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AC�® YYY) CERTIFICATE OF LIABILITY INSURANCE A DATE(MM/DDNMM/DDN 0 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 NAME CT Chloe Chang SEATTLE BEST INSURANCE PHONE o (425)741-3600 FAX (NC, (425)741-3300 18623 HIGHWAY 99 STE 240 E-MAIL info@seattlebesti.com LYNNWOOD WA 98037 � INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Liberty Mutual Insurance Co INSURED INSURER B: SB SUSHI, INC DBA TOKYO HOUSE INSURER C: 500 SE EVERETT MALL WAY STE B100 INSURER D: Everett,WA 98208 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00003751-15586 REVISION NUMBER: 1 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. IICY EXP NSR ADDLTYPE OF INSURANCE INSD SUER POUCY NUMBER (MMUDMIDD/YYYY) (MWDD/YYYY) UMITS LTR INSD WVD A X COMMERCIAL GENERAL LIABILITY BKS61511754 07/01/2020 07/01/2021 EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(EaENTED 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 $ 2,000,000 X POLICY TOF LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Stop Gap $ 1,000,000 A AUTOMOBILEUTY BKS61511754 07/01/2020 07/01/2021 COMBINEDaaca SINGLE LIMIT $ (Edent) 1 000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS - HIRED NON-0WNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) - -- UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ _ EXCESS UAB CLAIMS-MADE AGGREGATE $ _ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'UABILITY 1,/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POUCY OMIT $ A BKS61511754 07/01/2020 07/01/2021 BPP 163,909 A BKS61511754 07/01/2020 07/01/2021 Liquor Liability 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Everett, its officers,employees and agents are losted as additional insured 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 Community Development ACCORDANCE WITH THE POLICY PROVISIONS. 2930 Wetmore Avenue, Suite 8-A Everett, WA 98201 AUTHORIZED REPRESENTATIVE (CC5) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by CC5 on July 09,2020 at 09:19AM