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HomeMy WebLinkAboutCOI - FKC Company Ltd. - Expires 2024-07-20A� �® CERTIFICATE OF LIABILITY INSURANCE DAM (MMIDON ) 711112023 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 PO BOX 1347 Port Angeles WA 98362 NAME CT Cathy Wahlsten PHONE 360-457-1144 MC No, 360-457-9440 nnOJUL REES: fryer.pa@fyerins.com INSURERS AFFORDING COVERAGE NAICM INSURER A: The Ohio Casually Insurance Co 24074 INSURED FKCCOMP-01 FKC Company Ltd. INSURER B: Ohio Security Insurance Com an 24082 2708 West 18th Street INSURER C: INSURER D : Port Angeles WA 98362 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMRFR-9nn7R1R4FD RPVLCInM MIIMRPR• 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. ILTR TYPE OF INSURANCE ADOLSUBR Wa POLICYNUMBER POLICY EFF MWODAYYY) POLICY EXP (MM/ODfffYYI LIMITS A X COMMERCIALGENERAL LIABILITY CLAIMS -MADE I-XIOCCUR Y Y BKO56092021 7/20/2023 7/202024 EACHOCCURRENOE $1000000 DANiAGETORIENTED PREMISES Ea occurrence S1000000 MED EXP (my one person) $15000 PERSONALS ADV INJURY $1000000 GEN'L %( AGGREGATE LIMIT"PLIES PER POLICY[fl JECT LOC GENERALAGGREGATE $2000000 PRODUCTS-COMP/OPAGG $2000000 $ OTHER: B AUTOMOBILE LIABILITY Y Y BAS56092021 7202023 7/20/2024 COMBINED SINGLE LIMIT Ea aWdenl $1000000 X BODILY INJURY (Per parson) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per acddeni ) $ X HIRED X NON -OWNED AUTOIS ONLY AUTOS ONLYLY PROPERTY DAMAGE Per accident) $ S A X I UMBRELLALIAB X OCCUR Y Y US056092021 7/20/2023 7/202024 EACH OCCURRENCE $5000000 AGGREGATE S EXCSLIAB ES CLAIMS-MADE DED X RETENTIONS $ A WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED7 N N/A BKO56092021 7/202023 7/202024 X PER OTH- STATUTE ER WA STOPGAP E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1.000.000 (Mandatory In NH) If yes, describe antler DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $2.000.000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Addilional Remarim Schedule, may be aUachad if more apace 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 8061 01 14-AMENDMENT OF CJM,�MaVMalDays GILROYMY CLERK'S OFFICE South County Regional Waste Authority 7351 Rosanna Street Gilroy CA 95020 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 5� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD