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ACORD, CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDIYYYY)
08/07/2024
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 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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER NAMEACT Service Center CL Liberty
Propel Insurance PHONE 800 499-0933 FAX 866 577-1326A/C,No,Ext): A/C,No):
1201 Pacific Avenue; Suite 1000 E-MAILADDRESS:
COM Small Business INSURER(S)AFFORDING COVERAGE NAIC#
Tacoma,WA 98402-4321 INSURER A:West American Insurance Company 44393
INSURED INSURER B: Philadelphia Indemnity Ins Company 18058
Community Theatre Inc Markel Insurance CompanyINSURERC: P y 38970
599 Lebo Blvd American Fire and CasualtyCompany 24066
Bremerton,WA 98310
INSURERD: p y
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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.
INSRLTR TYPE OF INSURANCE INSRLSU BR
WVD POLICY NUMBER
POLICY EFF POLICY EXP LIMITSMMIDDIYYYY) (MMIDDIYYYY)
A X COMMERCIAL GENERAL LIABILITY BKW58107415 10/26/2023 10/26/2024 EACH OCCURRENCE 1,000,000
D
CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence) $1,000,000
MED EXP(Any one person) $15,000
PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY I JECOT I I LOC PRODUCTS-COMP/OPAGG $2,000,000
OTHER:
D AUTOMOBILE LIABILITY BAA58107415 10/26/2023 10/26/2024 o aBc deDn
INGLE LIMIT $1,000,000
ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURY(Per accident) $AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGEXAUTOSONLYXAUTOSONLYPeraccident)
UMBRELLA LIAB OCCUR EACH OCCURRENCE
EXCESS LIAB CLAIMS-MADE AGGREGATE
DED RETENTION$
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY Y I N
STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? N/A
Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
B D&O Liability PHSD1855338 03/13/2024 03/13/2025 $1M Occ/$1,000 Ded.
A Crime BKW58107415 10/26/2023 10/26/2024 $100,000/$1,000 Ded.
C Accident AMM399004 08/07/2024 08/07/2025 $250,000 Agg./
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
Evidence 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
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