The Bayside 12/28/2020 - Laserfiche WebLink

QCF-� DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12l1412020 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 NAME: Ben Miller Pacific Crest Services,Inc. (A/c No.Exty (425)212-3505 FAX Not: (425)212-3506 3301 Hoyt Ave. SE ADDRESS: Waservicing@pacificcrestinsurance.com Everett,WA 98201 _ INSURER(S)AFFORDING COVERAGE NAIC INSURER A: Liberty Mutual INSURED INSURER B: The Bayside INSURERC: 2111 Pine St INSURER D Everett,WA 98201 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00262652-46804 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 TYPE OF INSURANCE ADDL SUBR W POLICY EFF POLICY EXP LIMITS LTR INSD VD POLICY NUMBER (MM/DDIYYYYI IMM/DD/VYYY) A X COMMERCIAL GENERAL LABILITY Y BKS61497838 06/03/2020 06/03/2021 EACH OCCURRENCE $ 1,_000,000 DAMAGE TO RENTED CLAIMS-MADE , X OCCUR PREMISES(Ea occurrence) $ 1,000,,000_ MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000_ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POUCY jECUT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: - Liquor Liability $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ _ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN STATUTE ERH ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POUCY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Everett,its officers,employees and agents as additional insured with respects to the named insureds operations only and when required by written contract per attached endorsement#CG 8810 0413. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN The City of Everett ACCORDANCE WITH THE POLICY PROVISIONS. 2930 Wetmore Ave Everett,WA 98201 AUTHORIZED REPRESENTATIVE (BEN) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are regist ed marks of ACORD Printed by BEN on December 14,2020 at 12:57PM