SH23-003 Public Safety Psychological Services 2023-2024 PSA

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A [7►/tl CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE 12/14/2022 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 SUBROGATIONIS 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 NUTMEG INS AGENCY INC/PHS NAME: PHONE (888)925-3137 (A/C, No, Ext): FAX (A/c, No): 76210781 The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio, TX 78251 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURERA: Sentinel Insurance Company Ltd. 11000 LEPS-PSS PLLC DBA Public Safety Psychological 20818 44TH AVE W STE 150 Hartford Insurance Company of the 38261 INSURER B Southeast LYNNWOOD WA 98036-7734 INSURER C : INSURER D : INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER! RFVIRIAN 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. NOTVVITHSTAN DING 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 INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/Y YYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 CLAIMS -MADE -]OCCUR DAMAGE TO RENTED $1,000,000 PREMISES Ea occurrence X General Liability MED EXP (Any one person) $10,000 A X 76 SBU BF0017 05/21/2022 05/21/2023 PERSONAL &ADV INJURY $2000000 GEN'LAGGREGATE LIMIT APPLIES PER : GENERAL AGGREGATE $4,000,000 POLICY [] PRO- FX] LOC JECT PRODUCTS -COMP/OP AGG $4,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $2,000,000 Ea accident BODILY INJURY (Per person) ANY AUTO A ALL OWNEDSCHEDULED AUTOS AUTOS 76 SBU BF0017 05/21/2022 05/21/2023 BODILY INJURY (Per accident) HIRED NON -OWNED X AUTOS X AUTOS PROPERTY DAMAGE (Per accident) UMBRELLA LIAB X OCCUR EACH OCCURRENCE $1,000,000 A EXCESS LIAB CLAIMS - MADE 76 SBU BF0017 05/21/2022 05/21/2023 AGGREGATE $1,000,000 ED X I RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X PER OTH- STATUTE I ER E.L. EACH ACCIDENT $100,000 B ANY Y/N PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A 76 WEG AKOLBB 01/12/2023 01/12/2024 E.L. DISEASE -EA EMPLOYEE $100,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS below A EMPLOYMENT PRACTICES LIABILITY 76 SBU BF0017 05/21/2022 05/21/2023 Each Claim Limit $10,000 Aggregate Limit $10,000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Those usual to the Insured's Operations. Notice of Cancellation will be provided in accordance with Form SS1223, attached to this policy. Coverage is primary and noncontributory per the Business Liability Coverage Form SS0008, attached to this policy. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008, attached to this policy. CERTIFICATE H0l_nFR rAMCFI I ATir)M Klttitas County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 205 W 5TH AVE STE 108 BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED ELLENSBURG WA 98926-2887 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD