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Administrative Offices <br /> GREAT 301E 4th Street F.36270(Ed. 05/18) <br /> AMERICAN Cincinnati OH 45202-4201 <br /> INSURANCE GROUP 513 369 5000 ph <br /> CERTIFICATE OF COVERAGE (WASHINGTON) <br /> This certificate of coverage,together with the attached master policy and any endorsement(s)constitute the policy issued <br /> to the Certificate Holder. Any coverage listed below is subject to the terms,conditions and limitations set forth below and <br /> in the master policy referenced. <br /> POLICYHOLDER NAME AND ADDRESS: <br /> Special Markets Purchasing Group, Inc. <br /> The Little Gym Program <br /> 1055 Main Street, Suite 101 <br /> Stevens Point,WI 54481 <br /> CERTIFICATE HOLDER NAME AND ADDRESS: DreamBig for Kids,LLC dba The Little Gym of Everett <br /> 7207 Evergreen Way,Suite R <br /> Everett,WA 98203 <br /> ITEM 1. COVERAGE PERIOD: Effective: 08/01/2019 To: 08/01/2020 <br /> At 12:01 A.M. Standard Time at The Address of the Certificate Holder <br /> CERTIFICATE NUMBER: LGIT0138 <br /> ITEM 2. INSURER <br /> INSURER MASTER POLICY NUMBER <br /> Great American Insurance Company PAC 3110229-00 <br /> ITEM 3. AGENTS NAME AND ADDRESS <br /> Special Markets Insurance Consultants, Inc. <br /> 1055 Main Street, Suite 101 <br /> Stevens Point,WI 54481 <br /> ITEM 4. SCHEDULE OF CHARGES <br /> Total Premium(If Applicable): <br /> Premium: $2,542 Charged By Insurance Company <br /> Disclosure Regarding Shared Limits.Members Do Not Share Limits And Each Member Is Provided With Its Own Policy&/Or Certificate of Coverage. <br /> Disclosure Pursuant To Federal Law Regarding Purchasing Groups[U.S.C.15 3901,Et Seq.]PG Is A"Purchasing Group,"As Defined Under Federal Law,Formed <br /> To Purchase Liability Insurance On A Group Basis For Its Members To Cover The Similar Or Related Liability Exposure(s)To Which The Members Of PG Are Exposed By <br /> Virtue Of Their Related,Similar,Or Common Business Or Service.Members Do Not Share Limits And Each Member Is Provided With Its Own Policy&/Or Certificate of <br /> Coverage. <br /> ITEM 5. SCHEDULE OF CASUALTY COVERAGE AND LIMITS OF INSURANCE: <br /> COMMERCIAL GENERAL LIABILITY COVERAGE FORM <br /> General Aggregate Limit(Other Than Products Completed Operations) $5,000,000 <br /> Products-Completed Operations Aggregate Limit $5,000,000 <br /> Personal and Advertising Injury Limit $1,000,000 <br /> Each Occurrence Limit $1,000,000 <br /> Damage to Premises Rented to You Limit $1,000,000(Any One Premises) <br /> Medical Expenses Limit $ 20,000(Any One Person) <br /> ABUSE OR MOLESTATION COVERAGE FORM <br /> Aggregate Limit $5,000,000 <br /> Each Abuse Limit $1,000,000 <br /> F.36270 (Ed. 5/18) Page 1 of 3 <br />