Play Well TEKnologies 1/29/2020 - Laserfiche WebLink

A ® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 09/18/2019 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 Michael McNamara NAME: McNamara Insurance Services,Inc. TNN,Ext): (415)457-7856 FA(A/X,No): (415)457-7698 1050 Northgate Drive,Ste 515 E-ARE Mike©4apolicy.com INSURER(S)AFFORDING COVERAGE NAIC# San Rafael CA 94903INSURERA: Philadelphia Indemnity Insurance Companies 18058 INSUREDINSURER B: The Hartford Insurance Co of the Midwest 37478 Tim Bowen,DBA:Play-Well TEKnologies INSURER C: 224 Greenfield Ave.Ste B INSURER D: INSURER E: San Anselmo CA 94960 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITYEACH OCCURRENCE $ 1'000'DAMAGE T000 CLAIMS-MADE X OCCUR PREM SESO(Ea occurrRENTEence) $ 100,000 MED EXP(Any one person) $ 5,000 A Y PHPK2034090 10/01/2019 10/01/2020PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Professional Liability $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) _ _ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) $ X UMBRELLA LIAB X OCCUREACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE PHUB692546 10/01/2019 10/01/2020 AGGREGATE $ 5,000,000 DED RETENTION$ $ WORKERS COMPENSATION X STATUTE EORH AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000, W 000 B OFFICER/MEMBER EXCLUDED? N/A 57ECKZ9403 10/01/2019 10/01/2020 - - (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 10 , 00000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , Abuse/Molestation A PHPK2034090 10/01/2019 10/01/2020 EACH INCIDENT 1,000,000 AGGREGATE 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations.The City of Everett,its officers,agents and employees are added as Additional Insured per the General Liability Deluxe Endorsement Human Services PI-GLD-HS attached to this policy. 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,its officers,agents and employees ACCORDANCE WITH THE POLICY PROVISIONS. 802 E.Mukilteo Blvd. AUTHORIZED REPRESENTATIVE Everett WA 98203 ‘ok: �/4---( 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD