Northwest Family Entertainment Evergreen Lane 12/28/2020

A�' � DATE(MMrDD/YYYY; A-. CERTIFICATE OF LIABILITY INSURANCE E MNUDD2a 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 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 NAME: Rednil Insurance Brokers,Inc (CNN.Ext): 800-200-9998 (A/C,No): 559-298-2110 1865 Herndon Ave Ste K. ADDRESS: cameron.cinder@rednilbrokers.com INSURER(S)AFFORDING COVERAGE NAIC# _ Clovis CA 93611 INSURER A: Allianz Global Corporate and Specialty(35300) 35300 INSURED INSURER B: Northwest Family Entertainment,LLC DBA:Evergreen Lanes&Restaurant INSURER C: 5111 Claremont Way INSURER D INSURER E: Everett WA 98203 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 EFF POLICY EXP - INSR WVD POLICY NUMBER IMM/DDIYYYY) (MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGETO RENTED 100,000 ( PREMISES(Ea occurrence) $ CLAIMS-MADE f X OCCUR MED EXP(Any one person) $ 2,000 _. A USC010576190 12/21/2019 12/21/2020 PERSONAL&ADV INJURY $ 2,000,000 —....._..._._ GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 X POLICY Pi J LOG _ EBLI $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per Person) $ A ALL OWNED — SCHEDULED USC010576190 12121t2019 12/21/2020 BODILY INJURY Per accident) $ AUTOS AUTOS ( X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ _ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- V( OTH AND EMPLOYERS'LIABILITY Y J N TORY LIMITS X I ER Stop Gap-Employer s ANY PROPRIETOR/PARTNER/EXECUTIVE r E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBER EXCLUDED'? N NIA USC010576190 12/21/2019 12/21/2020 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 if yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 Liquor Liability Aggregate/Each Limit:$2,000,000/1,000,000 A Common Cause USC010576190 12/21/2019 12/21/2020 J DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) naming the City of Everett,its officers,employees and agents as 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. 2930 Wetmore Ave Suite 10A AUTHORIZED REPRESENTATIVE Everett WA 98201 e , • i * `•c i `> ACORD 25(2010105) )1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD