Invisible Creature 12/30/2019 - Laserfiche WebLink

AC RI® CERTIFICATE OF LIABILITY INSURANCE DATE(EdM1DD/YYYY) 12/20/2019 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 have ADDITIONAL INSURED provisions or 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 Scott Kizer NAME; State Farm Scott Kizer State Farm Insurance PHONE Etdi: 253-398-2746 FAX Nal. 253-398-2748 (04 3106 SE 240th St Suite 101 e'MAIL Scott®scottklzerinsurance.com IJV ADDRESS: x Kent,WA 98031 INSURER(S)AFFORDING COVERAGE NAIL a INSURER A: State Farm Fire and Casualty Company 25143 INSURED INSURER a: State Farm Mutual Automobile Insurance Company 25178 INVISIBLE CREATURE INC INSURER C: 23815 SE 196TH ST INSURER D: MAPLE VALLEY,WA 98038-8902 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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.OMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR IN SD MD POLICY NUMBER (MMIDDIYYY`(1 (MM10DIYYYYI Xj COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 —i—CLAIMS-MADE I OCCUR DAMAGEES(Ee RENTED S 300,000 I MED EXP(Any one person) -.$ 5,000 A 'I Y 98-BO-J770-5 03/21/2019 03/21/2020 PERSONAL 6 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2.000,000 X4 POLICY ire LOC PRODUCTS-COMP/OP AGG i 2,000,000 I OTHER' S AUTOMOBILE LIABLITY COMBINED SINGLE LIMIT S (Ea accident} ,ANY AUTO BODILY INJURY(Per person) S g —I OWNED —I SCHEDULED BODILY INJURY(Peracddent) $ __(AUTOS ONLYAUTOS • HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY .AUTOS ONLY (Per accident) S UMBRELLA UAB _ OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS-MADE AGGREGATES DEC I RETENTIONS y S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER _ A OOFFFICEEIOMEM ERR EXCLUDEEED ECUnvE ,N I A E.L.EACH ACCIDENT S (Mandatory In NH) E.LDISEASE-EAEMPLOYEE S If yes,describe under DESRIPTION OF OPERATIONS below • E.L DISEASE.POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Addkional Remarks Schedule,may be attached N more apace la required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Everett ACCORDANCE WITH THE POLICY PROVISIONS. 2930 Wetmore Ave,10-A Everett,WA 98201 AUTHORIZED REPRESENTATIVE I 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1001486 132849.12 03-16-2016