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HomeMy WebLinkAboutCOI - FKC Company Ltd. - Expires 2022-07-20ACORU® CERTIFICATE OF LIABILITY INSURANCE DATE(WIf) 7/9/202Y/2a21 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Fryer Insurance Agency Inc. PO Box 1347 Port Angeles WA 98362 CONTNAME: Cathy Wahlsten PHONE FAX • 360-457-1144 Arc No : 360-457-9440 A DRIESS: fryer.pa@fryerins.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: The Ohio Casualty Insurance Co 24074 INSURED FKCCOMP-01 FKC Company Ltd. 2708 West 18th Street INSURER B : Ohio Security Insurance Com an 24082 INSURER C : INSURER D : Port Angeles WA 98362 INSURER E : E INSURER F : COVERAGES CERTIFICATE NUMBER:224726318 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. INSR LTR TYPE OF INSURANCE ADDL IRM SUBR WVD POLICY NUMBER POLICY EFF MWDD POLICY EXP MMID/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y BKOSS092021 7/20/2021 7/20/2022 EACH OCCURRENCE S 1000000 CLAIMS -MADE a OCCUR DAMAGE T REN PREMISES Ea occurrence S 1000000 MED EXP (Any one person) $ 15000 PERSONAL & ADV INJURY $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 X POLICY PRO-- 7LOC JECT PRODUCTS - COMPIOP AGG $ 2000000 $ OTHER: B AUTOMOBILE LIABILITY Y Y BAS56092021 7/20/2021 7/20/2022 COMBINED SINGLE LIMIT Ea accident $1000000 X BODILY INJURY Per ( person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) S X PROPERTY DAMAGE Per accident S HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY $ A X UMBRELLA LIAR X OCCUR Y Y US056092021 7/20/2021 7/20/2022 EACH OCCURRENCE $ 5000000 AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I X RETENTION $ 1 nnnn $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBEREXCLUDED? ❑ NIA BKO56092021 7/20/2021 7/20/2022 SPETATUTE X ERH WA STOP GAP E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required) Operations of the above named insured. GL form CG8810 & Auto Liability form AC 8501 which respectively includes: Additional Insureds by written contract, written agreement or permit; Waiver of transfer of rights of recovery against others to us when required in a contract or agreement with you; Primary and Non -Contributory — Additional Insured Extension by written contract or written agreement. CERTFICATE HOLDER is afforded automatic additional insured status including waiver of subrogation/transfer of rights of recovery when required by written contract, agreement or permit as noted above per the attached CG8810 general liability extension endorsement. CG 806101 14 - AMENDMENT OF CANCELLATION PROVISIONS - 30 Days 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. South County Regional Waste Authority 7351 Rosanna Street Gilroy CA 95020 AUTHORIZED REPRESENTATIVE 6�� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD