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,..44:c Wei- DATE(MMtDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 11/25/2020 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 be endorsed. If SUBROGATIONIS 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 NAME: KEY HARBOR INSURANCE 52812778 PHONE (425)423-9707 FAX (425)320-4090 (A/C,No,Ext): (A/C,No): 12811 8TH AVE W SUITE A201 E-MAIL ADDRESS: EVERETT WA 98204 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Sentinel Insurance Company Ltd. 11000 INSURED INSURER B: HAPPY THAI LLC DBA RAMA HOUSE INSURER C: 909 SIEVERS DUECY BLVD STE D EVERETT WA 98203-6271 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD IMM/DD/YYYY) (MM/DD/Y YYY1 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED $1,000,000 PREMISES(Ea occurrence) X General Liability MED EXP(Any one person) $10,000 A 52 SBA AD9897 12/21/2019 12/21/2020 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $4,000,000 POLICY PRO- )( LOC PRODUCTS-COMP/OP AGG $4,000,000 JECT OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) -ALL OWNED SCHEDULED BODILY INJURY(Per accident) AUTOS AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) X UMBRELLA LIAB x OCCUR EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS- A MADE 52 SBA AD9897 12/21/2019 12/21/2020 AGGREGATE $2,000,000 DED X RETENTION$ 10,000 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY Y/N E L EACH ACCIDENT PROPRIETOR/PARTNER/EXECUTIVE N/A OFFICER/MEMBER EXCLUDED? E L DISEASE-EA EMPLOYEE (Mandatory in NH) If yes,describe under E L DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below A LIQUOR LIABILITY 52 SBA AD9897 12/21/2019 12/21/2020 Common Cause $500,000 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations.Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. CERTIFICATE HOLDER CANCELLATION CITY OF EVERETT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 2930 WETMORE AVE BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED EVERETT WA 98201-4067 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE c.73y ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD