Triangle Associates, Inc. 5/17/2016

AC�® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 4/19/2016 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 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 CL Central NAME: Leavitt Group Northwest PHO,NNo,Extl: 866.298.0570 (n//C,No):866.298.0570 PO Box 9068 DDRE E-MAIL SS:cicnorthwestQleavitt.com INSURER(S)AFFORDING COVERAGE NAIC# Tacoma WA 98490 INSURERA:OhiO Security Insurance Company 024082 INSURED INSURER B:Colony Group 39993 Triangle Associates Inc INSURERC: 811 First Ave #255 INSURERD: INSURER E: Seattle WA 98104 INSURERF: COVERAGES CERTIFICATE NUMBER:15/16 Master 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE RENTED A CLAIMS-MADE X OCCUR PREM SESO(Ea occurrence) $ 1,000,000 X Y BKS55302282 10/23/2015 10/23/2016 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $ 3,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG_ $ 3,000,000 OTHER: Damage to Rental Premises $ 100,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A ALLOWNED SCHEDULED AUTOS AUTOS BAS55302282 10/23/2015 10/23/2016 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER X OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A A (Mandatory in NH) BKS55302282 10/23/2015 10/23/2016 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under WA StopGap OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000 B Professional Liability E01000919 7/13/2015 7/13/2016 PerClaim 1,000,000 Deductible 5,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Everett Schoold Project City of Everett is named additional insured with respects to general liability on primary and non-contributory basis and waiver of subrogration per written contract with the named insured form CG88100413. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Public Works Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 3200 Cedar St. Everett, WA 98201 AUTHORIZED REPRESENTATIVE { � D zcTrammell/DITRAM `V�Q�CSZ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)