Bond Family Dentistry 9/21/2020 - Laserfiche WebLink

Ate REP CERTIFICATE OF LIABILITY INSURANCE D TE(MW2oD ) 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 NAME: TDIC Insurance Solutions PP/HCONE 800-452-0504 lact,No):866 240 9817 10121 SE Sunnyside Road,Ste 350 EMAIL RESS Clackamas, OR 97015 PRODUCER ER ID: INSURERS)AFFORDING COVERAGE NAIC a INSURED INSURER A: The Dentists Insurance Company 40975 Ryan C Bond DDS INSURER B: Bond Bond LLC 1923 Clover Place INSURER C: Mukilteo,Washington 98272 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INTRR ADDTYPE OF INSURANCE NSR SYAM POLICY NUMBER IIM�AILDD/YYYY) IICY EFF MWDD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ $2,000,000 J COMMERCIAL GENERAL LIABILITY PREM SESO a occurrence) $RENTD $250,000 (CLAIMS-MADE 1V1 OCCUR MED EXP(My one person) $ $10,000 A WA524364 03/24/2020 03/24/2021 PERSONAL BADV INJURY $ $2,000,000 GENERAL AGGREGATE $ $4,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ $1,000,000 POLICY n ECnj` n LOC Stop Gap AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ $2,000,000 ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY(Per person) $ A SCHEDULED AUTOS WA524364 03/24/2020 03/24/2021 BODILY INJURY(Per accident) $ HIRED AUTOS PROPERTY DAMAGE (Per accident) J NON-OWNED AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ , If yes,describe under .F,PTI"N OF OP ' TIC''°below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,N more space is required) City of Everett,its Officers,Employees and Agents is listed as Additional Insured with respects to the operations of and/or for the Named Insured,subject to Policy Terms and Conditions. Location:4608 Dogwood Dr Ste A,Everett,Washington,98203 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH City of Everett,its Officers, Employees and Ag EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITI Rebecca McCrary,City of Everett THE POLICY PROVISIONS- 2930 Wetmore Ave, Ste 8-A, Everett, Washington,98201 AUTHORED REPRESENTATIVE Christopher Verbiest ©1988-2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD