Players Bar & Grill LLC 12/28/2020

ACQ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) �...� _ 12/15/2020 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 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 NAME CT Andrew Pettygrove Sandin Insurance Group PHONE FAX PO Box 230785 tAtc.No,Ext): (503)899-9632 INC,No):(503)926-9193 IL Portland, OR 97281 ADDRESS: andrew@teamsandin.com License#: CA 0G94457 INSURER(S)AFFORDING COVERAGE NAIC# INSURER Certain Underwriters,Lloyds ofLondon- ---------------_-._-- INSURED Player's Bar&Grill LLC INSURER El DBA Player's Bar&Grill INSURER C: 5732 140th Place SE INSURER D Everett,WA 98208 INSURER E: — INSURER F COVERAGES CERTIFICATE NUMBER: 00001175-32798 REVISION NUMBER: 2 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 ADDL SUBRI POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDIYYYY) (MM/DDIYYYY) A X COMMERCIAL GENERAL LIABILITY Y RTB-0000499-02 11/01/2020 11/01/2021 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100 000 X Liquor Liability MED EXP(Any one person) $ 0 — 9 PERSONAL&ADV INJURY $ 1,000_1_000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY it Q LOC PRODUCTS-COMP/OP AGG $ 2000,000 OTHER: Liquor Liability $ 1,000,000 A AUTOMOBILE LIABILITY RTB-0000499-02 11101/2020 11/01/2021 COMBINEDaacciden SINGLE LIMIT $ {Et) 1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED j PROPERTY DAMAGE $ _X AUTOS ONLY X AUTOS ONLY _(Per $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION RTB-0000499-02 11/01/2020 11/01/2021 X AND EMPLOYERS'LIABILITY STATUTE OTH- ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE N t A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (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 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Everett is listed as an additional insured-city/state-CG2012 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 Avenue Everett,WA 98201 AUTHORIZED REPRESENTATIVE of 1,fray 1988-2015 ACORD CORPORAT .i'. I rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by AJP on December 15,2020 at 10:32AM