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0 HATE(MMlDDlYYYi)ACCRLCERTIFICATE OF LIABILITY INSURANCE <br /> 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 be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> �2a6) 838-7000 (206)838-7000 NAM�M Chris Elliott Insurance Agency <br /> Chris Elliott Insurance Agency HONE t t1:I;20 838-7000 (Fa No):(206) 838-7000_ <br /> 1200 Westlake Ave N Ste 502 An RESS:chris einsurancef(nancial.com <br /> ry INSURERLS1AFFORDING COVERAGE NAIC# <br /> Seattle,WA 98109_,. _ INSURER A:Truck Insurance Exchange 21709 <br /> INSURED INSURER B: <br /> M.G. Correa Enterprises, LLC INSURER C: <br /> DBA: Grades Cuisine INSURER a: <br /> 607 SE Everett Mail Way, #KL INSURER E: <br /> Everett.WA 98208 _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 /> INSR1 TYPE OF INSURANCE °ADDL SUBR POLICY EFF ' POLICY EXPLIMITS <br /> 1,TR I iNBR %ND, POLICY NUMBER (MM!DDNYYY) (MMIDD/YYYY) <br /> GENERAL LIABILITY : J ; EACH OCCURRENCE $1.000,000 <br /> A 1 COMMERCIAL GENERAL LIABILITY I DAMAGE <br /> MG EOaENTeT nec $75.000 <br /> I CLAIMS-MADE r/ OCCUR 606802080 07/2712020 07/27/2021 MED EXP(Any one person) $5,000 _a <br /> PERSONAL S ADV INJURY $I,000,oaa. <br /> GENERAL AGGREGATE $2,000,900 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP AGG ,$2,Q00,000 <br /> I POLICY 78T _,LOC $ <br /> AUTOMOBILE LIABILITY ' CoMIINED SINGLE LIMIT <br /> I (Ea accident) s 1.000.000 <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> .. ALL OWNED -SCHEDULED <br /> AUTOS ,AUTOS 606802080 M72020 07/27/2021 BODILY INJURY(Per accident) $$NON.O <br /> A / AUTOS NNEQ (Per accide tDAMAGE <br /> HIRED AUTOS �/ <br /> mi <br /> I $ <br /> UMBRELLA UAB i <br /> OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> DEC RETENTIONS $ <br /> WORKERS COMPENSATION WC STATU. 1 OTH- <br /> AND EMPLOYERS LIABILITY Y f N TORY LIMITS: ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ <br /> It yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ <br /> DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If mare space le required) <br /> City of Everett, its officers, employees and agents are named as additional insured <br /> CERTIFICATE HOLDER CANCELLATION <br /> M.G. Correa Enterprises, LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> DBA: Gracies Cuisine ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 607 SE Everett Mall Way,#KL <br /> Everett,WA 98208 AUTHORIZED REPRESENTATIVE �--' <br /> I <br /> C71988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />