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HomeMy WebLinkAboutInsurance Certificate: Barrett Business Services Inc. 6/26/2023 3 :36 PM FROM: SYSTEMTO.: +15414885320 P. 4 AC REI CERTIFICATE OF LIABILITY INSURANCE DATE(MMID°"YYY) ��' 7/1/2023 6/24/2022 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 Lockton Companies • CNAAME: • 444 W.47th Street,Suite 900 PHONE FAX Kansas City MO 641 12-1906 E-MAIL Ext); (A/c,No): (816)960-9000 _ ADDRESS: kctsu@lockton.com INSURER(S)AFFORDING COVERAGE NAIC S INSURER A:ACE American Insurance Company 22667 INSURED Barrett Business Services,Inc. • INSURER B: 1495506 8100 NE Parkway Drive,Suite 200 • INSURER C: Vancouver WA 98662 INSURER D: l • INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 17681815 REVISION NUMBER: - XXXXXXX 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. INSRUBR • POLICY EFF POLICY EXP TYPE OF INSURANCE NSD ADDL SWVD POLICY NUMBER (MIDDIYYYY) (MM DDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ XXXXXXX MED EXP(Any one person) $ XXXXXXX PERSONAL&ADV INJURY $ XXXXXXX• GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ XXXXXXX POLICY PE LOC PRODUCTS-COMP/OP AGG $ XXXXXXX OTHER: $ AUTOMOBILE LIABILITY NOT APPLICABLE COMBINED SINGLE LIMIT (Ea accident) $ XXXXXXX ANY AUTO BODILY INJURY(Per person) $ XXXXXXX _ AWNED SCHEDULED BODILYINJURY(Per $ XXXXXXX AUTOS ONLY AUTOSaccident) HIRED NON-OWNED ' PROPERTY DAMAGE AUTOS ONLY ^ AUTOS ONLY (Per accident) $ XXXXXXX $ XXXXXXX UMBRELLA LIAB — OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE AGGREGATE _ $ XXXXXXX DED RETENTION$ $ XXXXXXX A WORKERS COMPENSATION N X PER H- • AND EMPLOYERS'LIABILITY YIN C51238382 7/1/2022 7!I/2023 STATUTE ET ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT • a 2,000,000 OFFICER/MEMBER EXCLUDED? • N NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 If yes,describe under • DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000 • DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) STATES COVERED:AZ,UT,OR,WA.LIMITS SHOWN ARE ABOVE A$3,000,000 SELF INSURED RETENTION. CERTIFICATE HOLDER CANCELLATION • . 17681815 • EVIDENCE OF COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIV / ©1988 015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) . The ACORD name and logo are registered marks of ACORD •