DMH Industrial Electric Inc. 9/11/2020

A�oRD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/14/2020 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 Amy Mejia NAME: Bristol Insurance Group PHONE (206)634-1770 FAX (206)634-1787 (A/C,No,Ext): (MC,Not: 2296 W.Commodore Way#110 ADDRESS: amym@binsgrp.com _ INSURER(S)AFFORDING COVERAGE NAIC# Seattle WA 98199 INSURERA: NPI-Ohio Casualty Group 24074 INSURED INSURER B: NPI-American Fire&Casualty 24066 Dmh Industrial Electric INSURER C: 2701 Hewitt Ave INSURER D: INSURER E: Everett WA 98201 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1910906089 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 SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD ;MD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 �/ DAMAGE TO RENTED 1,000,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 15,000 A Y BK056954013 11/30/2019 11/30/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Package Modification $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED BAA54992933 11/30/2019 11/30/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) Bus Auto Enhncmt Endt $ X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 1'000'000 A EXCESSLIAB CLAIMS-MADE US054992933 11/30/2019 11/30/2020 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN 1,000,000 A ANY PROPRIMB PROPRIETOR/PARTNER/EXECUTIVE Y N/A BK056954013 11/30/2019 11/30/2020 E.L.EACH ACCIDENT $ (Mandatory In N ER EXCLUDED. 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER IS ADDED AS ADDITIONAL INSURED AS THEIR INTEREST MAY APPEAR IN THE OPERATIONS OF THE NAMED INSURED, PER ENDORSEMENTS CG 88 10 04 13,CA 88 10 01 10 AND CG 20 12 04 13 ATTACHED,THAT ARE PART OF THE NAMED INSURED'S POLICY 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 ACCORDANCE WITH THE POLICY PROVISIONS. 2930 Wetmore Ave AUTHORIZED REPRESENTATIVE Everett WA 98201 sit ""�-- I � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD