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ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD YYYY) <br /> 7/15/2020 <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 The J Spain Insurance Agency, Inc. NAMEACT <br /> 2237 California Ave S.W. _( /C PHONE,Ext):206-935-0917 1 FAX <br /> No): <br /> E-MAIL encS Adriana ain-A c <br /> Seattle WA 98116 ADDRESS: � P g Y• om <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Mid-Century Insurance Company 21687 <br /> INSURED Karen Reed Consulting LLC INSURER B:Farmers Insurance Exchange 21652 <br /> 4951 SW Forney St. INSURER C:Truck Insurance Exchange 21709 <br /> Seattle WA 98116 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 /> I POLICY EFF POLICY EXP <br /> NSR TYPE OF INSURANCE ADDL7Sy—yUyB^pR POLICY NUMBER III(MM/DD/YYYY),(MM/DD/YYYY) LIMITS <br /> LTR ✓ COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE CLAIMS-MADE I OCCUR ILLLSSLJJJJ PREMISES O(Ea RENTED <br /> $75,000 <br /> A MED EXP(Any one person) $5,000 <br /> 606789650 4/16/2020 4/16/2021 PERSONAL BADV INJURY _$ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> POLICY n PRO- <br /> JECT LOC PRODUCTS-COMP/OPAGG $ 1,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY I I COMBINED SINGLE LIMIT $ 1,000,000 <br /> u Li (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> A AOUTOS ONLY SCHEDULED 606789650 4/16/2020 4/16/2021 BODILY INJURY(Per accident) $ <br /> � HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY (Per accident) _ <br /> ✓ UMBRELLA LIAB OCCUR ✓ EACH OCCURRENCE $ 1,000,000 <br /> C EXCESS LIAB J I�CLAIMS-MADE 606789660 4/16/2020 4/16/2021 AGGREGATE $ 1,000,000 <br /> DED / RETENTIONS 10,000 $ <br /> WORKERS COMPENSATION ( PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANYPROPRIETOR/PARTNEWEXECUTIVE N/A E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBEREXCLUDED? --- <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> 2006 VOLVO S60 2.5T F Fin Liability $1,000,000 <br /> B Comprehensive nn 604731622 4/16/2020 4/16/2021 Deductible $100 <br /> D� Deductible $500 <br /> Collision <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space is required) <br /> Project: <br /> Certificate holder is named as additional insured. <br /> 30 days notice of cancellation. <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Everett <br /> Attn: Lori Cummings, ExecutiveSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Director THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 2930 Wetmore Ave. Suite 10A ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Everett WA 98201 <br /> AUTHORIZED REPRESENTATIVE <br /> Joshua Spain <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />