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HomeMy WebLinkAbout20260219_PJA26-0115_COI DATE(MM/DD/YYYY) ACORO® CERTIFICATE OF LIABILITY INSURANCE 2/16/2026 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 have ADDITIONAL INSURED provisions or be endorsed. 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). PRODUCER CONTACT NAME: Christi Kunnap Highstreet Insurance& Financial Services PHONE FAX 425-775-6446 No:425-640-9225 600 Main Street, Suite A EMAIL Edmonds WA 98020 ADDRESS: Christi.Kunnap@highstreetins.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Red Shield Insurance Company 41580 INSURED GUTI&FA-01 INSURER B: The Gutierrez&Family LLC DBA Tacos La Mas Fregona 19322 VISTA DR INSURERC: Arlington WA 98223 INSURERD: INSURER E. INSURER F: COVERAGES CERTIFICATE NUMBER:1972321530 REVISION NUMBER: 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. INSR D UBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD V1fVD POLICY NUMBER MM/DD/YYYY) IMMIODIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY Y CLP 029735 4/2/2025 4/2/2026 EACH OCCURRENCE $1.000.000 CLAIMS-MADE FRI OCCUR PREMISEOES(Ea oomirrencel $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY JECOT- ❑ LOC PRODUCTS-COMP/OP AGG $Included OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Food Vendor The City of Arlington is an Additional Insured under General Liability when required by written contract per the attached form(s). CERTIFICATE HOLDER 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. City of Arlington 18204 59th Ave NE Arlington WA 98223 AUTHORIZED REPRESENTATIVE 11 �1�� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CLP 029735 COMMERCIAL GENERAL LIABILITY GL 11 15 11 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: CITY OF ARLINGTON 18204 59TH AVE NE ARLINGTON,WA 98223 A. Section II — Who Is An Insured is amended to 4. The person or organization are not additional include as an additional insured the additional insureds for liability arising out of their own insured(s) shown in the Schedule, when you and negligence, or the "products completed such person or organization have agreed in writing operations hazard". in a contract or agreement that such person or organization you are contracting with be added as C. With respect to the insurance afforded to the an additional insured on your policy. Such person or additional insureds the following limitations and organization is an additional insured only with exclusions apply: respect to "bodily injury" or "property damage" This insurance does not apply to, and the additional occurring subsequent to execution of the written insureds are not insureds for: contract or agreement, while you are performing your ongoing operations at the person's or 1. "Bodily injury", "property damage" or "personal organization's premises, and caused only by your and advertising injury" arising out of the negligence in the performance of those operations. rendering of, or the failure to render, any The person's or organization's status as an professional architectural, engineering or additional insured ends when your personnel are no surveying services, including: longer present at the premises of the person or organization. a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, B. The insurance provided to the additional insureds is opinions, reports, surveys, field orders, limited as follows: change orders or drawings and specifications; and 1. Any insurance afforded to such additional insureds by this endorsement only applies to the b. Supervisory, inspection, architectural or extent permitted by law; and engineering activities. 2. If coverage provided to the additional insured is This limitation and exclusion applies even if the required by a contract or written agreement, the claims against an insured allege negligence or other insurance afforded to such additional insured wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if will not be broader than that which you are the "occurrence"which caused the "bodily injury" or required by the contract or written agreement to "property damage", or the offense which caused the provide for such additional insured; and "personal and advertising injury", involved the 3. The person or organization is an additional rendering of or the failure to render any professional insured only for vicarious liability resulting from architectural, engineering or surveying services. your negligent acts; and GL 11 15 11 15 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 2 2. "Bodily injury", "property damage" or "personal and advertising injury" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, or the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. D. Coverage afforded to the additional insured is no greater than that provided to you and is subject to all policy terms, conditions, and exclusions, including those applicable to other insurance, to the same extent they are applicable to you. E. The following duties are added to the Duties in Event of Occurrence, Offense, Claim or Suit Condition of this policy: Additional insureds under this endorsement shall tender any claim or"suit" to all available insurance and shall give written notice to us of any "occurrence" which may result in a claim or "suit" under this insurance. F. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the written contract or agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. GL 11 15 11 15 Includes copyrighted material of Insurance Services Office, Inc.,with its permission Page 2 of 2