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AC0 ® CERTIFICATE
<br /> q� �ap DATE(MWDD/WYY)
<br /> ��. `i�1li l ���t�ii�� OF LIABILITY INSURANCE 1/30/2019
<br /> 1 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. r
<br /> IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
<br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTANAME:CT Debbie Cook
<br /> Leavitt Group Northwest PHcNNo,Exq. (800)726-8771 {AArc,No):(866)72e-9168
<br /> P0 Box 65770 AtDRkss.debbie—cook@leavitt.com
<br /> INSURERS)AFFORDING COVERAGE NAIC 0
<br /> University Place WA 98464 INSURERA:Philadelphia Indemnity Insurance A18058
<br /> _
<br /> INSURED .. -._ _._.__,. _INSURER B -,--
<br /> Little Red School House Inc, DBA: Childstrive INSURER C:
<br /> 14 E Casino Rd INSURER a:
<br /> INSURER S:
<br /> Everett WA 98208 INSURERF:
<br /> COVERAGES CERTIFICATE NUMBER:19-20 Misc Master, no Emp 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 /> INSRADMSUBR POLICY EFF POLICY EXP LIMITSLTR TYPE OF INSURANCE JNSOJVVO- POLICY NUMBER (MMLOD/YYYYI (MM/DD/YYYY)
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> ENTED
<br /> A CLAIMS-MADE X OCCUR PREMISES(Eaoccurrence) $ 100,000
<br /> X PRP51933191 1/23/2019 1/23/2020 MED EXp(Any one person) $ -- 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
<br /> X POL ICY I JE
<br /> IPROCT LOC PRODUCTS-COMP/OP AGG $ 3,000,000
<br /> OTHER: SexuaYPhysical Abuse Ago. $ 1,000,000
<br /> AUTOMOBILE LIABILITY Ea�dennt)INGLELiMR $ 1,000,000
<br /> BODILY INJURY(Per person) $
<br /> A X ANY AUTO
<br /> —
<br /> ALL OWNED -SCHEDULED P5P1{1933191 1/23/2019 1/23/2020 BODILY INJURY(Per accident) $
<br /> AUTOSHIRED AUTOS AUTOS
<br /> PROPERTY DAMAGE $
<br /> (Per P
<br /> Underinsured motorist $ 1,000,000
<br /> X UMBRELLA LIAR X OCCR EACH OCCURRENCE $ 3,000,000
<br /> A EXCESS LIAR CLAIMS-MADE AGGREGATE $ 3,000,000
<br /> DED X RETENTIONS 10,000 PBDB662464 1/23/2019 1/23/2020 $
<br /> WORKERS COMPENSATION STATUTE I X ETH-
<br /> AND EMPLOYERS'LIABILITY Y IN
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE i 1 N/A WA Stop Gap E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFI(ManCER/MEMBER H)EXCLUDED? P�g1233191 1/23/2019 1/23/2020
<br /> A OFFICERM la NH) E L DISEASE-Flt EMPLOYEE$ 1,000,D00
<br /> dyes,describe under
<br /> DESCRIPTION OF OPERATIONS below _ EL.DISEASE-POLICY LIMIT,$ 1,000,000
<br /> A Professional Liability 55P51933191 1/23/2019 1/23/2020 Aggregate$3000,000 1,000,000
<br /> A Directors & Officers 1.11SD1415696 1/23/2019 1/23/2020 Aggregate 4,000,000
<br /> DESCRIPTION OP OPERATIONS(LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
<br /> City of Everett, Its officers, employees and agents are added as additional insureds as per CG 2026 0413
<br /> attached.
<br /> Ii
<br /> CERTIFICATE HOLDER CANCELLATIONi.
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 2930 Wetmore St., Suite 10A ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Everett, WA 98201
<br /> AUTHORIZED REPRESENTATIVE
<br /> jJeff Olsen/DECOOiC 9 ---7/aZ!.,—____
<br /> 01988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
<br /> INS025(201x01)
<br />
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