Vitality Corporation dba Renaissance Family 11/30/2020

AC D CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 11/20/2020 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 Patrick Fitzgerald State Farm State Farm Insurance PHONE 425-821-9548 1 FA Not 425-821-1458 vsL No,Ext): O 11922 98th Ave NE E-MAIL atrick.fitz erald.st2s statefarm.com 00. ADDRESS: p g @ _ _.. INSURER(S)AFFORDING COVERAGE i NAIC# Kirkland WA 98034 INSURER A: State Farm Fire and Casualty Company I 25143 INSURED INSURER B: Vitality Corporation INSURER C: 2824 Grand Ave Ste 102 INSURER D: INSURER E: Everett WA 98201 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. COMMERCIAL GENERAL LIABILITY LIMITS LTR, TYPE OF INSURANCE INSQ WVD I i !. EACH OCCURRENCE I $ 1,000,000 POLICY NUMBER "{MMIDDY/YYYY) — — — INSR , POLICY DAMAGE TO RENTED $ 300,000 ' '� �CLAIMS-MADE X OCCUR �, I lMM/OD/YYYY) PREMISES(Ea occurrences MED EXP(Any one person) $ 5,000 A 06/06/2021 PERSONAL a ADV INJURY $ 1 OOO OOO E LIMIT APPLIES PER: I GENERAL AGGREGATE !$ 2,000,000 Y 98-CT-J167-3 GEN'L AGGREGATE PRO- - " ---- -_-- ' --- X POLICY JECT PRODUCTS-COMP/OP AGG $ 2 OOO,000 !, LOC ! ;OTHER: ,'1 AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT , $ ANY AUTO I BODILY YdIN)U -... _-----------__ _._ 1-- � I JURY(Per person) !$ OWNED I I SCHEDULED ` i (Per AUTOS ONLY L AUTOS BODILY INJURY accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY Ir -,'AUTOS ONLY 1 (Per accident_ ! $ II' I UMBRELLA LIAR (OCCUR , IEACHOCCURRENCE I$ 1 _EXCESS LIAR CLAIMS MADE! �'I I AGGREGATE $ _ 1 DED RETENTION$ j I III'$ WORKERS COMPENSATION --_ STATUTE i i EOTH 'AND EMPLOYERS'LIABILITY YIN ----- --_---- ---_ ANY PROPRIETOR/PARTNER/EXECUTIVE ' E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A I r--- - --- ---- --- I(Mandatory ry in NH) I EtDISEASE-EA EMPLOYEE $ If yes,describe under I- ----- ------- --Y - -____.__ _.._-_— II DESCRIPTION OF OPERATIONS below i I E.L.DISEASE-POLICY LIMIT $ • 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is also 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 ACCORDANCE WITH THE POLICY PROVISIONS. It's officers,employees and agents AUTHORIZED REPRESENTATIVE 2930 Wetmore Ave,Suite 10A Everett WA 98201 ,4nrahola f insbelgek- ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1001486 132849.12 03-16-2016