DC Lothrop LLC Toggle's Bottle Shop 9/21/2020

10 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/22/2020 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 NAME: Cheri Bahmanyar Evergreen Insurance Managers Inc (A/CN o,E=ti: (503)616-7901 FAX No): (503)259-3065 5293 NE Elam Young Pkwy Ste 160 ADDARESS: cbahmanyar@evergreenins.com INSURER(S)AFFORDING COVERAGE NAIC# Hillsboro OR 97124 INSURERA: The Princeton Excess&Surplus Lines Insurance 10786 INSURED INSURER B: DC Lothrop LLC,DBA:Toggle's Bottle Shop INSURER C: 4709 College Ave INSURER D: INSURER E: Everett WA 98203 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. INSR LTR ND DLSWVD POLICY NUMBER UBR POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE (MMIDD/YYYY) (MM/DDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(a occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A Y JQA3CM000009600 12/15/2019 12/15/2020 PERSONAL&ADVINJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X PRO- Included , POLICY JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) _ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS _ AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ _ AUTOS (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER STATUTE X OERH Wash Stop Gap AND EMPLOYERS'LIABILITY --- -- - - - - ---- A OFFICER/MEMBEREXCLUDED?ANY ECUTIVE YNN N/A JQA3CM000009600 12/15/2019 12/15/2020 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 LIQUOR LIABILITY $2,000,000 Aggregate Limit A JQA3CM000009600 12/15/2019 12/15/2020 $1,000,000 Each Common Cause Limit DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Premises Location: 1420 Hewitt Ave., Everett,WA 98201 City of Everett,its officers,employees and agents are included as Additional Insured per attached form CG2012 04 13 Additional Insured-State or Governmental Agency or Subdivision or Political SubDivision-Permits or Authorizations 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 Avenue AUTHORIZED REPRESENTATIVE ' Everett WA 98201 I F ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD