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Home My WebLink About6195 - L2 Systems LLC - COI_1Humble & Davenport Insurance Brokers Inc. BATE IMWODNYYY) ,4CC?#? " CERTIFICATE OF LIABILITY INSURANCE 1orz51zoz1 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 CONTACT Kathy Kane NAME: Humble & Davenport Insurance Brokers Inc. AfcNNo Ext : (425) 226 8221 1, No : (425) 255 9342 3500 Maple Valley Hwy enMnvlFcc. kathy.k@humbledavenport.com Renton INSURED WA 98058 1 INSURERA: Western National Mutual Insurance Company 1 15377 L2 Systems LLC INSURER C : 3925 88th St NE, Ste F INSURER D : INSURER E Marysville WA 98270 INSURER F : COVERAGES CERTIFICATE NUMBER- CL21102529609 REVISION NLIMRER- 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD EFF POLI MM OD EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 � RETED 100,000 CLAIMS -MADE OCCUR PREM SES Ea olccurrence $ MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 A Y CPP 1032664 11115/2021 11/15/2022 GEN'LAGGREGATE LIMIT APPUESPER: GENERAL AGGREGATE $ 2,000,000 POLICY � PRO JECT LOC PRODUCTS -COMPIOPAGG 2,000,600 $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED CPP 1032260 11115/2021 11/15/2022 BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS PROPERTY DAMAGE $ HIRED NON -OWNED AUTO$ ONLY AUTOS ONLY Per accident) X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 1,000,000 HCLAIMS-MADE AGGREGATE $ 1,000,000 A EXCESSLIAB UMB 1005317 11115/2021 11/15/2022 DIED I X RETENTION $ 10,000 $ WORKERS COMPENSATION PER OTH- X WA STOP GAP AND EMPLOYERS' LIABILITY Y 1 N STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETORIPARTNERfEXEGUTIVE El CPP 1032664 11115/2021 11/15/2022 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below EL. DISEASE - POLICY LIMIT $ LIMIT 1,000,000 PROFESSIONAL LIABILITY A CPP 1032664 11115/2021 11115/2022 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES tACORD 101, Additional Remarks Schedule, may be attached if more space is required) The certificate holder is named as additional insured with respects to the operations of the named insured. Coverage is primary and non-contributory per form WNGL49. Waiver of subrogation applies per form WNGL39. Completed operations apply per form WNGL84. CFRTIFICATF 1-Ir1I r1FR CANCFI I ATInid SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Bremerton, Attn: Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. 345 6th Street AUTHORIZED REPRESENTATIVE Suite 600 Bremerton WA 98337� @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD