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HomeMy WebLinkAbout2024 COI - Kellermeyer Bergensons ServicesAC.� ® DATEO(M OM/D�/3YYY) � CERTIFICATE OF LIABILITY INSURANCE 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 IrvsuReD, the pollcy(les) must nave a�DrnQIVAL INsuriru provisions or ne enaorsea. It 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 AOn Risk Services Central, Inc. Chicago IL office 200 East Randolph Chicago IL 60601 USA INSURED Kellerineyer Rergensons Services, LLc 3605 ocean Ranch Blvd. suite 200 Oceanside CA 92056 USA (NC No. ExO; C866) 283-7122 (aC. Ns E-MAIL RECEIVED ADDRESS: INSURERS) AFFORDING COVERAGE y y 9 INSURER A: ZUriCh American Ins CO APR 1 1, 2023 INSURERS: American zurich ins co City of Bremerton Risk Management CERTIFICATE NUMBER: (800) 363-0105 NAIC # 16535 INSURER C: ACE Property & CdsUalty Insurance Co. ZU(i99 INSURER D; INSURER E: INSURER F: 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY GLO EACH OCCURRENCE $2 , OOO , 000 CLAIMS -MADE ❑X OCCUR PREMISES Ea occurrence $500,000 MED EXP (Any one person) $10, 000 PERSONAL&ADVINJURY $2,000,000 GEN'LAGGREGATELIMITAPPLIESPER: X POLICY ❑ PRO � LOC JECT GENERALAGGREGATE $4,000,000 PRODUCTS-COMP/OPAGG S4,000,OOO OTHER: A AUTDMOBILELIABILITY BAP 6510032-33 04/Ol/2023 04/01/2024 COMBINED SINGLE LIMIT Ea accident $5,000,000 X ANY AUTO BODILY INJURY (Per parson) OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED ONLY AUTOS ONLY BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) C X UMBRELLALIAB EXCESS LIAB X OCCUR CLAIMS -MADE XEUG72514117003 sIR applle5 per policy ter 04 Ol 2023 s & COndl 04 Ol 2024 tons EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 DED X RETENTION B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? � (Mandatory fn NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC651003033 04 Ol 2023 04 Ol 2024 X PER STATUTE ORH- E.L. EACH ACCIDENT $1, 000,000 E.L. DISEASE -EA EMPLOYEE $1, 000 , 000 E.L. DISEASE -POLICY LIMIT $l, 000, 000 DESCRIPTION OFOPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate Holder is included as Additional Insured in accordance with the policy provisions of the General Liability policy. General Liability evidenced herein is Primary and Non -Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A waiver of subrogation is granted in favor of certificate Holder in accordance with the policy provisions of the General Liability policy, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ,� City Of Bremerton AUTHORIZED REPRESENTATIVE 345 6th street, Suite 100 ernterton WA 98337 USA (� %�� /I �Q p �i t�{KGilt c%ems �sGtfe2L•id UI'J�L�taG e/72G1 v c ai 'O i Gl v 0 2 h.�' rn 0 0 r O Z V N U ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD