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AcoRD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM!DD/YYYY) <br /> `.... 11/05/2020 <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 CONTNAME:AOT Denies Knowlton <br /> Pacific Crest Services, Inc. DBA Jones Insurance PHONE 425209-0569 FAX <br /> 3301 HoytAve lac.No.Ezt) ( ) I MIC,No): <br /> ADDRESS: jonesservicing@pacificcrestinsurance.com <br /> Everett,WA 98201 INSURER(S)AFFORDING COVERAGE NAIC# _ <br /> INSURER A: Mutual of Enumclaw 14761 <br /> INSURED CE&G LLC INSURER B: <br /> DBA ASIAN NOODLE HOUSE INSURER C: <br /> 607 SE Everett Mall Way Ste 11 INSURER D: <br /> Everett,WA 98208 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 00181029-35730 REVISION NUMBER: 1 <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 VNTH 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXPY LIMITS <br /> LTRINSD WVD POLICY NUMBER (MM/DD/ TY) (MM/DD/YYYYI <br /> A X COMMERCIAL GENERAL LIABILITY BOP0016703 11/1512020 11/15/2021 EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE TO <br /> CLAIMS-MADE OCCUR PREMISES((EaENTED ocwrrrence! $ 100,000 <br /> MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> X POLICY JPER4 LOC PRODUCTS-COMP/OP AGG $ 1,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT $ <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per ecddent) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> _ AUTOS ONLY ,_ AUTOS ONLY (Per accident) <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABIUTY Y/N STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? n N/A <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 /> I <br /> DESCRIPTION OF OPERATIONS r LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> The certificate addds the City of Everett and its officers,employees and Agents as additional insureds. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> City of Everett Community Development ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 2930 Wetmore Ave Suite 8-A <br /> Everett,WA 98201 AUTHORIZED REPRESEN TIVE <br /> Jo <br /> (DNK) <br /> ©1 -2 15 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br /> Printed by DNK on November 05,2020 at 03:14PM <br />