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DATE(MM/DD/YYYY) <br /> ACCORD CERTIFICATE OF LIABILITY INSURANCE 12/15/2020 <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 /> CONTACT <br /> PRODUCER <br /> Liberty Mutual Insurance NAME: <br /> PO Box 188065 PHONE <br /> 800-962-7132 FAX <br /> Fairfield, OH 45018 E-MAIL (A/C,No): 800-845-3666 <br /> (A/C,No.Ext): <br /> ADDRESS: BusinessService@LibertyMutual.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A: Ohio Security Insurance Company 24082 <br /> INSURED INSURER B: <br /> 2 Horse and a Monkey LLC <br /> 2933 Colby Ave INSURER C: <br /> Everett WA 98201 INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 59064368 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 /> INSR ADDL SUBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) LIMITS <br /> A d COMMERCIAL GENERAL LIABILITY BKS61808945 8/14/2020 8/14/2021 EACH OCCURRENCE $1,000,000 <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE I OCCUR PREMISES(Es occurrence) $1,000,000 <br /> MED EXP(Any one person) $15,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> ✓ POLICY r-- 70 OT- LOC PRODUCTS-COMP/OP AGG $2,000000 <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY BKS61808945 8/14/2020 8/14/2021 (Ea aBcideDntSINGLE LIMIT $1,000,000 <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> ✓ HIRED NON-OWNED RTY <br /> AUTOS ONLY f AUTOS ONLY (Perr accident)_)AMAGE ^ $ <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> DEC RETENTION$ $ <br /> WORKERS COMPENSATION <br /> AND EMPLOYERS'LIABILITY STATUTE OTH- <br /> ER <br /> Y/N ANYPROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICERIMEMBEREXCLUDED? N IA <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 /> A Liquor Liability BKS61808945 8/14/2020 8/14/2021 Each Common Cause $1,000,000 <br /> Aggregate Limit $2,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) <br /> The City of Everett is Additional Insured if required by written contract or written agreement subject to General Liability Blanket Additional <br /> Insured Provision. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> The City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 2930 Wetmore Ave Ste 10A ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Everett WA 98201 <br /> AUTHORIZED REPRESENTATIVE 7," <br /> Becky Koehler <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br /> 59064368 1 61808945 1 20-21 GL AU CT I Becky Koehler 1 12/15/2020 3:17:01 PM (EST) 1 Page 1 of 9 <br />