Triangle Associates Inc. 6/16/2020

AC CERTIFICATE OF LIABILITY INSURANCE DATE T (M )/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 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 CLC3 NAME: Leavitt Group Northwest AICONNo.Extl: (800)726-8771 FAX (AIC,No): (866)72a-916a PO Box 65770 E-MAIL Broker ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# University Place WA 98464 INSURER A:American Fire & Casualty Company 24066 INSURED INSURER B:Ohio Security Insurance Company .24082 Triangle Associates Inc INsuRERc:Underwriters at Lloyds of London 15792 811 First Ave #255 INSURERD: INSURER E: Seattle WA 98104 INSURER F: COVERAGES CERTIFICATE NUMBER:19/20 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 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. INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE LSD VVVD POLICY NUMBER (MMIDDIYYYY) (MM/DDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE RENTE A CLAIMS-MADE X OCCUR PREMISESO(Ea o currence) $ 1,000,000 X Y BKA55302282 10/23/2019 10/23/2020 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BAS55302282 10/23/2019 10/23/2020 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $X HIRED AUTOS X AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER X OTH- AND EMPLOYERS'LIABILITY Y I N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE WA Stop Gap E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A A (Mandatory in NH) BKA55302282 10/23/2019 10/23/2020 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C Professional Liability MPL103380519 7/13/2019 7/13/2020 Per Claim/Deductible 1,000,000/5,000 Sexual Abuse/Molestation MPL103380519 7/13/2019 7/13/2020 Aggregatee 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Everett is named additional insured with respect to General Liability on a Primary Non-Contributory basis including Waiver of Subrogation per form CG8810 04.13, Completed Operations per form CG8583 04.13 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Attn: April Hynes ACCORDANCE WITH THE POLICY PROVISIONS. 3200 Cedar St Everett, WA 98201 AUTHORIZED REPRESENTATIVE n PJ zcGilmer/PJGILM 1dC(4' ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(zolaol)