Las Tres Beautifuls 10/14/2020 - Laserfiche WebLink

ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) • 08/18/2020 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 NAME: Cherry Legaspi _ Villa Insurance Group PHONE 425 FAX -tAical„FXt1.__ ( 771-9000) (A/c,No): (425)771 9008 18910 28th Ave.W. Ste. 201 E-MAIL ADDRESS: support@villainsurancegroup.com Lynnwood,WA 98036 y INSURER(S)AFFORDING COVERAGE I NAIL# INSURERA Ohio Security Insurance Co. INSURED INSURER B: Las 3 Beautifuls LLC INSURER C: 7715 Grant Dr INSURER D: Everett,WA 98203 INSURERE: INSURER F COVERAGES CERTIFICATE NUMBER: 00007162-16371 REVISION NUMBER: 2 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 LTR X Ili CLAIMS-MADE AL GEN X OCCUR INSD Y 4WD POLICY NUMBER (MM/DDIYYYY) (MMIDD/20YY) LIMITS TYPE OF INSURANCE MMERCIAL GENERAL (ABILITY 08/17/2020 08/17/2021 EACH OCCURRENCE $ 1 UOU ODU CO � N BZS61872183 DAMAGE TO RENTED PREMISES(Ea occurrence) $ 1,000,000 MED EXP(Any one person) $ 15,000 PERSONAL BADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2i000,000PRO- X POLICY JECT LOC I PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ OWNED I SCHEDULED �aaccident)_____ ANY AUTO i BODILYILYINJURY(Per person) $ AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ -- HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY �,I(Per accident) $ - UMBRELLA LIAB _ OCCUR EACH OCCURRENCE EXCESS LIAB rCLAIMS-MADE; AGGREGATE $ DED j RETENTION$ $ A WORKERS COMPENSATION N BZS61872183 STOP GAP 08/17/2020 08/17/2021 X AND EMPLOYERS'LIABILITY STATUTE EORH ANY ANYIPROPRIETOR EXCLUDED?ECUTIVE OFFICER/MEMBER NIA !, I 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 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Everett,its officers,employees and agents are named as additional insureds as their interests may appear to Business Property policy as required by written agreement as per form BP 79 96 09 16. 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 Ave. Ste. 8-A Everett,WA 98201 AUTHORIZED�R�EPRESENTATIVE �JAILL0`ES1, \ALA (CL1) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by CL1 on August 18,2020 at 10:56AM