, Mayor -Wcam6S4*lobson, President Date: 1123 I Z'ozo Date: 1/7/2020 APPROVED AS TO FORM: ATTEST: I By:` By: akkmip.A Roger A. Lubovicl� ty Attorney Angela , City Clerk 4400 Ver Page 6 of Bremerton/Brown&Brown Insurance Brokerage Services Rev.07/2018 DocuSign Envelope ID: BF1773D5-7F28-4BBE-9FED-0843BCE0B739 Exhibit • SCOPE OF ORK Consultant will administer the insurance brokerage .ervices in accordance with the requirements of State law, and City ordinances and policies. The ollowing is the scope of services: Property/Casualty/Specialty Line Risk Analysis, arketing and Placement of Insurance: 1. Develop and recommend to the Ci insurance and other risk financing or loss funding programs, contracts, techniq es and methods whenever they will benefit the City. 2. Develop underwriting information, p epare specifications for marketing insurance coverage, structure offerings to ins vers, and secure insurance desired, providing an analysis of coverage scope, cost a d services. 3. When possible, design insurance po icy wording to meet the specific needs and requirements of the City. 4. Structure insurance programs to eli inate gaps and overlaps in coverage and to provide the limits or amounts of cov:1 age requested by the City. 5. Review each insurance policy, bind.r, certificate or other insuring document to ensure that wording is complete and accurate and that coverage is in compliance with specifications. Deliver binders :nd insurance policies to the City as soon as possible. 6. Obtain competitive insurance quotes rom various insurers when feasible. 7. Service each insurance policy iss ed to the City, processing changes and endorsements as needed. 8. Issue Certificates of Insurance as req ested by the City. 9. Provide answers to the City on insura ce coverage and risk management questions. 10. Consultant shall assume oversight responsibilities for any existing insurance policies the City has in place at the b;ginning of the contract period. 11. Act as liaison between City and insu -rs. 12. Provide the City with a written explnation of the basic structure of each policy, including coverages, exclusions, to s, analysis of coverage scope, cost and services, and other essential informat on,in a format suitable for use as a high level executive summary document. 13. Provide early warning of pending r. e, coverage or renewal problems, including significant changes in the financial status of insurers. Keep City informed of significant market conditions that ma, affect the City's insurance programs Loss Control Services: 1. Work with the City to evaluate the of ectiveness of its current loss control program and make recommendations on how ti address any deficiencies found to strengthen the overall program. 2. Assist the City in the settlement of.elf-administered claims. This service may include the monitoring of particularly severe claims by the Consultant or its claims' service affiliates so as to provide ass'stance to City's Risk Management Specialist in negotiating settlements or establis ing a defense strategy. Page 7 of 9 Bremerton/Brown&Brown Insurance Brokerage Services Rev.07/2018 DocuSign Envelope ID:BFI773D5-7F28-4BBE-9FED-0843BCE0B739 3. Assist the City in obtaining settleme t from the insurance carrier for those losses which are not self-administered. 4. When requested, perform premise in.pections of City properties together with the City's Risk Management Specialist or the purpose of identifying employee and public safety hazards. Provide re'ommendations for correction of identified hazards. 5. Consultant shall monitor the loss con of services provided by the insurance carrier or service company. Consultant fu er will monitor all inspections reports. 6. Assist the City as needed in compili loss costs; in preparing claims to adjusters; in negotiating settlements; and in pur.uing payment. 7. As requested, provide studies of alte ative loss funding plans including, but not limited to, captive feasibility, bond g feasibility, SIR/limits determination and retention level studies, and loss frequ-ncy and severity projections. 8. Monitor all insurance and other ris financing or loss funding arrangements to assure their continuing adequacy in t;rms of cost and protection. 9. Assist in the identification and evalu.tion of loss exposure as requested, including comparative data regarding other pub is entities that share the size and scope of the City, and provide loss prevention str. egies to reduce said exposures. Other: 1. Provide general risk management an. insurance consulting. 2. Maintain the usual written records customary in the business of an insurance brokerage operation, as well as an other records which the City may deem necessary to the proper handling of. d accounting for the insurance placed by the Consultant. 3. Provide contract review and insuran e services support for professional services contracts,construction projects,subcontractor agreements,equipment and premises leases, purchase orders, and maintem nce agreements. As requested by the City, assist in the development of insuranc: and hold harmless clauses for City contracts. Assist the City in the development o standards to be used for contract provisions and review. 4. Attend meetings with City as require.. 5. Provide the City with semi-annu.1 activity reports on the performance of Consultant's function. These reports .hall detail the progress and status of all work required under the agreement. 6. Provide annual updating of the City'• insurable value. 7. Be responsible for billing and sub-bi ling of premiums, and verify the accuracy of each invoice. Consultant shall ma e every reasonable effort to assure that all billings sent to the City are correct. ach invoice shall include the (a) insurer; (b) policy number; (c) policy period; . d (d) coverage provided. Consultant shall furnish invoices on a monthly basis or services which have been provided to the City to: City of Bremerton Attn: Risk Management 345 6th Street, Suite 100 Page 8 of 9 Bremerton/Brown&Brown Insurance Brokerage Services Rev.07/2018 DocuSign Envelope ID: BF1773D5-7F28-4BBE-9FED-0843BCE0B739 Bremerton, WA 98337 Within 30 days after receipt of a properly prepared invoice, the City will pay the Consultant for authorized materials and/or services satisfactorily delivered. Page9of9 Bremerton/Brown&Brown Insurance Brokerage Services Rev.07/2018 A� /Y CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDYYY) 1,/21/20,9 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 CONT CT Laurie Kohler Brown&Brown of Florida,Inc. PHONE (386)239-7242 FAX (386)323-9159 (A/C,No,Ext): (A/C,No): 220 South Ridgewood Avenue E-MIME Ikohler@bbdaytona.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Daytona Beach FL 32114 INSUIRERA: Travelers Property Casualty Company of America 25674 INSURED INSURER B: The Continental Insurance Company 35289 BROWN&BROWN INC ETALINSURER C: XL Specialty Insurance Company 37885 PO Box 2412 INSURER D: INSURER E: Daytona Beach FL 32115 INSURERF: COVERAGES CERTIFICATE NUMBER: 2019-20 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS /� LTR INSD WVD (MM/DD/YYYYI (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITYEACH OCCURRENCE $ 1,000,W CLAIMS-MADE X OCCUR PREM SESO(Ea occurr, DAMAGE ence) $ 1,000,000 MED EXP(Any one person) $ 5,000 r A Y Y TC2JGLSA9527B87419 01/01/2019 ))1/01/2020 PERSONAL BADV INJURY $ 1,000,000 2,000; GEN'L AGGREGATE LIMIT APPLIES PER: N/ GENERAL AGGREGATE $ (T/ X POLICY JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ I,000,00pr (Ea accident) '., ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED TC2JCAP9527B86219 01/01/2019 01/01/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XHIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /_� AUTOS ONLY (Per accident) Combined single limit $ UMBRELLA LIAB 5,000,000 X X OCCUR EACH OCCURRENCE $ B EXCESS LIAB CLAIMS-MADE 6011849429 01/01/2019 01/01/2020 AGGREGATE $ 5,000,060 DED RETENTION$ $ WORKERS COMPENSATION X STATUTE EORH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBER EXCLUDED? NIA TC2JUB9517B58019 01/01/2019 01/01/2020 • • (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,0U0 If yes,describe under 1,000000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , INS AGENTS E&O LIMIT 20,000 .96 C ELU15939919 01/01/2019 01/01/2020 AGGREGATE 20,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) NAMED INSURED:BROWN&BRO OF WASHINGTON,INC. CITY OF REMERTON IS ADDI AL INSURED ON THE GENERAL LIABILITY,ON A PRIMARY -NON-CONTRIBUTORY BASIS,ANI IV SUER ATION APPLIES,PER FORMS CG D2 48 08 05,CG DO 37 04 AND CG 24 04 10 93. I�/�® DEC 1 3 2019 City of 9nernano') CERTIFICATE HOLDER CANCELLATION P13kManQyemeRt 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 98337-1891 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: --'1, LOC#: AC RD ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Brown&Brown of Florida,Inc. BROWN&BROWN INC ETAL POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM ISA SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: Notes INSURER A-WORKERS COMPENSATION-POLICY TRJUB9518B76110-TRAVELERS INDEMNITY-EFF 1-1-19 TO 1-1-20,LIMITS 1,000,000/1,000,000/1,000,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD coR�® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/2/28I2020 Y) 020 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 NAME: /� ^' ADDRESS: Daytona Beach JAN 0 L AZ114 INSURERA: INSURED INSURER B BROWN &BROWN INC ETAL City of Bremerton Po Box 2412 Risk Management Daytona Beach FL 32115 rnvooncac CERTIFICATE NIIMRFR• 21003 INSURER C ie DeSandre Laur (386) 239-7242 Brown & Brown - Daytona Beach RECEIVE® WC, No Ext 300 N Beach Street E-MAIL Idesandre @bbdaytona.com INSURERS) AFFORDING COVERAGE Travelers Property Casualty Company of America XL Specialty Insurance Company The Continental Insurance Company INsuRER D : The Charter Oak Fire Insurance Company INSURER E REVISION NUMBER: (386) 239-5729 NAIC H 25674 37885 35289 25615 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREC 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDY/YYYY MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX] OCCUR Y Y TC2JGLSA9527B87421 01/01/2021 01/01/2022 EACH OCCURRENCE S 1,o002000 DAMAGE TO RENTED PREMISES Ea occurrence S I,0001000 MED EXP (Any one person) S 51000 PERSONAL &ADV INJURY 5 17000,o00 GENERAL AGGREGATE $ 1010001000 GEN'LAGGREGATE LIMITAPPLIES PER: ❑ PRO- ❑ LOC X POLICY JECT OTHER: PRODUCTS - COMP/OPAGG $ 2,000,000 5 AH AUTOMOBILE LIABILITY ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOSONLYPer TC2JCAP9527B86221 01/01/2021 01/01/2022 COMBINED SINGLE LIMIT Ea accident 5 21000,000 BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ PROPERTY DAMAGE accident $. 50,000 5 C X UMBRELLA LIAB EXCESS LIAB NX OCCUR CLAIMS MADE 6011849429 01/01/2021 01/01/2022 EACH OCCURRENCE S 51000,000 AGGREGATE 5 51000,000 $ DED RETENTIONS D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N FX ANY PROPRIETOR/PARTNER/ECUTIVE OFFICERWEMBEREXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A UB1R8701982151K 01/01/2021 01/01/2022 X STATUTE H ER E.L. EACH ACCIDENT 5 1,000,000 E.L. DISEASE - EA EMPLOYEE g 11000,000 E.L. DISEASE - POLICY LIMIT 11000,000 $ g INS AGENTS E&O ELU172413-21 01/01/2021 01/01/2022 EAWRONGFULACT AGGREGATE 202000,000 20,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) NAMED INSURED: BROWN & BROWN OF WASHINGTON, INC. CITY OF BREMERTON IS ADDITIONAL INSURED ON THE GENERAL LIABILITY, ON A PRIMARY & NON-CONTRIBUTORY BASIS, AND A WAIVER OF SUBROGATION APPLIES, PER FORMS CG D2 48 08 05, CG DO 37 04 AND CG 24 04 10 93. 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 98337-1891 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD I;L�3 iL3Li�� l-WillA 9f" LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY Brown & Brown of Florida, Inc. NAMED INSURED BROWN & BROWN INC ETAL POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE:_.. _...... -- --- ADDITIONAL REMARKS The ACORD name and logo are registered marks of ACORD