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ACORN® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 8/1/2021 3/23/2021 <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 have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER Lockton Companies,LLC NAMEACT <br /> 601 108th Avenue NE,Suite 1969 PHONE FAX <br /> Bellevue WA 98004 E-MAILo.Est): (A/C,No): <br /> ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Alliance of Nonprofits for Ins,Risk Retention Group 10023 <br /> INSURED Seattle Goodwill Industries INSURER B: <br /> 1490501 700 Dearborn Pl.S. INSURER C: <br /> Seattle WA 98144 INSURERD: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES SEAGO01 CERTIFICATE NUMBER: 17433957 REVISION NUMBER: XXXXXXX <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 LIMITS <br /> LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) <br /> A X COMMERCIAL GENERAL LIABILITY y N 2020-65235 8/1/2020 8/1/2021 EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 500,000 _. <br /> MED EXP(Any one person) $ Excluded <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 <br /> POLICY PECOT- X LOC PRODUCTS-COMP/OP AGG $ 3,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY NOT APPLICABLE COMBINED SINGLE LIMIT $ <br /> (Ea accident) XXXXXXX <br /> ANY AUTO BODILY INJURY(Per person) $ XXXXXXX <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ XXXXXXX <br /> H ONLY AUTOS <br /> $ XXXXXXX <br /> NON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY _ AUTOS ONLY (Per accident) _ <br /> $ XXXXXXX <br /> UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ XXXXXXX _ <br /> DED RETENTION$ $ XXXXXXX <br /> WORKERS COMPENSATION NOT APPLICABLE PER <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> Y N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE / N/A E.L.EACH ACCIDENT $ XXXXXXX <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX <br /> A Professional Liability N N 2020-65235(PL) 8/1/2020 8/1/2021 $1M per occ./$3M per agg. <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) <br /> RE:The City of Everett and its officers,employees and agents is an Additional Insured to the extent provided by the policy language or endorsement issued or <br /> approved by the insurance carrier. <br /> CERTIFICATE HOLDER CANCELLATION See Attachment <br /> 17433957 <br /> City of Everett,WA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Attn.:Kembra LandryTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 2930 Wetmore Ave.,Suite 8A <br /> Everett WA 98201 <br /> AUTHORIZED REPR <br /> I I/ <br /> ©1 88-201 AC D CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />