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Ac D® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD(YYYY) 7/14/2020 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 pollcy(les) 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). CONTACT PRODUCER Liberty Mutual Insurance NAME: PO Box 188065 FAX (A/Co.EM); 800-962-7132 (A/C,No): 800-845-3666 Fairfield, OH 45018 E-MAILDSS: BusinessService@LibertyMutual.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: West American Insurance Company 44393 INSURED INSURER B: Charlie Knoedler Tracy Knoedler INSURER C: DBA Everett Comics &Cards 3414 183rd Dr NE INSURER D: Snohomish WA 98290 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 56565490 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER (MMIDD(YYYY) (MMIDD/YYYY) LIMITS A ✓ COMMERCIAL GENERAL LIABILITY ✓ BKW57774906 5/23/2020 5/23/2021 EACH OCCURRENCE $1,000,000 CLAIMS MADE ,/ OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $1,000,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $1,000,000 ✓ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ OFFI CER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A STOP GAP BKW57774906 5/23/2020 5/23/2021 Each Accident $1,000,000 Each Employee $1,000,000 Aggregate Limit $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Everett,its officers, employees and agents are Additional Insured if required by written contract or written agreement subject to General Liability Blanket Additional Insured Provision for the duration of the program. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett Community Development THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN do Rebecca McCrary ACCORDANCE WITH THE POLICY PROVISIONS. 2930 Wetmore Avenue, Suite 8-A Everett, WA 98201 AUTHORIZED REPRESENTATIVE Clara Gabriel ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD S6565490 157774906 120-21 GL OT 1 Clara Gabriel 1 7/14/2020 5:43:15 PM (COT) 1 Page 1 of 9