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^—"" NVLLABO-01 RIKBREEN
<br /> A�ORO CERTIFICATE OF LIABILITY INSURANCE
<br /> DATE(MM/°D/YYYY)
<br /> 9/16/2020
<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,ISSUINO 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 CONTACT
<br /> AssuredPartners of Washington,LLC PHONE
<br /> NAM : Breen
<br /> FAX
<br /> P.O.Box 847 (ac,No,Est):(425)952-2662 (A c,No):
<br /> Redmond,WA 98073 E-MAIL
<br /> AREss:kim.breen©assuredpartners.cpm
<br /> q
<br /> INSURER(S)AFFORDINGICOVERA G
<br /> E NAIL#
<br /> INSURER
<br /> B:Western National Mut l
<br /> _._..-. SURER A:ColonyInsurance Co
<br /> INSURED yal Ins 39993
<br /> �O 15377
<br /> NVL Laboratories,Inc. INSURER C: !,I
<br /> 4708 Aurora Avenue N INSURER D: ,
<br /> Seattle,WA 98103 — — —{
<br /> INSURER E:
<br /> t
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION IVMBER:
<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 DOt UMENT 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 ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE !NM) WVD POLICY NUMBER (MM/DDIYYYY) IMM/DD/YYYYI i'1 LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACHOCCUR NCE $ 2,000,000
<br /> CLAIMS-MADE [-X OCCUR X DAMAGE TO RjNTED
<br /> PACEP4245871 9/18/2020 9/18/2021 pREA,(I$ES IEa gccurrence) $ 100,000
<br /> X $5,000 Ded Each Occ
<br /> X Emp Liab/WA Stop Gap MED'XP(Any one person) $ 10,000
<br /> --- PERSONAL&APV INJURY $ 2'000'000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER. GENE1RAL AGGREGATE $ 2,000,000
<br /> POLICY X JECT [ ,LOC PRODUCTS-C_CMP/OP AG
<br /> ' PROD ' 2,000,000
<br /> ., _G $
<br /> OTHER
<br /> B AUTOMOBILE LIABILITY COMErINED SINGLE LIMIT 1,000,000
<br /> $
<br /> (Eaacadent) $
<br /> X ANY AUTO CPP1221798 9/18/2020 9/18/2021 BODILY INJURY,(Per person) $
<br /> OWNED SCHEDULED -- ---
<br /> _ AUTOS ONLY AUTOS BODILY INJURY.Per accident) $
<br /> NON-OWNED PROPERTY X UTOS ONLY XUUO ONLY Paa ci t__ $
<br /> $
<br /> A UMBRELLA LIAB X OCCUR 1 5,000,000
<br /> EACHIOCCURRINCE $
<br /> X EXCESS LIAB CLAIMS-MADE EXC4245872 9/18/2020 9/18/2021 AGGREGATE ;� $ 5,000,000
<br /> DED X RETENTION$ 0 !
<br /> PER
<br /> A AND EMPLOYERS'LIABIILIIT' PACEP4245871 9/18/2020 9/18/2021 EL.IEACH Accl[ X�.ERH- $
<br /> _ _j.,,TATUTE
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? 1 N/A PENT $
<br /> (Mandatory in NH) EI f A
<br /> L.DSEASE- EMPLOYEE $ 1,000,000
<br /> If yes,describe under - - -
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-FIIOLICY LIMIT $ 1,000,000
<br /> A Professional Liab PACEP4245871 9/18/2020 9/18/2021 [1 Included
<br /> A Contrs Pollution PACEP4245871 9/18/2020 9/18/2021 Included
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Certificate Holder&All Other Entities are Additional Insureds if required by written contract per forms EPACE1000814„EPACE!1010814,&WNCA800619.
<br /> Waiver of Subrogation applies per forms EPACE1130714,&WNCA800619.Primary/Non-Contributory applies per forms EPACE(1070714&WNCA800619.
<br /> Per Project Aggregate applies per form EPACE1100714-$10 Mil Max Aggregate.All forms attached.
<br /> RE:Professional Liab-Claims Made 5/1/96 Retro Date-$5,000 Deductible Each Claim
<br /> RE:Contractors Pollution-$5,000 Deductible Each Pollution Condition
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Everett THE EXPIRATION DATE THEREOF, NOTI E WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS;
<br /> Community Housing Improvement Program
<br /> 2930 Wetmore Avenue,Suite 8B
<br /> Everett,WA 98201 AUTHORIZED REPRESENTATIVE
<br /> ,
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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