Loading...
HomeMy WebLinkAboutCertificate of InsuranceaACOROCERTIFICATEOFLIABILITYINSURANCEOATS(MMIOONYYYI12130/2019ThisCERTiFICATEISISSUEDASAMATTEROFINFORMATIONONLYANDCONFERSNORIGHTSUPONTHECERTiFICATEHOLDER.ThISCERTIFICATEDOESNOTAFFIRMATIVELYORNEGATIVELYAMEND,EXTENDORALTERTHECOVERAGEAFFORDEDBYTHEPOLICIESBELOW.ThisCERTIFICATEOFINSURANCEDOESNOTCONSTITUTEACONTRACTBETWEENTHEISSUINGINSURER43).AUTHORIZEDREPRESENTATIVEORPRODUCER,ANDTHECERTiFICATEHOLDER.IMPORTANT:IfthecertificateholderIsanADDITIONALINSURED,thepollcy(Ies)musthaveADDITIONALINSUREDprovisionsorbeendorsed.IISUBROGATIONISWANED,subjecttothetermsandconditionsofthepolicy,certainpoliciesmayrequireenendorsementAstatementonthi.certificatedonnotconferrightstothecertificateholderinlieuofsuchendorsement(s).ROWCERBdlanyBryanHumble&DavenportinsumnBrokersInc.,,(425)226-8221IF,(425)255-93423500MapleValleyHi.wbi1tanyhumbledavenport00mIN5UN5)AFFORDINGCOVERAGENCSRennWA96058INSURERA:Dev&opersSurety&lndCo12715INSUREDINsURER6ilgerMountainCustomHomes,LLCINsURERc’27037NE29thPLINSURER0:INSURER!:Redntnd965Ip1auF:COVERAGESCERTIFICATENUMBERCL19123025435REVISIONNUMBER:ThisISTOCERTIFYTHATThEPOUCIESOFINSURANCELISTEDBELOWHAVEBEENISSUEDTOTHEINSUREDNMAEDABOVEFORThEPOLICYPERIODINDICATED.NO1WTHSThNDINGAHYREQUIREMENtTERMORCONDITiONOFAWYCONTRACTOROThERDOCUMENTWIThRESPECTTOW-IICHTHISCERTIFICATEMAYBEISSUEDORMAYPERTAIN,THEINSURANCEAFFORDEDBYrNEPOLICIESDESCRIBEDFEREINISSUBJECT10AUThETERMS,EXCLUSIONSANDCONDITiONSOFSUCHPOLICIES.UMFISSHOt%NMAYHAVEBEENREDUCEDBYPAIDCLAIMS.RJIWIVS.PcIXY!flPJCYEPLw—TYPEOFINSURANCE---—POUt?NUMBER(MMIDDYYTfl(MMJOWVYYV)UNITS)COMMEROALGENERALUASIWYEACHOCCURRENCEI1,000,000—,OM4AGETDRaTtUCLAIMS-MADEOCCURpnaii&s(Esnnc.II,,,MEDEXP(Mwcq,.per.alII5000A—VYB1S0001357S-0807/261201907/25/2020PERS0rfl,aADvIURY$1.000,000GEI1LAGOREGATEUMITAPPLIESPEftGENERALAGGREGATE2,000,000POucYLOCPRODUCTS-COMP/OPAGG2,000,000—SALUOMOaCLIASMT’YUOM8INEDSINGLEUNITAWAUTDSOOtYINJURY(PerpenonIIAUTOSONLY[ElSCHEOLAIDBODILYINJURY(PeradwdIIHIREDNON-O%F4EDPROPERTYDAMAGEAUTOSONLYALITOSONLYIPrnuMSRaIAUASLiOCCUR——EACHOCCURRENCEEXCESSUASICUJMSMADEAGGREGATE$RETENTiONS——SWORKERSCOMPENSATIONIIANOEMPLOYERS’UAUIUIVY/NISTATUTEERANYPROPRIETOR/PARTNERIEXECU11VEELEACHACCIDENTOFFICERJAEMEEREXCLUDED?N/A(M.nd.IoryhNH)ELOISEASE-EAEMPLOYEEIIfyes,dnatheunderDESCRIPTIONOFOPERICI1ONSbelow—ELDISEASE-POLICYLIMITCwpnoNOFOPERATIONSILOCA11OIIVEI4OIS(ACORD¶01,AddNflnv*aSdiediM,meybe.mbedNmoltipcsbrequIred)TheOSrUhcateholderIsnamedasadditionalInstndwithrespectstotheop&ationsorthenamedthsued.CoverageIspdmaryandnon-OOnthbulo,andawaiver&subrogationappilesperattachedendoaementCERTIFICATEHOLDERCANCELLATIONSHOULDANYOFTHEABOVEDESCRIBEDPOLiCIESBECANCELLEDBEFOREThEEXPIRATIONDATETHEREOF,NOTICEWILLBEDEUVEREDINCItyofRaritanACCORDANCEWITHTHEPOLICYPROVISIONS.1055SouthGradyyALflNDREPRES!N1AflVEIRentonWA98057s..,a....©1988-2015ACORDCORPORATiON.Ailrightsreserved.ACORD25(2018/03)TheACORDnameendlogoareregisteredmarksofACORD ID00370413THISENDORSEMENTCHANGESTHEPOLICY.PLEASEREADITCAREFULLYBLANKETADDITiONALINSUREDThisendorsementmodifiesinsuranceprovidedunderthefollowing:COMMERCIALGENERALLLABIUTVCOVERAGEPARTA.SectionIi—WhoIsAnInsuredIsamendedtoIncludeasanadditionalInsuredanyparsonororganizationforwhomyouampedonnlngoperationswhenyouandsuchpersonororganizationhaveagreedinwritinginacontractoragreementthatsuchpersonororganizationbeaddedasanadditionalInsuredonyourpolicy.SuchpersonororganizationIsanadditionalinsuredonlywithrespecttoliabilityfor“bodilyinjury,“propertydamage”or“personalandadvertisinginjury”causedbyandtotheextentofyournegligencehitheperformanceofyourongoingoperationsfortheadditionalinsured.Aperson’sororganization’sstatusasanadditionalinsuredunderthisendorsementendswhenyouroperationsforthatadditionalinsuredarecompleted.B.WithrespecttotheInsuranceaffordedtotheseadditionalhisureds,thefollowingadditionalexclusionsapplThisinsurancedoesnotapplyto:1.“BodilyInjury”,“propertydamage”or“personalandadvertisinginjury”arisingoutoftherenderingof,orthefailuretorender,anyprofessionalarchitectural,engineeringorsurveyingservices,Including:a.Thepreparing,approving,orfatlingtoprepareorapprove,maps,shopdrawings,opinions,reports,surveys,fieldorders,changeordersordrawingsandspecifications;orb.Supervisory,inspection,architecturalorengineeringactivities.2.“Bodilyinjury”or“propertydamage”occurringaftera.Miwork,Includingmaterials,partsorequipmentfurnishedInconnectionwithsuchwork,ontheproject(otherthanservice,maintenanceorrepairs)tobeperformedbyoronbehalfoftheadditionalinsured(s)atthelocationofthecoveredoperationshasbeencompleted;orb.Thatportionof“yourwork”outofwhichtheInjuryordamageariseshasbeenputtoitsintendedusebyanypersonororganizationotherthananothercontractororsubcontractorengagedinperformingoperationsforaprincipalasapartofthesameproject.3.“Bodilyinjury”,“propertydamage”or“personaiandadvertisinginjury”involvingorrelatedtoorinconnectionwithanyadditionalinsuredoranylocationcoveredbyascheduledorblanketadditionalinsuredendorsementthatIsapartofthepolicy.C.PrimaryandNon-contributoryInsurance-Wewillconsiderthisinsurancetobeprimaryandnon-contributorytootherInsuranceIssueddirectlytoadditionalinsuredperson(s)ororganization(s)towhichthisendorsementappliesifeachsuchadditionalinsuredisanamedinsuredInsuchotherinsuranceandawrittencontractbetweenyouandsuchperson(s)ororganization(s)specificallyrequiresthatweconsiderthisinsurancetobeprimaryandnon-contributory..0.WaiverofSubrogation—Wewaiveanyrightofrecoverywemayhaveagainsttheadditionalinsuredperson(s)ororganization(s)towhichthisendorsementappliesIfeachsuchadditionalInsuredisanamedinsuredInsuchotherinsuranceandawrittencontractbetweenyouandsuchperson(s)ororganization(s)specificallyrequiresthatwewaivesubrogationofpaymentswemakeforinjuryordamagearisingoutofyourwork”doneunderacontractwithsuchperson(s)ororganization(s)towhichthisendorsementapplies.1D00370413Pagelofi