Certificate of Liability Insurancems 's. - a
CERTIFICATE OF LIABILITY INSURANCE
E (MM/DD/YYYY)
DAT 6/19/2009
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ASSOCIATED AGENTS GROUP INC
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
PO BOX 13008
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
SPOKANE, WA 99213
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY
A RED SHIELD INSURANCE COMPANY
PHONE NO.
( 509)928-7528
INSURED
SPOKANE VALLEY HERITAGE MUSEUM
COMPANY
B
PO BOX 141341
COMPANY
SPOKANE VALLEY, WA 99214
C
COMPANY
D
COMPANY
E
COVERAGE
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.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YY)
POLICY EXPIRATION
DATE (MM/DD/YY)
LIMITS
GENERAL
GENERAL AGGREGATE
2 , 000 , 000
A
X
COMMERCIAL GENERAL
CLAIMS MADE OCCUR
OWNER'S & CONTRACTOR'S PROT
CLP 015523
4/23/2009
4/23/2010
PRODUCTS - COMP /OP AGG
ncl in Gen A gg
PERSONAL & ADV INJURY
1000 000
EACH OCCURRENCE
1 , 000,000
FIRE DAMAGE (Any one fire)
100 000
EXP (Any one person)
5 , 000
ri MED
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO
BODILY INJURY
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES /SPECIAL ITEMS
MUSEUM
Attn: Chris Bainbridge
The Certificate Holder is included as an additional insured pursuant to ISO form CG 2026(07/04) an exemplar copy of which is attached
hereto for informational purposes.
CERTIFICATE
CANCELLATION
SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
CITY OF SPOKANE VALLEY
11707 E SPRAGUE AVE
SPOKANE VALLEY WA 99206
LEFT, EXCEPT FOR NON - PAYMENT OF PREMIUM WHEN MORETT AN 10 DAYS IS
INDICATED, BUT FAILURE T.�1�M. SUCH 1� 91LL IMPOSE NO
� O ��. t1b P `E� L , ITS AGENTS OR
OBLIGATION OR LIABILITY I U O _
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
CER 00 02 (05/08)
Page I or 2 Refer to page 2 for important information.
Jv f— .W'"
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between the
issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
Page 2 of 2 CER 00 02 (05/08)
-1% —,
POLICY NUMBER: CLP 015523
COMMERCIAL GENERAL
CG 20 26 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization
CITY OF SPOKANE VALLEY
11707 E SPRAGUE AVE
SPOKANE VALLEY, WA 99206
Information required to complete this Schedule if not shown above will be shown in the Declarations.
Section II - Who Is An Insured is amended to include as an
additional insured the person(s) or organization(s) shown in
the Schedule, but only with respect to liability for "bodily
injury ", "property damage" or "personal and advertising
injury" caused, in whole or in part, by your acts or omissions
or the acts or omissions of those acting on your behalf:
A. In the performance of your ongoing operations; or
B. In connection with your premises owned by or rented
to you.
CG 20 26 07 04 Copyright, ISO Properties, Inc., 2004 Page 1 of 1 ❑