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HomeMy WebLinkAbout6556CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 02/27/2024 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 endorse 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 Insurance Services, Inc. 2106 PacifcAve, Ste 501 Tacoma INSURED Pacific Netting Products Inc. 25993 United Rd NE Iri9�eILCiY] Leyalle Harris Leyalle. Harris@bbrown.com INSURERS) AFFORDING COVERAGE INSURERA: Western National Mutual Insurance Company INsuRER B : Western National Assurance Company INSURER C INSURER D INSURER E Kingston WA 98346 I INSURER F COVERAGES CERTIFICATE NUMBER: 24/25 REVISION NUMBER: NAIC # 15377 24465 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 AIJULIbUbil INSD WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICYEXP MM/DD/YYW LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence 1000000 $ MED EXP (Any one person) $ 52000 PERSONAL& ADV INJURY $ 11000,000 A Y CPP1232627-04 02/27/2024 02/27/2025 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000,000 PRO - POLICY JJECT ❑ LOG PRODUCTS - COMP/OPAGG $ 290003000 OTHER: WA Stop Gap $ 1 m/1 m/1 m AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 100000000 BODILY INJURY (Per person) $ X ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOS CPP 1228996-04 02/27/2024 02/27/2025 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Medical payments $ 50000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 510001000 AGGREGATE $ 510001000 B EXCESS LIAB CLAIMS -MADE UMB 1039398-04 02/27/2024 02/27/2025 DED I X1 RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER STATUTE OTH- ER A ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N /A CPP1232627-04 02/27/2024 02/27/2025 E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT s DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mores ace is require P VEIUt; City of Bremerton is listed as additional insured per attached endorsement MAR 0 4'20Qrll City of Bremerton Risk Kgrignomout City of Bremerton 345 6th street Ste 100 'iL7ii.Ti1 -fTia WA 98337 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2018103) The ACORD name and logo are registered marks of ACORD