PSA polygraph - Laserfiche WebLink

Home Browse Search

ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) ~ 1/26/2016 THIS CERTIFICATE IS ISSUED AS A MAnER 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 ~~~~~CT Vicki Boser InsuranceTek, Inc. i~gN~nEyt), (888)505-1555 I rffc. No): (800) 521-1528 CA #OE32789 ~OMD~~SS: Info@Insurance-tek. com PO Box 70 INSURER(S) AFFORDING COVERAGE NAIC # Snohomish WA 98291-0070 INSURER A :Wes tern Heritage Ins CO INSURED Richard A. Schuknecht INSURER B: Schuknecht's P.O.F. Polygraph Service INSURER c: 413 N 2nd St INSURER 0: INSURER E: Yakima WA 98901 INSURER F: COVERAGES CERTIFICATE NUMBER'CL1612 652 615 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 ADDL SUBR (~~hl5ivWr) (~2~6%~) LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 f--DAMAGE TO RENTED ~ 5MMERCIAL GENERAL LIABILITY PREMISES {Ea occurrenceL $ 100,000 A CLAIMS-MADE W OCCUR SCP0988600-371 2/4/20l6 2/4/20l7 MED EXP (Anyone person ) $ 5,000 I-- ~ PROFESSIONAL E&O PERSONAL & ADV INJURY $ 1,000,000 ~ BLANKET ADDL INSURED GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COM Pl OP AGG $ INCLUDED 'Xl POLICY n ~fP,: n LOC PROFESSIONAL E&O $ 1,000,000 AUTOMOBILE LIABILITY -fE~~~~~~t)SINGLE LIMIT $ ANY AUTO BODILY INJURY (Per person ) $ --ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ --NON-OWNED ip~7~;C~d:~t?AMAGE HIRED AUTOS AUTOS $ -- $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ - EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION I T~g$TtJI~S I IOJ~- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 0 E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The certificate holder is added as additional insured when required by contract per Blanket WHI21-1124 attached CERTIFICATE HOLDER CANCELLATION dora.vanepps@co.kittitas.w SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Kittitas County ACCORDANCE WITH THE POLICY PROVISIONS. Dora Van Epps AUTHORIZED REPRESENTATIVE 205 W 5th Ave, Suite 105 Ellensburg, WA 98926 Vicki Boser/DAWSON ~~ ~ "E>~ ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved_ INS02!i (?n1nn" 01 Tho .A~n~n n::.mo ::an'" Innn :::tIro rg,nic:tAr,:ui M::arlcc: "f Ar.:('u:~n