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HomeMy WebLinkAboutWestern Display Fireworks Ltd. - Certificate of Liability InsuranceACORtfCERTIFICATE OF LIABILITY INSURANCE DATE IYYYY► 1 r20/20zor2oz3 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 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 CONTACT NAME: Britton -Gallagher and Associates, Inc. PHONE , 216-658-7100 FinAX No,: 216-658-7101 IIC One Cleveland Center, Floor 30 EMAIL 1375 East 9th Street Cleveland OH 44114 INSURERS AFFORDING COVERAGE NAIC9 INSURERA: Everest Indemnity Insurance Co. 10851 INSURED 18234 INSURER B : AXIS Surplus Ins Company 26620 Western Display Fireworks Ltd. P. O. Box 932 INSURERC: Alaska National Insurance Company Canby OR 97013 INSURERD: Everest Denali Insurance Company 16044 INSURER E : CnVFROGFS CFRTIFICOTF NIIMRFR• 1A1_rAA1R9Q RFVISIAN NIIMRFR- 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDD/YYYY MMIDD/YYYY A GENERAL LIABILITY S18ML00215-231 1/1512023 1/15/2024 EACH OCCURRENCE $1,000,000 DAMAGE To RENTED PREMISES Ea occurrence $500,000 XCOMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PRO- LOC D AUTOMOBILE LIABILITY SIBCA00098-231 1/15/2023 1/1512024 COMBINED SINGLE LIMIT Ea accident 000 BODILY INJURY (Per person) $ X ANY AUTO rx ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ ParaccidenDAMAGE $ HIRED AUTOS X AUTOS NON-OWNED $ B UMBRELLA LIAB X OCCUR P-001-000069176-05 1/15/2023 1115/2024 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 X EXCESSLIAB CLAIMS -MADE DED� i RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN S18ML00215-231 1115/2023 1/15/2024 W'C STATU- X OTH- LIM,I ER Stop Gap ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N / A (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $1,000,DD0 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 C Washington USLH 22D WU 08933 (WA) 4/162022 4/16/2023 BI by Accident $1,000,000 BI by disease policy limit $1,000,000 Bby disease Each Employee$1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Display Date: 7/4123 Display Site: Pasco Sporting Complex, 6200 Burden Blvd., Pasco, WA 99301 Additional Insured: City of Pasco Pasco Sporting Complex Pasco Fire Dept. CERTIFICATE HOLDER CANCELLATION City of Pasco PO Box 293 Pasco WA 99301 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 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD