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<br /> ACC Q® DATE(MM/DD/YYYY)
<br /> A CERTIFICATE OF LIABILITY INSURANCE 08,26,2019
<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 /> PRODUCER CONTACT
<br /> NAME:
<br /> Willis of Oregon, Inc. PHONE 1-877-945-7378 FAX 1-888-467-2378
<br /> c/o 26 Century Blvd (A/C.No.Ext): (A/C,No):
<br /> E-MAIL certificates@willis.
<br /> P.O. Box 305191 ADDRESS: com
<br /> Nashville, TN 372305191 USA INSURER(S)AFFORDINGCOVERAGE NAIC#
<br /> INSURERA: Charter Oak Fire Insurance Company 25615
<br /> INSURED INSURER B: Travelers Indemnity Company 25658
<br /> Perteet, Inc.
<br /> PO Box 1186 INSURER C: Travelers Casualty and Surety Company of A 31194
<br /> 2707 Colby Avenue, Suite 900 INSURER D:
<br /> Everett, WA 98201
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:W12381353 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 EFF POLICY EXP
<br /> LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
<br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE OCCUR DAMAGES RENTED 1,000,000
<br /> PREMISES(
<br /> (Ea occurrence) $
<br /> A MED EXP(Any one person) $ 5,000
<br /> 6805J284500 06/27/2019 06/27/2020 PERSONAL&ADV INJURY $ 1,000,000
<br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> PRO-
<br /> JECT
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> (Ea accident)
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> B OWNED SCHEDULED BA-5J284770-19-GRP 06/27/2019 06/27/2020 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY (Per accident)
<br /> $
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED RETENTION$ $
<br /> WORKERS COMPENSATION PER X OT H- WA Stop Gap
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> Y/N
<br /> A ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBEREXCLUDED? N/A 6805J284500 06/27/2019 06/27/2020
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under
<br /> 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> C Professional Liability 106321064 06/27/2019 06/27/2020 Per Claim $3,000,000
<br /> Aggregate $5,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Project # 20190190, Everett Parks Streetscape Evaluation.
<br /> Per Project Aggregate applies when required by written contract. General Aggregate Capped at $8,000,000.
<br /> City of Everett are included as Additional Insureds as respects to General Liability as required by written contract.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Everett
<br /> Attn: Mark Harrison AUTHORIZED R�EEPPPRREESENTA(�T�I✓V�E
<br /> 802 E. Mukilteo Blvd. Z'Y 4j /
<br /> Everett, WA 98203
<br /> ©1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> SR IS 18431606 BATCH: 1341430
<br />
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