FIELD DOCUMENTS - Laserfiche WebLink

Home Browse Search

ACERTIFICATE OF LIABILITY INSURANCE DA101022012YY) 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 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 NAME: Parker,Smith&Feek,Inc. PHONE425-709 3600 FAc425-709-7460 2233 112th Avenue NE WC,N.p,ext): N _ E-MAIL o) _.. __..... _.. Bellevue,WA 98004 ADDRESS: INSURER(S)AFFORDING COVERAGE NAC k INSURER A: Zurich American Insurance Co. INSURED INSURER B: American Guarantee�.Liability Ins. National EWP,Inc. _.. 500 Main Street INSURER C: Steadfast Insurance Company Woodland,CA 95695 INSURER D 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 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. TYPE OF INSURANCE LTR ;$UBR -- POLICY EFF POLICY EXP INSR� 'ADDU WVD POLICY NUMBER MM!DD/YYYY) IMMIDDryYYY1 LIMITS GENERAL LIABILITY GL0931933100 A r 10/6/2011 12/15/2012 EACHOCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100,000 PREMISES(Ea o curronpe/ CLAIMS-MADE X OCCUR MED EXP(Any one person. $ 5,000 ...... .._. _._.. _._. PERSONAL R ADV INJURY $ 1,000,000 _ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER* PRODUCTS-COMPrOP AGG $ 2.000.000 ......,.POLICY XPRO- X_ LOC S _. T _. AUTOMOBILE LIABILITY BAP931933000 COMBINED SINGLE LIMIT A 10/6/2011 12115/2012 (Ea a-cident)_ g 1,000,000 X ANY AUTO BODILY INJURY(Pet pemon) S ............................. ............. ............... .......... ......_.. 'ALL OWNED SCHEDULED BODILY INJURY(Per accident I$ ;AUTOS AUTOS � / NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS B UMBRELLA LIAR _ 10/6/2011 !12/15/2012 EACH OCCURRENCE $ 5.000,000 1 X EXCESS LIAR X OCCUR UMB931933300 -- - _- 5.000,000 CLAItdS_MADE 1 AGGREGATE $ DED X I RETENTIONS 10,000 A WORKERS COMPENSATION VVC931933200 X 1 WC STATU- j OTH- AND EMPLOYERS'LIABILITY YIN 10/6/2012 12/1512012 -- TORY L.iMl75 ER..�. ._.._. ANY PROPRIETOFL'PAR7NER'EXECUTIVE OFF ICERMEMBER EXCLJDED-, N/A C L..EACH II ACCIDENT g 1,000.000 (Mandatory in NH) E L.DISEASE-EA EMPLOYEE;$ 1.000,000 If yes,DESCRIPTION under 1,000,000 DESCRIPTION OF OPERATIONS bElc.+/ '. E.L.DISEASE-POLICY LIMIT !$ C j Pollution Liability CPL557152600 '6.000.000 Each Claim/6.000.000 Aggregate 8/2/2012 8/2/2013 DESCRIPTION OF OPERATIONS/LOCATIONS VEHICLES (Attach ACORD 101,Additional Remarks Schedule.if more space is required) EXHIBIT OF INSURANCE. 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. FOR BID/PREOUALIFICATION PURPOSES ONLY AUTHORIZED REPRESENTATIVE 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD