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<br /> Client#: 105477 MCCACONS2
<br /> ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 12/13/2019
<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 CONTACT Joy Arakaki
<br /> Propel Insurance PHO/C,NNEo,Ext):800 499-0933 FAX
<br /> (A/C,No): 866 577-1326
<br /> (A
<br /> Seattle Commercial Insurance E-MAIDRLESS: y.arakaki r0 O elinsurance.com
<br /> AD @p P
<br /> 601 Union Street,Suite 3400 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Seattle,WA 98101-1371 The Phoenix Insurance Company INSURER A: P Y 25623
<br /> INSURED INSURER B:Travelers Property Casualty CoofAmerica 25674
<br /> Road Construction Northwest Inc Homeland Insurance Company INSURER C: P Y of New York 34452
<br /> P.O. Box 2228 Travelers IndemnityCo of Connecticut 25682
<br /> Renton,WA 98056 INSURER D:
<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 /> INSRR TYPE OF INSURANCE N W SR VD POLICY NUMBER POLICY EFF POLICY EXP
<br /> LTR (MM/DD/YYYY) LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY C0527D3347PHX19 05/15/2019 05/15/2020 EACH OCCURRENCE $1,000,000
<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 /> GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000
<br /> POLICY A JECT LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER. $
<br /> D AUTOMOBILE LIABILITY 8100N3757641926 05/15/2019 05/15/2020 Ea accdentSINGLE LIMIT $1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY _ AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> X AUTOS ONLY X AUTOS ONLY 1Per 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 ORTH-
<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/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
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