Loading...
HomeMy WebLinkAboutInsurance CertificatesWASHINGTON COUNTIES RISK POOL 2558 R.W. Johnson Road SW. Suite 106 Tumuater. Washington 98512-6103 tit Created by Counties for Counties October 19th, 2022 Washington State Parks and Recreation 1111 Israel Road SW Tumwater, WA 98501-6512 RE: Notice to Certificate of Membership Holder Member County: Kittitas County Effective Dates: October 1, 2022 — September 30, 2023 Dear Certificate Holder: The Member County listed above and on the attached Certificate of Membership is a member of the Washington Counties Risk Pool (WCRP), a group of Washington counties that have come together under an interlocal agreement as permitted under RCW 48.62 to group self -insure for liability coverage. The WCRP and its participating members group purchase re -insurance and excess liability insurance, and the self-insured retention of the WCRP is completely self-funded by the membership. The WCRP is not an insurance company and therefore cannot name other entities, organizations, or individuals as an "additional insured." However, the WCRP and its reinsurers provide contractual coverage to its members and will extend protection to those parties that the Member County has contractually agreed to indemnify. Coverage is subject to all the terms, conditions, exclusions, definitions, and limits of liability in the current WCRP Memorandum of Liability Coverage document. We hope that this satisfies the requirement that Kittitas County name your organization as an additional insured. Sincerely, P'10�1 /4 -- Derek C. Bryan, Executive Director Washington Counties Risk Pool Phone (360) 292-4500 Fag (360) 292-4501 Email: infori wcrp.wa.goe Website: %%w%%.%kcrp.info CERTIFICATE OF MEMBERSHIP IN THE WASHINGTON COUNTIES RISK POOL THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE JOINT SELF-INSURANCE LIABILITY COVERAGE AFFORDED BY THE WASHINGTON COUNTIES RISK POOL MEMBER COUNTY: Liability Coverage Afforded by the: Kittitas County, Washington Washington Counties Risk Pool Attn: Chris Homer, DPA 2558 R W Johnson Rd SW, Suite 106 205 W. 5th Ave, Suite 107 Tumwater, WA 98512-6103 Ellensburg, WA 98926-2887 Kittitas County (the "County") is a member of the Washington Counties Risk Pool (the "Pool"), as authorized by RCW 48.62.031, and the County is covered by the Pool's Joint Self -Insurance Liability Program. The Pool's Joint Self -Insurance Liability Program was created by interlocal cooperative agreement amongst the Pool's member counties to share risks by "jointly, self-insuring" certain third -party liabilities. The Pool is NOT an insurance company. Claims that are covered under a Memorandum of Liability Coverage ("MLC") from the Pool and were submitted under Chapter 4.96 RCW ( "Actions against political subdivisions, municipal and quasi -municipal corporations") against the County, its employees, officers, volunteers and agents and/or actions in connection with or incidental to the performance of an agreement/contract which the County and/or its officers, employees or volunteers are found to be liable for will be paid by the Pool and/or the County. MLC NUMBER: 20222023RISKPOOL-KTCO MLC EFFECTIVE DATE: October 1, 2022 MLC EXPIRATION DATE: October 1, 2023 LIMITS OF LIABLITY EACH OCCURRENCE BI AND PD COMBINED: 1$10,000,000 TYPES OF LIABILITY COVERAGE AFFORDED: General Liability Including: Bodily Injury Personal Injury Property Damage Errors and Omissions/Professional Advertising Injury Automobile Liability DESCRIPTION OF OPERATIONS/LOCATION/VEHICLE CANCELLATION SHOULD THE ABOVE DESCRIBED MLC BE CANCELLEDBEFORE Washington State Parks and Recreation Commission THE EXPIRATION DATE THEREOF, THE ISSUER Subrecipient Grant Agreement: Agreement No. NEE 123-343 WILL ENDEAVOR TO PROVIDE THIRTY (30) DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION NOR LIABILITY OF ANY KIND UPON THE During the NEC Period 10/1/22 - 10/1/23 ISSUER OR ITS AGENTS OR REPRESENTATIVES. CERTIFICATE HOLDER: ISSUE DATE: October 19, 2022 Washington State Parks Commission PO Box Olympia, WA WA 98504-2650 Bryden Barbee, Risk Analyst ACORO® EVIDENCE OF PROPERTY INSURANCE DATE (MM/DD/YYYY) DEDUCTIBLE 10/20/2022 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY PHOWC.NE N :425 586-1002 Earth Movement $25,000,000 Starr Surplus Lines Insurance Company Arthur J. Gallagher Risk Management Services, Inc. 399 Park Avenue 8th Floor 777 108th Avenue NE, #200 New York, NY 10022 Bellevue, WA, WA 98402 $100,000 nIC No 425-451-3717 AX ..ESS: ste hen erni@ajg.com CODE: SUB CODE: AGENCY CUS MEE ID INSURED LOAN NUMBER POLICY NUMBER Kittitas County 205 West 5th Ave., Suite 107 SLSTPTY11682822 EFFECTIVE DATE EXPIRATION DATE Ellensburg WA 98926-2887 CONTINUED UNTIL 10/01/2022 10/01/2023 TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LO CATIO NIDES C RI PTI ON On File 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 EVIDENCE OF PROPERTY INSURANCE 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. rnVFRAr:F INFr1RMATInPd D9=D11 a 1KICi iD�n I IDAC11 I I -- I X COVERAGE I PERILS I FORMS AMOUNT OF INSURANCE DEDUCTIBLE All Risk, including Earthquake and Flood, Equipment Breakdown and Terrorism LENDER'S LOSS PAYABLE LOSS PAYEE LOAN # Blanket Limit, Special Form Coverage, Replacement Cost subject to terms and conditions of the policies. $25,000,000 $100,000 Earth Movement $25,000,000 2%/$100,000 Flood $25,000,000 See below Leased, Rented or Borrowed Property/Equipment - Each $750,000 $100,000 mr-i AnnJ linumuing J eclat l.onumonS The Flood deductible is $100,000 except in SFHA zones, where the deductible is excess of the NFIP limit, whether carried or not. Carrier Participations: Allied World Assurance Company #0307-0115-1A; Westchester Surplus Lines #D37390471-010; Everest Indemnity Insurance Company #CA3P00696-221; Starr Surplus Lines #SLSTPTY11682822. Washington State Parks and Recreation Commission Subrecipient Grant Agreement: Agreement No. MLE 123-343 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL INTEREST NAME AND ADDRESS ADDITIONAL INSURED MORTGAGEE LENDER'S LOSS PAYABLE LOSS PAYEE LOAN # Washington State Parks Commission PO Box 42650 AUTHORIZED REPRESENTATIVE Olympia, WA 98504-2650 r ACORD 27 (2016/03) ©1993-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD