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BRIDGEW-01 CDANELL <br /> ACORO DATE(MM/DD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 3112/2019 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> CONTACT <br /> PRODUCER NAME: <br /> PLC Insurance LLC <br /> 19401 40th Ave W,Suite 440 la/°Nro,Eat):(425)712-3664 FAX <br /> No):(425)7124786 <br /> Lynnwood,WA 98036 E-MAILADDRESS:Plc@plcins.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Philadelphia Indemnity Ins Co. <br /> INSURED INSURER B: <br /> Bridgeways INSURER C: <br /> 5801 -23rd Dr.W. Suite 104 INSURER D: <br /> Everett,WA 98203 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD IMM/DD/YYYY1 IMM/DD/YYYYI <br /> COMMERCIAL GENERAL UABILITY EACH OCCURRENCE $ <br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED <br /> PREMISES(Ea occurrence) $ <br /> MED EXP(Any one person) $ <br /> PERSONAL 8 ADV INJURY $ <br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> POLICY 78-F LOC PRODUCTS-COMP/OP AGG $ <br /> OTHER: COMBINE $ <br /> A AUTOMOBILE LIABIUTY (EaacccidentSINGLE LIMIT $ 1,000,000 <br /> X ANY AUTO PHPK1953810 3/2/2019 3/2/2020 BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY _ AUTOSSWN BODILYORINJURY(Per accident) $ <br /> HIREJD OSS ONLY ATOS ONLY (Peri aEuiRdent�AMAGE <br /> UMBRELLA LIAB _ OCCUR EACH OCCURRENCE _$ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PR PEATUTE ETH <br /> AND EMPLOYERS'LIABILITY �,/N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory m NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> A Professional Liab PHPK1953810 3/2/2019 3/2/2020 Occurrence 1,000,000 <br /> A PHPK1953810 3/2/2019 3/2/2020 Aggregate 3,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) <br /> City of Everett,its officers,employees and agents are additional insured per attached CG2026 0413 and PI-GLD-HS(10-11); <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Cityof Everett Attn Rebecca McCraryTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Dept of Plannning&Community Dev <br /> 2930 Westmore Ave <br /> Suite 8A AUTHORIZED REPRESENTATIVE <br /> Everett,WA 98201 <br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />