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. •��..44, BRIDGEW-01 SSHIMONO
<br /> i'aCCP G," DATE(MWDD/YYYY)
<br /> 4...----- CERTIFICATE OF LIABILITY INSURANCE 3/6/2020
<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 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 rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Shannon Shimono
<br /> PLC Insurance LLC PHONE 275-0571 I FAX
<br /> 19401 40th Ave W,Suite 440 (A/C,No,Ext):(425) (A/C,No):
<br /> Lynnwood,WA 98036 ADDAIL
<br /> RESS:shannonb@picins.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA:Philadelphia Indemnity Ins Co. 18058
<br /> INSURED INSURER B:
<br /> Bridgeways INSURER C:
<br /> 5801 -23rd Dr.W. Suite 104 INSURER D:
<br /> Everett,WA 98203
<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 NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD (MM/DD/YYYYI (MM/DD/YYYYI
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR X PHPK2105754 3/2/2020 3/2/2021 PREMISES(Ea occurrence) $ 100,000
<br /> MED EXP(Any one person) $ 5,000
<br /> • PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 3,000,000
<br /> X POLICY PRO-
<br /> JECT LOC PRODUCTS-COMP/OP AGG $ 3,000,000
<br /> OTHER: Stop Gap $ 1,000,000
<br /> A AUTOMOBILE LIABILITY (Ea accident SINGLE LIMIT $ 1,000,000
<br /> X ANY AUTO PHPK2105754 3/2/2020 3/2/2021 BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> AUTOS ONLY X AUUTOS ONLY PROPERTY DAMAGE
<br /> X
<br /> (Per accident)) $
<br /> $
<br /> A X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000
<br /> EXCESS LIAB CLAIMS-MADE PHUB713920 3/2/2020 3/2/2021 AGGREGATE $ 1,000,000
<br /> DED X RETENTION$ 10,000 $
<br /> WORKERS COMPENSATION PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> ANYIPRR/MEY PROPRIET R EXRTN ED?ECUTIVE N/A E L.EACH ACCIDENT $
<br /> B(Mandatory in NH) E L DISEASE-EA EMPLOYEE $
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $
<br /> A Prof Liability PHPK2105754 3/2/2020 3/2/2021 Occurrence 1,000,000
<br /> A PHPK2105754 3/2/2020 3/2/2021 Aggregate 3,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> The City of Everett,its officers,employees and agents are included as Additional Insured when required by written contract or agreement per attached GL
<br /> form.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 2930 Wetmore Ave Ste 10A
<br /> Everett,WA 98201
<br /> ALUTHHOORIZED REPRESENTATIVE
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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