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10 <br />CERTIFICATE OF INSURANCE ISSUE DATE 4/24/2014 <br />PRODUCER <br />PROFESSIONAL PROGRAM INSURANCE BROKERAGE <br />371 BEL MARIN KEYS BLVD., SUITE 220 <br />NOVATO CA, 94949-5662 <br />THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, <br />EXTEND OR LATER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURER(S) AFFORDING COVERAGE <br />INSURER A: <br />LLOYD'S OF LONDON <br />INSURED <br />Wolverine Fireworks Display, Inc. <br />205 W. Seidlers Road <br />Kawkawlin, MI 48631 <br />INSURER B: <br />INSURER C: <br />INSURER D: <br />COVERAGES <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NAMED INSURED ABOVE <br />FOR THE PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER <br />DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY <br />THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />CO <br />LTR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE (MM/DD/YY) <br />POLICY EXPIRATION <br />DATE (MM!DDIYY) <br />OMITS <br />A <br />GENERAL LIABILITY <br />CLAIMS MADE <br />GEN'L AGGREGATE LIMIT <br />APPLIES PER POLICY <br />PY/14-0013 <br />02/01/2014 <br />02/01/2015 <br />EACH ACCIDENT <br />$ 5,000,000 <br />MEDICAL EXP (Any one <br />person) <br />$ <br />FIRE LEGAL LIABILITY <br />$ 50,000 <br />GENERAL AGGREGATE <br />$ 5,000,000 <br />- <br />PRODUCTS-COMP/OPS AGG <br />$ <br />AUTOMOBILE LIABILITY <br />_ ANY AUTO <br />_ ANY OWNED AUTOS <br />SCHEDULED AUTOS <br />I HIRED AUTOS <br />NON -OWNED AUTOS <br />COMBINED SINGLE UMi T <br />(Ea accident) <br />$ <br />BODILY INJURY <br />(Per person) <br />$ <br />BODILY INJURY <br />(Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />EXCESS LIABILITY <br />FOLLOWING FORM <br />EACH ACCIDENT <br />$ <br />AGGREGATE <br />$ <br />WORKERS COMPENSATION <br />AND <br />EMPLOYERS' LIABILITY <br />WC STATU- OTH- <br />TORY LIMITS ER <br />$ <br />EL.EACH ACCIDENT <br />$ <br />E.L DISEASE -EA EMPLOYEE <br />$ <br />E.L DISEASE -POLICY LIMIT <br />$ <br />OTHER <br />DESCRIPTION OF OPERATIONS!LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />City of Everett; Everett Aqua Sox Basebal Club; Everett School District #2; 7th Inning Stretch, LLC its agents, employees, and officers, ATIMA. are Additional <br />Insured as respects the 06/13/2014, 06/27/2014, 07/04/2014, 07/18/2014, 07/25/2014, 08/16/2014. and 08/23/2014 fireworks displays located at Everett <br />Memorial Stadium, Everett, WA <br />CERTIFICATE HOLDER <br />City of Everett <br />2390 Wetmore <br />Everett, WA 96201 • <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br />DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br />FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY <br />KIND UPON THE ENSURER, ITS AGENTS SENTATIVES.., <br />f}' <br />AUTHORIZE REPRESENTATIVE <br />47 <br />