83-055 - WA Cities Insurance Authority (WCIA)

Browse Search

EVIDENCE d0 fNSURA PRODUCER ROBERT F DRIVER COMPANY INC P 0 BOX 6450 NEWPORT BEACH CA 92658 -6450 Ph (949) 756 -0271 Fax (949) 756 -2713 LICENSE NO 0084379 CODE SUB -CODE COVERAGE INFORMATION FOR EVIDENCE ONLY G: \JPA UNITN P X\ CERTIFICATES \WCIA \2002 -2003 PROPERTY \02 -03 WCIA PROPERTY PRIMARY.DOC 9/16/02 THIS IS EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED IS IN FORCE, AND CONVEYS ALL THE RIGHTS AND PRIVILEGES AFFORDED UNDER THE POLICY COMPANY INSURED NATIONAL PUBLIC ENTITY EXCESS PROGRAM MEMBER. WASHINGTON CITIES INSURANCE AUTHORITY AND ITS MEMBER: CITY OF TUKWILA 0/0 P 0 BOX 1165 RENTON, WA 98057 PROPERTY INFORMATION LOCAAS PER SCHEDULE OF LOCATIONS WITH THE INSURANCE COVERAGE PERILS FORMS ALL RISKS OF DIRECT PHYSICAL LOSS OR DAMAGE. PER OCCURRENCE LOSS LIMIT SUBJECT TO SUB LIMITS AND AGGREGATES EARTHQUAKE PER OCCURRENCE AND ANNUAL AGGREGATE. LOAN NUMBER FLOOD PER OCCURRENCE AND ANNUAL AGGREGATE. BUILDERS RISK/COURSE OF CONSTRUCTION (INCLUDING NEW FOR PROJECT VALUES) REMARKS {Including Special Conditions) *EXCEPT 10 DAYS FOR NON PAYMENT OF PREMIUM AS PER SCHEDULE ATTACHED NATURE OF INTEREST MORTGAGEE EFFECTIVE DATE (MM /DD/YY) 09/01 /02 THIS REPLACES PRIOR EVIDENCE DATED: COMPANY AND ROBERT F DRIVER ASSOCIATES PLEASE REFER TO THE POLICY FOR SPECIFIC TERMS, CONDITIONS AND EXCLUSIONS. Note additional deductibles: Flood: except $250,000 per occurrence in flood Zone A or within 100 year flood area special flood endorsement for the Lexington Policy only per the attached Vehicles, Property Damage /Collision Damage $50,000 Fine Arts $50,000 per occurrence Earthquake or Flood. Specially Trained Animals $1 000 per occurrence. $500 000 per occurrence for tunnels, bridges, dams, catwalks (except those not for public use), roadway highways, streets, sidewalks, culverts, streetlights and traffic signals unless a specific value has been declared CANCELLATION THE POLICY IS SUBJECT TO THE PREMIUMS FORMS AND RULES IN EFFECT FOR EACH POLICY PERIOD SHOULD THE POLICY BE TERMINATED THE COMPANY WILL GIVE THE ADDITIONAL INTEREST IDENTIFIED BELOW '30 DAYS WRITTEN NOTICE, AND WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD AFFECT THAT INTEREST IN ACCORDANCE WITH THE POLICY PROVISIONS OR AS REQUIRED BY LAW ADDITIONAL INTEREST NAME AND ADDRESS LOSS PAYEE 1 438 BFU SIGNATURE OF AUTHORIZED AGENT OF COMPANY POLICY NUMBER VARIOUS PER ATTACHED EXPIRATION DATE (MM /DD /YY) 09/01/03 AMOUNT OF INSURANCE 250 000 25 000 000 ISSUE DATE (MM /DD /YY) 10 000 000 C (OTHER) EVIDENCE ONLY CONT UNTIL TERMINATED :III IF CHECKED ADDITIONAL INSURED DEDUCTIBLE $250,000 each every occurrence n 5% Per Unit of Insurance (Real Property Personal Property Time Element) 10% on Pre 1940 Biuldings Subject to $100,000 Min. per Member Earthquake Shock occurrence 250 000 000 $250,000 each every occurrence $10,000 Course of Construction All Perils except Earthquake Flood.