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ACC]RD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 11/23/2020 <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 /> Hiscox Inc. HONEFAX <br /> Ext� (888)202-3007 (A/C,No): <br /> 520 Madison Avenue E-MAIL <br /> contact@hiscox.com <br /> 32nd Floor — <br /> New York,NY 10022 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A: Hiscox Insurance Company Inc 10200 <br /> INSURED INSURER B: <br /> Odyssey-2,LLC -- <br /> 5815 Evergreen Way INSURER c <br /> Everett,WA 98203 INSURER D <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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 /> --------— ------ <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE RENTE <br /> CLAIMS-MADE X OCCUR PREMISESO(Ea occur ence) $ 100,000 <br /> MED EXP(Any one person) $ 5,000 <br /> A __._ Y UDC-4582899-CGL-20 08/25/2020 08/25/2021 PERSONAL&ADV INJURY $ 1,000,000 <br /> GE 'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 2,000,000 <br /> X POLICY ECT LOC PRODUCTS;COMP/OP AGG $ 2,000,000 — <br /> !OTHER: <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> (Ea accident)__ <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident)I$ <br /> AUTOS ONLY AUTOS _ <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY (Per accident)__ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE f$ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED 1 RETENTION$ $ <br /> WORKERS COMPENSATION STATUTE 1__- EORH <br /> AND EMPLOYERS'LIABILITY Y/N <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E L.EACH ACCIDENT $ _ <br /> OFFICER/MEMBEREXCLUDED? —_ <br /> (Mandatory in NH) f 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 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> City of Everett,Its officers,employees and agents are listed as additional insured per policy terms and conditions. <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Everett <br /> 2930 Wetmore Ave,Suite 110A Everett WA 98201 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> U 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />