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AC CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 11/09/2020 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> NAME: <br /> USI INSURANCE SERVICES LLC (A/C,No,Eat):(888)661-3938 FAX <br /> No): (877)872a604 <br /> 8000 NORMAN CTR DR STE 400 E-MAIL <br /> BLOOMINGTON, MN 55437 ADDRESS:service.center@travelers.com <br /> (888)661-3938 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA <br /> INSURED INSURER B:TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA <br /> STOYANOVI LLC <br /> DBA AMANTE PIZZA AND PASTA INSURER C: <br /> 1409 HEWITT AVE INSURERD: <br /> EVERETT,WA 98201 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 437050516251413 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADDL SUER POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS <br /> 680-7B606777-20 04/16/2020 04/16/2021 EACH OCCURRENCE $1,000,000 <br /> A X COMMERCIAL GENERAL LIABILITY X DAMAGE TO RENTED <br /> CLAIMS-MADE f X OCCUR PREMISES(Ea occurrence) $300,000 <br /> MED EXP(Any one person) , $5,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> X POLICY PRO- <br /> JECT LOC PRODUCTS-COMP/OPAGG $2,000,000 <br /> OTHER: COMBINED $ <br /> AUTOMOBILE LIABILITY (Ea accident) <br /> LIMIT $ <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident $ <br /> AUTOS ONLY AUTOS ) <br /> HIRED NON-OWNED <br /> AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE <br /> (Per accident) <br /> $ <br /> B X UMBRELLA LIAB X OCCUR CUP-7B607971-20 04/16/2020 04/16/2021 EACH OCCURRENCE $1,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 <br /> DED X RETENTION$5,000 <br /> $ <br /> WORKERS COMPENSATION N/A <br /> STATUTE OTH- <br /> ER <br /> AND EMPLOYERS'LIABILITY Y/N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> AS RESPECTS TO GENERAL LIABILITY,CERTIFICATE HOLDER IS ADDITIONAL INSURED-DESIGNATED PERSON OR <br /> ORGANIZATION,CG T4 91 . <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF EVERETT ISAOA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 2930 WETMORE AVE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> STE 10A ACCORDANCE WITH THE POLICY PROVISIONS. <br /> EVERETT,WA 98021 <br /> AUTHORIZED REPRESENTATIVE �^n , <br /> /71 <br /> ©1988-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />