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Client#: 326377 PERTEINC
<br /> ACORD,,, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)411312016
<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 /> NAME:
<br /> Kibble&Prentice,a USI Co PR PHONE 206 441-6300 FAX 610-362-8528
<br /> 601 Union Street, Suite 1000 Mao,
<br /> -MA Lo' ) (A/c,No):
<br /> ADDRESS: pl.CertregU@Stl*�kpCOm.COm
<br /> Seattle,WA 98101
<br /> INSURER(S)AFFORDING COVERAGE NAIL#
<br /> INSURER A:Travelers Indemnity Company of 25682
<br /> INSURED INSURER B:Travelers Casualty and Surety C 31194
<br /> Perteet, Inc.
<br /> INSURER C:
<br /> P.O. Box 1186
<br /> INSURER D:
<br /> Everett,WA 98206-1186
<br /> INSURER E:
<br /> 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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP WLIMITS
<br /> LTRINSR VD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY)
<br /> A GENERAL LIABILITY 6809A973147 06/27/2015 06/27/2016 EACHEAOCCURRENCEECp $1,000,000
<br /> X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrDence) $1,000,000
<br /> CLAIMS-MADE X OCCUR MED EXP(Any one person) $10
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GENERAL AGGREGATE $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000
<br /> POLICY I ^I JECT fl LOC $
<br /> A AUTOMOBILE LIABILITY BA9A974666 06/27/2015 06/27/2016 COMBINED nt)SINGLE LIMIT ,000,000
<br /> emu
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> X HIRED AUTOS
<br /> X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS (Per accident)
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED RETENTIONS $
<br /> A WORKERS COMPENSATION 6809A973147 06/27/2015 06/27/2016 RY IAIMITS X ORTH-
<br /> AND EMPLOYERS'LIABILITY
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N (WA Stop Gap) E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $1,000,000
<br /> B Professional 106321064 06/27/2015 06/27/2016 $2,000,000 per claim
<br /> Liability $2,000,000 annl aggr.
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required)
<br /> RE:City of Everett 2016 Construction Inspection Services.
<br /> The General Liability policy includes an automatic Additional Insured endorsement that provides Additional
<br /> Insured status to the City of Everett,only when there is a written contract that requires such status,and
<br /> only with regard to work performed on behalf of the named insured.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> Cityof Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Attn: Mark Kangas ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 3101 Cedar Street
<br /> Everett,WA 98201 AUTHORIZED REPRESENTATIVE
<br /> 1110$4044-
<br /> ©1988-2010 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br /> #S17661740/M15626694 DRSZP
<br />
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