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HomeMy WebLinkAboutCityofBremerton_W24475813SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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 THISCERTIFICATE 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY Willis Towers Watson Northeast, Inc.c/o 26 Century BlvdP.O. Box 305191Nashville, TN 372305191 USA Ferguson Enterprises, LLC and Subsidiaries(See Attached Named Insured Schedule)12500 Jefferson AvenueNewport News, VA 23602 City of Bremerton, its officials, employees, agents and volunteers are included as Additional Insureds under GeneralLiability as required by written contract but only with respect to liability arising out of Named Insured'soperations. General Liability policy shall be Primary and Non-contributory with any other insurance in force for or which may bepurchased by City of Bremerton. City of BremertonAttn: Risk Management345 6the Street, Suite 100Bremerton, WA 98337 04/05/2022 1-877-945-7378 1-888-467-2378 certificates@willis.com ACE American Insurance Company 22667 ACE Property & Casualty Insurance Company 20699 W24475813 A 5,000,000 5,000,000 5,000 5,000,000 10,000,000 10,000,000 Y Y HDO G72489494 05/01/2022 05/01/2023 A 5,000,000 05/01/202305/01/2022 Self-Insured Physical Damage ISA H25564637 B 1,000,000 XOOG72519802 002 05/01/2022 05/01/2023 1,000,000 247637622420995SR ID:BATCH: Willis Towers Watson Certificate Center Page 1 of 2 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: Ferguson Enterprises, LLC and Subsidiaries(See Attached Named Insured Schedule)12500 Jefferson AvenueNewport News, VA 23602 Waiver of Subrogation applies in favor of City of Bremerton with respects to General Liability as per written contractor agreement. 2 2 Willis Towers Watson Northeast, Inc. See Page 1 See Page 1 See Page 1 See Page 1 25 Certificate of Liability Insurance W24475813CERT:2476376BATCH:22420995SR ID: As of 04/04/2022 Entity Name Entity Name AC Wholesalers Ferguson Facilities Supply (for Matera Paper -TX only) ACF Environmental (effective 11/16/2020)Ferguson Facilities Supply, Dogwood Building Supply Division (eff 10/22/18) Action Automation, a Wolseley Industrial Group company (eff 8/20/2018)Ferguson Fire & Fabrication, Inc. Action Plumbing Supply (effective 7/15/2019)Ferguson Fire & Fabrication International Adirondack Piping Solutions (effective 2/7/2022)Ferguson Heating & Cooling ADL (effective 7/16/2018)Ferguson Hospitality Sales Alaska Pipe & Supply Ferguson HVAC – Air Cold Amerock, LLC (effective 1/11/2021)Ferguson HVAC – EastWest Air Amerock Holdings, Inc. (effective 1/11/2021)Ferguson HVAC – Lyon Conklin AMS Steam Products (effective 12/13/2021)Ferguson Industrial (effective 3/15/2022) Andrews Lighting & Hardware Gallery Ferguson Integrated Services The Ar-Jay Center Ferguson International Atlantic American Fire Equipment Company Ferguson Panama, S.A. Avallon Global Ferguson Parts & Packaging BAC Appliance Center Ferguson Valve & Automation Bath + Beyond Ferguson Waterworks Bayport Partners, LLC Ferguson Waterworks - Municipal Pipe Blackman Plumbing Supply, LLC (effective 12/11/2018)Ferguson Waterworks - Red Hed Brock-McVey (effective 7/30/2018)Ferguson Waterworks EPPCO Bruce-Rogers Company Ferguson Waterworks International Build.com, Inc. (fka Improvement Direct, Inc.)Galleria Bath & Kitchen Showplace Cal-Steam Grand Junction Pipe (effective 9/24/2018) Canyon Pipe & Supply (effective 7/26/2021)HM Wallace, Inc. Capital Distributing (effective 10/29/2018)Hot Water Products (effective 12/13/2021) City Lights Design Showroom Hot Water Sales and Associates (effective 12/13/2021) CFP H.P. Products Corporation Clawfoot Supply, LLC HP Logistic, Inc. Cline Contract Sales Improvement Brands Holdings, Inc. Columbia Pipe & Supply LLC (eff 3/13/2020)Industrial Hub of the Carolinas Custom Lighting & Hardware Innovative Soil Solutions LLC (effective 7/29/2019) Davies Water James Martin Signature Vanities, LLC (effective 1/28/2019) DBS Holdings, Inc. J&G Products Dealernet Jones Stephens Corp. (effective 8/13/2018) Duhig Stainless (effective 3/12/2018)Jones Stephens Global Sourcing (Wuxi) Ltd. (effective 8/13/2018) Energy & Process Corporation J.D. Daddario Company Equarius Waterworks, Meter & Automation Group Joseph G. Pollard Co. Factory Direct Appliance JWIT Hydrotherapy Bath Solutions (effective 3/16/2020) Ferguson Bath & Kitchen Gallery Karl’s Appliances Ferguson Bath, Kitchen & Lighting Gallery Kitchen Art (effective 2/4/2019) Ferguson.com Lakeland Plumbing Supply, LLC Ferguson CESCO, Inc.Lighting Design Center Ferguson Direct Lighting Unlimited Ferguson CeSCO, Inc.Lincoln Products Ferguson Enterprises, Inc. Linwood Pipe and Supply Ferguson Enterprises, LLC Living Direct, Inc. Ferguson Enterprises LLC dba Henry Plumbing Kitchen & Bath Galleries (eff 2/9/2022)Louisiana Utilities Supply Company Ferguson Enterprises LLC dba Henry Plumbing Supply (effective 2/9/2022)LUSCO Ferguson Enterprises LLC dba Henry Kitchen & Bath (effective 2/16/2022)Mahwah Realty, LLC Ferguson Enterprises LLC dba Plumbers Supply Company of St. Louis (eff 2/16/2022)Maskir Properties Inc. Ferguson Enterprises of Virginia, LLC Matera Paper Company, Inc. Ferguson Facilities Supply (FEI)Max Industries, Ltd. (effective 1/28/2019) FERGUSON ENTERPRISES, LLC ACTIVE DBA SUBSIDIARY LIST As of 04/04/2022 FERGUSON ENTERPRISES, LLC ACTIVE DBA SUBSIDIARY LIST PAGE 2 - DBA & SUBSIDIARY LIST Entity Name Entity Name McFarland Supply Sunstate Meter & Supply, Inc. (effective 10/25/2021) Meyer Appliance (effective 9/20/2021)Supply.com MFP Design (effective 3/25/2020)Tarpon Wholesale Supplies Michigan Meter The Davidson Group Millennium Lighting, Inc. (effective 8/27/2018)The Kitchen Showcase (effective 6/21/2021) Mission Valley Pipe (effective 6/3/2019)The Plumbing Source Mississippi Utility Supply Co. (MUSCO)The Stock Market Moore Industrial Supply (effective 7/12/2021)Tinkar Realty, LLC Myers HVAC Supply TotalFab, LLC National Fire Products TPW Kitchen & Bath New Jersey Plumbing Group, LLC Uncle Sam Piping Solutions (effective 2/7/2022) New York Plumbing Designs, LLC Wallwork (effective 12/10/2018) North Point Plumbing Supply, LLC Wanlyn Realty Corp. Old Dominion Supply, Inc. (effective 10/26/2020)Waterworks Industries Orange County Plumbing Group, LLC Webb Distributors Palm Designs LLC Western Air Supply PCS Industries Westfield Lighting PL Sourcing Wholesale Group Plumb Source Wholesale Group Operations, Inc. Plumbers Supply Company (effective 1/24/2022)Wolseley (Barbados) Ltd Plumbing Décor Wolseley de Puerto Rico, Inc. Plumbing Holdings Corp.Wolseley Financial Services Pollardwater Wolseley Industrial Group Powell Pipe & Supply Co.Wolseley Integrated de Mexico S.A. de C.V. Power Equipment Direct Inc.Wolseley Investments North America, Inc. Process Instruments & Controls, LLC (effective 9/9/2019)Wolseley Investments, Inc. Professional's Bath Source Wolseley NA Construction Services, LLC PV Sullivan Supply Wolseley NA Finance, Inc. Ramapo Wholesalers Wolseley Staffing de Mexico S.A. de C.V. RB Huntington Realty, LLC WPCC Forwarding Rencor Controls (effective 3/16/2020 Wright Plumbing Supply Robertson Supply (effective 11/19/2018) Rocky Hollow Realty, LLC Renwes Sales Redlon & Johnson Reese Kitchen, Bath & Lighting Gallery Royal Pacific Limited (effective 11/22/2021) S.W. Anderson Sales Corporation (effective 11/11/2019) Safe Step Walk in Tub (effective 11/1/2021) Safe Step Walk in Tub, LLC (effective 7/31/2018) SG Supply Co. Ship-Pac Signature Hardware SimplyPlumbing, LLC SOS Sales Southhampton Realty Corp. HDO G72489494 ANY PERSON OR ORGANIZATION WHOM YOU HAVE AGREED TO INCLUDE AS AN ADDITIONAL INSURED UNDER A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS. All locations where you are performing ongoing operations for such additional insured pursuant to any such written contract. HDO G72489494 2.Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase theapplicablelimitsofinsurance. C.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 wewillpayonbehalfoftheadditionalinsuredisthe amount of insurance: 1.Required by the contract or agreement;or CG 20 10 12 19©Insurance Services Office,Inc.,2018Page2of2 Policy Number: HDO G72489494 Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss. HDO G72489494