Blue Marble Environmental LLC 5/7/2020

A�CORD� CERTIFICATE OF LIABILITY INSURANCE DATE(MhllDOIYYYY) o4/01/2020 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 Mark Scheele NAME: StateFarm Thury Foster State Farm MMC.NNo.Esti: 206-985-2528 A/c.Nol; 206.985-2549 c-.) 1311 NE Ravenna Blvd orORess; marls@thuryfaster.com INSURER(S)AFFORDING COVERAGE NAIC N Seattle WA 98105 INSURER A: State Farm Fire and Casualty Company 25143 INSURED INSURER a: State Farm Mutual Automobile Insurance Company 25178 BLUE MARBLE ENVIROMENTAL LLC INSURER C: 5419 GREENWOOD AVE N INSURER D: INSURER E: Seattle WA 98103 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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. IXP LTR TYPE OF INSURANCE SR INSSO Iwo POLICY NUMBER !MM/DDIIYY YYY) IMN100IIYYYY 1, UNITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE ®OCCUR PREMISES lEa occurrence) S 300,000 MEO EXP(My one person) $ 5,000 A — Y Y 98-CD-W013-4 07/17/2019 07/17/2020 PERSONAL C.ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 7 POLICY PRO- I I LOC PRODUCTS-COMP/OP AGO $ 2,000,000 JECT OTHER: S AUT°MOBILELIABIUTY Y Y 342 2501-B10-47N 02/10/2020 08/10/2020 (Ea accid COMBINED SiDfGLE LIMIT $ nt) ANY AUTO BODILY INJURY(Per person) 8 1,000,000 B — OWNED X SCHEDULED BODILY INJURY(Per accident) S 1,000,000 AUTOS ONLY AUTOS — HIRED NON-OWNED PROPERTY DAMAGE S 1,000,000 AUTOS ONLY AUTOS ONLY (Per accident) S UMBRELLA UAB OCCUR EACH OCCURRENCE $ — EXCESS UAB CLAIMS-MADE AGGREGATE S DED RETENTION$ S WORKERS COMPENSATION PER ER AND EMPLOYERS'LIABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE Y0 N!A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yyes,dascriba under DESCRIPTION OF OPERATIONS below _ EL.DISEASE•POLICY LIMIT i DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Location:Seattle/King?Snohomish Additional Insured City of Everett is Primary and Non-Contributory Vehicle:2000 Ford Ranger Pidcup VIN 1 FTZR15X6YPB03239 Service:Provide Communicatgion,Coordination,and resources management among meal providers in Everett,as a response to COVID-19 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,The Associate Agency,and their officers ACCORDANCE WITH THE POLICY PROVISIONS. Employees,and Agents 2930 Wetmore Ave 10A AUTHORIZED PRE NTa Everett WA 98201 d,,�,� I 0 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1001488 132849.12 0348-2016