Hoglund's Top Shop 11/23/2020 - Laserfiche WebLink

A4COR�� DATE(MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE 11/5/2020 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 Westphal Insurance Agency NAMEACT 2820 Oakes Ave Ste D PHONE 425-330-1148 FAX 888-265-5038 Everett WA 98201 (etc'Na.EXn: (A/c Ne E-MAIL West hal armersa ent.com ADDRESS:.1 p g INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Truck Insurance Exchange 21709 INSURED Hoglunds Top Shop, Inc. INSURER B: , 6323 Evergreen Way Everett WA 98203 INSURER C: 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. INSR 'ADM_SUER: POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE ''� 1 YNQ' POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) v, COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE i $2,000,000 � DAMAGE TO RENTED 100 000 I CLAIMS-MADE I- OCCUR PREMISES(Ea occurrence) $ I A ✓ Garage Liability MED EXP(Any one person) I$5,000 606638978 12/1/2019 12/01/2020 PERSONAL&ADVINJURY I$2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $4,000,000 V POLICY n JEC�T n LOC ,PRODUCTS-COMP/OP AGG $4,000,000 OTHER: $ AUTOMOBILE LIABILITY iU u COMBINED SINGLE LIMIT I $2,000,000 (Ea accident)✓ I ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED 606638978 12/1/2019 12/1/2020 BODILY INJURY(Per accident)! $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY ,(Per accident) ,$ UMBRELLA LIAB _ OCCUR u Li EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED FlRETENTIONS I$ WORKERS COMPENSATION ✓ STATUTE I ERR- A ANYPROPRIETORlPARTNERlEXECUTIVE AND EMPLOYERS'LIABILITY YIN NIA .....606638978 12/1/2019 12/1/2020 E.L.EACH ACCIDENT $1,000,000 '' OFFICER/MEMBEREXCLUDED? StopGap1 000 000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ + It yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below i E.L DISEASE-POLICY LIMIT $ J- _I U Garage Keepers $450,000 A Garage Keepers n II 606638978 12l01l2019 1210112020 Direct Primary Li 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 additional insureds. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2930 Wetmore Ave Ste 10A ACCORDANCE WITH THE POLICY PROVISIONS. Everett,WA 98201 AUTHORIZED REPRESENTATIVE Julie Stahler ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Web software.www.FormsBoss.com;?Impressive Publishing 800-208-1977