Laserfiche WebLink
AGENCY CUSTOMER ID: <br />AC 40 4� LOC #: <br />ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br />AGENCY NAMED INSURED <br />FEDERATED MUTUAL INSURANCE COMPANY JOHNSTON FUNERAL PARLORS, LLC <br />301 E 3RD AVE <br />POLICY NUMBER ELLENSBURG, WA 98926-3348 <br />SEE CERTIFICATE # 9.0 <br />CARRIER NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE # 9.0 <br />SEE CERTIFICATE # 9.0 —. <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: rFRTIFICATE O LIABILITY ISRURANCE <br />(ADDITIONAL NAMED INSUREDS INCLUDE <br />JOHNSTON & WILLIAMS FUNERAL HOME AND CREMATORY <br />STOP -GAP (EMPLOYER'S LIABILITY) COVERED STATE(S) WA <br />ADDITIONAL LNSURED'S INCLUDES THE CORONER, ITS SUCCESSORS, AND ASSIGNS, AND THE RESPECTIVE DIRECTORS, OFFICERS, <br />EMPLOYEES, AGENTS AND REPRESENTATIVES OF THE CORONER AND ITS SUCCESSORS AND ASSIGNS. <br />THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ON GENERAL LIABILITY SUBJECT TO THE CONDITIONS OF THE ADDITIONAL <br />INSURED - OWNERS, LESSEES, OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION ENDORSEMENT. <br />THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ON BUSINESS AUTO LIABILITY SUBJECT TO THE CONDITIONS OF THE <br />BUSINESS AUTO ADDITIONAL INSURED ENDORSEMENT <br />INSURANCE PROVIDED BY THE GENERAL LIABILITY COVERAGE IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE SUBJECT TO <br />THE CONDITIONS OF THE PRIMARY AND NONCONTRIBUTORY CLAUSE- OTHER INSURANCE CONDITION. <br />INSURANCE PROVIDED BY THE BUSINESS AUTO LIABILITY IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE SUBJECT TO <br />THE CONDITIONS OF THE PRIMARY AND NONCONTRIBUTORY CLAUSE- OTHER INSURANCE CONDITION. <br />COMMERCIAL UMBRELLA FOLLOWS FORM ACCORDING TO THE TERMS, CONDITIONS, AND ENDORSEMENTS FOUND IN THE COMMERCIAL <br />UMBRELLA POLICY. <br />ACORD 101 (2008/01) O 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />