Avocados Restaurant Inc. 12/21/2020

9 A CERTIFICATE OF LIABILITY INSURANCE DATE( DaYYYY) hlimppoo-_ 12/1512020 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 Nicole Siegfried NAME: Bell Anderson Agency,Inc. AIC N�,Extl: (425)291-5200 Etc,No): (425)291-5100 600 SW 39th St,Suite 200 E-MAIL nicoles@bell-anderson.com ADDRESS; INSURER(S)AFFORDING COVERAGE NAIC# Renton WA 98057 INSURER A: Mutual Of Enumclaw Insurance Co 14761 INSURED INSURER B: Avocados Restaurants Inc,DBA:Avocados Mexican Restaurant INSURER C: 10822 Evergreen Way INSURER 0 INSURER : Everett WA 98204 INSURER F; COVERAGES CERTIFICATE NUMBER: CL20121543895 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. ADDL SUER POLICY EFF - POLICY EXP iLT R TYPE OF INSURANCE POLICY NUMBER LIMITS LTR 1NSCl 1NVfl {NIMJDDIYYYY�.(MMl01:1lYY1rY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s 2,000,000 � DAMAGE TO RENTED 100,000 I CLAIMS-MADE t' OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,00{1 A Y BDP002031900 07/1512020 07/1512021 PERSONAL S ADV INJURY $ 2,Q00,000 ►—' 4 000,000 XGEEN'LAGGREGATE LIMIT APPLIES PER; GENERALAGGREGATE a ' POLICY L ,PEREi LOC PRODUCTS-COMP,OPAGG $ 4,000,000 X OTHER: Liquor Liability Aggregate: s 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT s lea accident) — ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ r—�AUTOS ONLY — AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE S Y— EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEO ,RETENTION$ $ WORKERS COMPENSATION - PPER TUTE 1 0RH- AND EMPLOYERS'LIABILITY Y1 N ANY PROPRIETOR/PARTNEREXECUTIVE t ; N IA E.L.EACH ACCIDENT $ OFF]CER!MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ II yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If rears apace Is required) The City of Everett its officers,employees and agents are additional insured per the attached endorsement#BP0407 0713, 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. 2930 Wetmore Ave AUTHORIZED REPRESENTATIVE Everett WA 98201 ''1 i ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD