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062-18 - West Sound Utility District - Insurance Exp 11-1-2021DATE (MM/DD/YYYY) AC"R" CERTIFICATE OF LIABILITY INSURANCE �� F11/2/2020 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 Mqi " Jamie Arnoldi Alliant Insurance Services, Inc. PHONE FAX 1420 Fifth Avenue, Suite 1500 • 949-627-7000 FAX No): Seattle WA 98101 ADDRESS: Jamie.Arnoldi alliant.com _ INSURERfSJ AFFORDING COVERAGE NAIC# INSURER A; WSRMP - Water & Sewer Risk Man INSURED WATEAND-01 INSURER B ; WEST SOUND UTILITY DISTRICT C/O WATER & SEWER RISK MANAGEMENT POOL (WSRMP) INSURERC: 40 LAKE BELLEVUE DRIVE, SUITE 220 INSURERD: BELLEVUE WA 98005 INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 1581053700 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 ILTR TYPE OF INSURANCE AD90L 5UBR POLICY NUMBER MPMO/DD/YYYV MM/DD/YPOLICY YYY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY WSRMP20-21 1111/2020 11/1/2021 EACH OCCURRENCE $10,000,000 CLAIMS -MADE I X OCCUR PREMISES (Ea oec J $10 000,000 $ X SIR: $200,000 MED EXP (Any one person) PERSONAL & ADV INJURY $10 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000 X POLICY El j LOC $ PRODUCTS - COMP/OPAGG $ OTHER A AUTOMOBILE LIABILITY WSRMP20-21 11/1l2020 11/1/2021 OMBINEDSINGLELIMrT Ea accident $10,000,000 BODILY INJURY (Per person) X ANY AUTO $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ $ BODILY INJURY (Per accident) PROPERTY.DANiAGE Per acnida t UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE R OTH- STATUTE 07 $ E L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? F] NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ E.L DISEASE - POLICY LIMIT If yes, describe under DESCRIPTION OF OPERATIONS below $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) AS RESPECTS ORDINANCE NO. 016-18. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF PORT ORCHARD ACCORDANCE WITH THE POLICY PROVISIONS. MAYOR 216 PROSPECT STREET AUTHORIZED REPRESENTATIVE PORT ORCHARD WA 98366 �, '? ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD