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ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 05/11/2021 <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 CONTACT Cristina Pena <br /> NAME:TA <br /> Bell Anderson Agency,Inc. PHONE (425)291-5218 FAX 425 291-5118 <br /> 600 SW.,39th St.,Suite 200 E-M(A/C,IL <br /> No,Eat): (A/C,No): ( ) <br /> ADDRESS: CristinaP@Bell-Anderson.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> Renton WA 98057 INSURERA: Philadelphia Indemnity Insurance Co. 18058 <br /> INSURED <br /> INSURER B: <br /> Seattle Sports Leagues,Inc.,DBA:Underdog Sports Leagues INSURER C: <br /> 101 Nickerson St. <br /> INSURER D: <br /> Suite 110 <br /> INSURER E <br /> Seattle WA 98109 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: CL2151146180 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 ADUL-SUBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DO/YYYY) LIMBS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE X OCCUR DAMAGE I O RENTED 100,000 <br /> PREMISES(Ea occurrence) $ <br /> MED EXP(Any one person) $ 0 <br /> A PHPK2262105 04/17/2021 04/17/2022 PERSONAL$ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000 <br /> X POLICY PRO- <br /> JECT LOC 3,000�00 <br /> PRODUCTS-COMP/OP AGG $ <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> A OWNED SCHEDULED PHPK2262105 04/17/2021 04/17/2022 BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> XHIRED NON-OWNED <br /> AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE $ <br /> (Per accident) <br /> UMBRELLA LIAB OCCUR <br /> EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE <br /> AGGREGATE S <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PER oTH- WA Stop Gap <br /> AND EMPLOYERS'LIABILITY Y I N STATUTE X ER <br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE N/A PHPK2262105 04/17/2021 04/17/2022 E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below J E.L.DISEASE-POLICY LIMIT $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> City of Everett,its officers,agents,and employees are additional insured per the attached endorsement##CG2011 0413. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> City of Everett ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 2930 Wetmore Ave <br /> AUTHORIZED REPRESENTATIVE <br /> Everett WA 98201-4067 <br /> I �\✓icy--- <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />