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DATE(MM/DD/YYYY) <br /> ACCORD CERTIFICATE OF LIABILITY INSURANCE 2/4/2020 <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> CONTACT BRENT W SATERN <br /> PRODUCER NAME: <br /> BRENT W SATERN(19344) PHONE 503-874-8434 FAX <br /> No):503-874-0414 <br /> 204 W.MAIN ST E-MAILINCNo,Ext): <br /> E-M gRENT.SATERN@COUNTRYFINANCIAL.COM <br /> SILVERTON,OR 97381-0000 ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A: COUNTRY Mutual Insurance Company 20990 <br /> INSURED 9586549 INSURER B: <br /> CADAPULT SOFTWARE SOLUTIONS INC INSURER C: <br /> 702 JUNE DR INSURER D: <br /> MOLALLA,OR 97038 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO THAT THE <br /> INDICATED.CERTIFY <br /> NOTW NOTWITHSTANDING POLICIESANY REQUIREMENT,TERM OR CONDITIONABOVECE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED FOR POLICY <br /> OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH PERIOD 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) <br /> GENERAL LIABILITY AB9028744 9/1/2019 9/1/2020 EACH OCCURRENCE $2,000,000 <br /> A DAMAGE TO RENTED <br /> ✓ COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $100,000 <br /> CLAIMS-MADE I OCCUR MED EXP(Any one person) $5,000 <br /> PERSONAL&ADV INJURY $2,000,000 <br /> GENERAL AGGREGATE $4,000.000 <br /> PRODUCTS-COMP/OP AGG $4,000,000 <br /> _GEN'L AGGREGATE LIMIT APPLIES PER: <br /> PRO- $ <br /> COMBINED SINGLE LIMIT✓ POLICY JECT LOC <br /> AUTOMOBILE LIABILITY (Ea accident) $ <br /> BODILY INJURY(Per person) $ <br /> ANY AUTO <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $HIRED AUTOS AUTOS (Per accident) $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> $ <br /> DED RETENTION$ WC STATU- OTH- <br /> WORKERS COMPENSATION WC LIMITS T <br /> ER <br /> AND EMPLOYERS'LIABILITY Y/N E.L.EACH ACCIDENT $ <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N/A <br /> OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ <br /> (Mandatory in NH) <br /> If yes,describe under E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS below <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> CITY OF EVERETT ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 3200 CEDAR STREET <br /> EVERETT,WA 98201 AUTHORIZED REPRESENTATIVE <br /> /i <br /> 1 <br /> ©1988-2010 A •RD C k ' ORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />