The URL can be used to link to this page

Home My WebLink AboutInsuranceHUMANRESOURCESANDRISKMANAGEMENTMEM0RANDUMNovember23,2021TO:JenniferSpencerRecreationCoordinator,CommunityServicesFROM:KelseyUrban,RiskManagerSUBJECT:InsuranceReview/BuduRacingdCRe:K9CandyCane5KFunRunandWalkDecember5,2021RiskManagementhasreviewedthecertificateofinsurancefortheabove-namedentity.TheinsurancecertificatemeetstheCity’sriskmanagementrequirements.CorrespondingwiththeCCIexpiration,thisapprovalmemoisvaliduntil9/18/2022,oruntilchangesinthecontractorworkinvalidatetheinsurancecoverage.DATE: A%RLJCERTIFICATEOFLIABILITYINSURANCETHISCERTIFICATEISISSUEDASAMATTEROFINFORMATIONONLYANDCONFERSNORIGHTSUPONThECERTIFICATEHOLDER.TI!IISCERTIFICATEDOESNOTAFFIRMATIVELYORNEGATIVELYAMEND,EXTENDORALTERTHECOVERAGEAFFORDEDBYTHEPOLICfrSBELOW.THISCERTIFICATEOFINSURANCEDOESNOTCONSTITUTEACONTRACTBETWEENTHEISSUINGINSURER(S),AUTHORIZEDREPRESENTATIVEORPRODUCER,ANDTHECERTIFICATEHOLDER.IMPORTANT:IfthecertificateholderisanADDITIONALINSURED,thepoIicy(Ies)musthaveADDITIONALINSUREDprovisionsorbeendorsed.IfSUBROGATIONISWAIVED,subjecttothetermsandconditionsofthepolicy,certainpoliciesmayrequireanendorsement.Astatement:onthiscertificatedoesnotconferriahtstothecertificateholderinlieuofsuchendorsement(s.PRODUCERCONTACT.GARYTURNERINSURANCEAGENCYjoExtt:(2538760775I.No:(253)8040141—820HarveyRoadSuiteDADDRESS:garv.turnerinsurance1pmaiI.comAuburn,WA98002AFFORDINGCOVERAGENAIC1INSURERA:MesaUnderwritersSpecialtyInsuranceCompany—INSUREDINSURERB:—BuduRacingLLCINSURERc:3140547thAveSINSuRERD:INSURERE:Auburn,WA98001WA98001INsURERF:—COVERAGESCERTIFICATENUMBER:REVISIONNUMBER:—iADOCsUitPOLICYEFFPoLIcyEXP—LTRTYPEOFINSURANCEiisnPOLICYNUMBERIMMIDD1YYYY1IMM/DDIVYYYILIMITS____________XCOMMERCIALGENERALCIABILITYEACHOCCURRENCE$f,000000DAMAGEToRENTEDPREMISES(Esoccurrence)$1001000AJCLAIMS-MADEOCCURYMP0046001MEDEXP(Anyoneperson)$5100000401809/18/2109/18/22PERSONAL&ADVINJURYS.1,0001000GENLAGGREGATELIMITAPPLIESPER:GENERALAGGREGATE.$2,0001000XocicvPRO-UCTS-COMP/OPAGG$2,0001000JECTULOCPROD——$—AUTOMOBILELIABILITYCOMBINEDSINGLELIMIT$,(EaaccIdent)ANYAUTOBODILYINJURY(Perpernon)$OWNEDr—iSCHEDULEDAUTOSONLYIIAUTOSBODILYINJURY(Peraccident)$HIREDTiNON-OWNEDPROPERTYDAMAGE$—AuTosONLYj....._jAuTosONLY—.(Peraccident)$UMBRELLALIABLiOCCUR.EACHOCCURRENCE$EXCESSLIABCLAIMS-MADEAGGREGATE$——IIRETENTION$——.$—WORKERSCOMPENSATIONIPERII0TH-IISTATUTEIERANDEMPLOYERSLIABILITYy/N-IANYPROPRIECDR/PARTNEPJEXECUTIVEjNIAEL.EACHACCIDENTSI—OFFICERIMEMBEREXCLUDED?(MandatoryInNH)EL.DISEASE-BAEMPLOYEI$I/yes,describeunderDESCRIPTIONOFOPERATIONSbelcw—ELDISEASE-POLICYLIMITS—DESCRIPTIONOFOPERATIONSILOCATIONS/VEKICLES(ACORO101,AddItionalRemarksSchedule,maybealtacheditmoreapaceIsrequired)certificateholdernamedasadditionalinsuredCERTIFICATEHOLDER-CANCELLATIONSHOULDANYOFTHEABOVEDESCRIBEDPOLICIESBECANCELLEDBEFORECityofRentonTHEEXPIRATIONDATETHEREOF,NOTICEWILLBEDEUVEREDINACCORDANCEWITHWEPOLICYPROVISIONS.Attn:JenniferSpencerParksandRec1055SouthGradyWayRenton,WA.98057AUTHORIZEDREPRTI/DATE(MMIDOFYVV1’)11/01/21ITHISISTOCERTIFYTHATTHEPOLICIESOFINSURANCELISTEDBELOWHAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPEFINDICATED.NOTWITHSTANDINGANYREQUIREMENT,TERMORCONDITIONOFANYCONTRACTOROTHERDOCUMENTWITHRESPECTTOWHICHCERTIFICATEMAYBEISSUEDORMAYPERTAIN,THEINSURANCEAFFORDEDBYTHEPOLICIESDESCRIBEDHEREINISSUBJECTTOALLTHETEFEXCLUSIONSANDCONDITIONSOFSUCHPOLICIES.LIMITSSHOWNMAYHAVEBEENREDUCEDBYPAIDCLAIMS100HISMS,Ø1988-2015ACORDCORPORATION.Allrightsreserved.ACORD25(2016103)TheACORDnameandlogoareregisteredmarksofACORD