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Client#: 105477 MCCACONS2 <br /> ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)12/13/2019 <br /> • <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 any rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER ACT Joy Arakaki <br /> Propel Insurance FAx 866 577-1326 <br /> 800 499-0933 <br /> Ext): (AIC,No): <br /> Seattle Commercial Insurance E-MAIL o arakaki r0 elinsurance.com <br /> ADDRESS: Y• @P P <br /> 601 Union Street, Suite 3400 <br /> INSURER(S)AFFORDING COVERAGE NAIL# <br /> Seattle,WA 98101-1371 INSURER A:The Phoenix Insurance Company 25623 <br /> INSUREDINSURER B:Travelers Property Casualty CoofAmerica 25674 <br /> Road Construction Northwest Inc Homeland Insurance Company of New York 34452 <br /> INSURER C: p Y <br /> P.O. Box 2228 Travelers Indemnity D: Co of Connecticut 25682 <br /> Renton,WA 98056 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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 LIMITS <br /> LTR INSR WVD POLICY NUMBER _JMM/DDM YYL(MM/DDIYYYY) <br /> A X COMMERCIAL GENERAL LIABILITY C0527D3347PHX19 05/15/2019 05/15/2020 EACH OCCURRENCE $1,000,000 <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $300,000 <br /> X PD Ded: $5,000 MED EXP(Any one person) $10,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> i l PRO- PRODUCTS-COMP/OP AGG $2 000,000 <br /> POLICY I XI JECT LOC s <br /> OTHER: $ <br /> D AUTOMOBILE LIABILITY 8100N3757641926 05/15/2019 05/15/2020 COMBaaccidINEDent)SINGLE LIMIT $1,000,000 <br /> (E <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> AUTOWNEDOSONLY SCHEDTOSULED BODILY INJURY(Per accident) $ <br /> AU <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> X AUTOS ONLY AUTOS ONLY (Per accident) <br /> B X UMBRELLA LIAB X OCCUR CUP5J0216681926 05/15/2019 05/15/2020 EACH OCCURRENCE $8,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $8,000,000 <br /> DED X RETENTION$$10,000 $ <br /> A WORKERS COMPENSATION C0527D3347PHX19 05/15/2019 05/15/2020 STATUTE X ERH <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N (WA Stop Gap) E.L.EACH ACCIDENT $1,000,000 <br /> OFFICER/MEMBER EXCLUDED? N N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> C Pollution Liab 79333390002 05/15/2018 05/15/2020 Limit: $3,000,000 <br /> Ded: $5,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> The General Liability,Auto Liability and Umbrella Liability policies include a blanket automatic <br /> additional insured endorsement that provides additional insured status to the certificate holder only when <br /> there is a written contract between the named insured and the certificate holder that requires such status. <br /> (See Attached Descriptions) <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 3200 Cedar St ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Everett,WA 98201-0000 <br /> AUTHORIZED REPRESENTATIVE <br /> ©1988-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD <br /> #S3938021/M3660319 JYA00 <br />