Document VG3JNxRg52QBbpOM6qGX5mZaN
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AOOlill. CERTIFICATE OF INSURANCE
ISSUe DATE
PRODUCER
WILLIS CORROON CORPORATION OF SEATTLE P.O. Box 034201 Seattle, WA 98124 (206) 386-7400
[ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND I CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE ' DOES NOT AMENO, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE ; POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
company a
letter A
Reliance Insurance Co. of Illinois
tusufieD BARTELLS MATERIALS MANAGEMENT, 700 Powell Avenue S.W. Renton, WA 98055
INC.
Project Name: FOR BIO PURPOSES ONLY
company q
LETTER
COMPANY LETTER **
COMPANY n LETTER U
Contract Cost: N/A
COMPANY c LETTER C
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTEO 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 ANO CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
^ TYPE OF INSURANCE
POLICY NUMBER
GENERAL LIABILITY
A X COMMERCIAL GENERAL LIABILITY
NG1149698502
CLAIMS MADE X OCCUR.
OWNER'S a CONTRACTOR'S PROT.
x Incl. Asbestos Abatement x Contractual Liability
* AUTOMOBILE LIABILITY ANY AUTO
ALL OWNEO AUTOS
SCHEOULEO AUTOS
HIREO AUTOS
NON-OWNEO AUTOS
GARAGE LIABILITY
POLICY EFFECTIVE POLICY EXPIRATION DATE (MUfDOnrY) DATE (MM/DO/YY)
LIMITS
04/30/92
04/30/93
GENERAL AGGREGATE prooucts-comp/op ago. PERSONAL A ADV. INJURY EACH OCCURRENCE FIRE DAMAGE (Any on* flra) MED. EXPENSE (Any on* poraon)
COMBINED SINGLE LIMIT
5.000.000 "
1.000.000 1,000,000 5,000,000
50,000 Excluded
BOOILY INJURY (Par p*ron)
BOOILY INJURY (Par accident)
PROPERTY DAMAGE
EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION ANO
EMPLOYERS' LIABILITY
OTHER
Project: N/A
Start: N/A
EACH OCCURRENCE AGGREGATE
STATUTORY LIMITS EACH ACCIDENT DISEASE--POLICY LIMIT OISEASE--EACH EMPLOYEE
Completion: N/A
DESCRIPTION or OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEM*
Re: Requisition #861337WN, Bid * Wenatchee, WA Proof of Insurance FOR BID PURPOSES ONLY.,
CERTIFICATE HOLDER A)usinun Company of America 2070 Alcoa Building
Pittsburg, PA 15219
I ACORO 25-S (7/90)
4683460985
CANCELLATION
SHOULD ANY OF THE ABOVE OESCRIBEO POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILC ENDEAVOR TO MAIL___*2 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
73AUTHORIZED REPRESENTATIVE 0UNCAH BRONSON
(20)
OACORD CORPORATION 1990
ACK. CERTIFICATE OF INSURANCE
"""'TOl
PRODUCER
FILLIS C0RR00N CORPORATION OF SEATTLE P.0. Box C-34201 Seattle, WA 98124 (206) 386-7400
1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND I CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE ! DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE , POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY A LETTER A
Wausau Underwriters Insurance Co.
INSUAEO
THE E.J. BARTELLS COMPANY P.0. Box 4160 Renton, WA 98057-4160
COMPANY q
LETTER
COMPANY LETTER V*
COMPANY n LETTER U
Employers Insurance of Wausau, a Mutual Co.
COMPANY c LETTER c
COVERAGES
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 LTA
TYPE OF INSURANCE
GENERAL UABILITY A X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE x OCCUR. x OWNER'S 4 CONTRACTOR'S PROT.
POLICY NUMBER 2322-00-051805
AUTOMOBILE LIABILITY
B X ANY AUTO
ALL OWNEO AUTOS SCHEOULEO AUTOS X HIREO AUTOS X NON-OWNEO AUTOS GARAGE LIABILITY
EXCESS LIABILITY B X UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION ANO
EMPLOYERS' LIABILITY
OTHEA
2322-02-051805
----- - 1 *' .......... ' '
2332-00-051805
POLICY EFFECTIVE POLICY EXPIRATION 0ATE (MM/DO/YY) DATE (MM/OO/YY)
LIMITS
11/12/91
11/12/92
GENERAL AGGREGATE PROOUCTS-COMP/OP AGO. PERSONAL 4 AOV. INJURY EACH OCCURRENCE FIRE OAMAGE (Any on* flro) MED. EXPENSE (Any ono person}
T.doo.oW '
1,000,000 1,000,000 1,000,000
50,000 5,000
11/12/91
11/12/92
COMBINEO SINGLE LIMIT
1,000,000
BODILY INJURY (Por person}
BOOILY INJURY (Per eecMent)
11-12-91
11-12-92
PROPERTY OAMAGE
EACH OCCURRENCE AGGREGATE
4,000,000 4,000,000
STATUTORY LIMITS EACH ACCIDENT DISEASE--POLICY LIMIT DISEASE-EACH EMPLOYEE
DESCRIPTION OF OPERATIONSA.OCATIONS/VEHICLES/SPCCIAL ITEMS Re: Requisition #861337WN, Bid - Wenatchee, WA
4683460986
I CERTIFICATE HOLDER Aluminum Company of America 2070 Alcoa Building Pittsburg, PA 15219
ACORD 25-S (7/80)
CANCELLATION
SHOULD ANY Of THE ABOVE OESCRIBEO POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL'ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON T COMPANY. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE f
Duncan Bronson
(467) OACORO CORPORATION 1880
WILLIS CORROON
June 4, 1992
U illis Corrtmn
('orjMiration of
Seattle
Aluminum Company of America 2070 Alcoa Building Pittsburg, PA 15219
Insurance Bonds Benefits
Re: THE E. J. BARTELLS COMPANY Gentlemen / Ladies:
Risk Management TO! Fifth Avenue 4200 Columbia Center
We are pleased to enclose documents indicated below:
PO Box 34201 (Zip 981241
X_____________ Certificate of Insurance ______________ Memorandum of Insurance ______________ Copy of Policy (As Captioned)
Seattle, WA 98104 Telephone 206-386-7400 Fax 206-386-7960
______________ Loss Payable and/or Mortgage Clause
______________ Contract of Sale Clause
______________ Cover Note and/or Binder
______________ Other
The enclosed is issued in connection with:
Evidence of Insurance
We trust you will find the enclosure(s) to be entirely satisfactory.
Very truly yours.
Lattice Lembke Account Assistant (206) 386-7483
JL:mj(467)
Enclosure
cc: The E. J. Bartel Is Company Wausau Underwriters Insurance Co. Employers Insurance of Wausau, a Mutual Co.
4683460987 *
WILLIS CORROON
June 4, 1992
Willis Corroon Corj>oration of
Seattle
Aluminum Company of America 2070 Alcoa Building Pittsburg, PA 15219
j
Re: BARTELLS MATERIALS MANAGEMENT, INp.
Insurance Bonds Benefits Risk Management 701 Fifth Avenue
Gentlemen/Ladies:
We are pleased to enclose documents indicated below: X_____ Certificate of insurance (Amended) Memorandum of Insurance
_________ Copy of Policy (As Captioned)
4200 Columbia Center PO Box 34201 {Zip 98124) Seattle, WA 98104 Telephone 206-386-7400 Fax 206-386-7960
Loss Payable and/or Mortgage Clause
Contract of Sale Clause
Cover Note and/or Binder
Other
I
j
The enclosed is issued in connection with: Evidence of Insurance
We trust you will find the enclosure(s) to be entirely satisfactory. Very truly yours.
(206) 386-7483
JL:mj(20)
Enclosure
cc: Bartells Materials Management, Inc. Reliance Insurance Co. of Illinois
468346 0988
1