Apply-A-Line LLC 7/26/2021 - Laserfiche WebLink

,----1 ACc RD` CERTIFICATE OF LIABILITY INSURANCE DATE(M/NDD/YYYY) ktiis....----" 1/1/2022 7/14/2021 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 LOCKTON COMPANIES CONEALT 3657 BRIARPARK DRIVE,SUITE 700 PHQNNo,Ext): jAIC,No): HOUSTON TX 77042 E-MAL 866-260-3538 ADDRESS: INSURERISI AFFORDNG COVERAGE NAIC# INSURER A: Zurich American Insurance Company 16535 INSURED Frontline Road Safety Holdings,LLC INSURER B: American Guarantee and Liab.Ins.Co. 26247 1485069 Apply-A-Line,LLC INSURER C 175 Roy Road SW,Bldg C Pacific WA 98047 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 17701530 REVISION NUMBER: XXXXXXX 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. INSRL _ TYPE OF INSURANCE ADDLI WVD POLICY NUMBER IMMIDD/YYYY)IPOLICY /DDY/YYYYYI LIMITS A x COMMERCIAL GENERAL LIABLITY y y GLO 3002387 00 1/1/2021 1/1/2022 EACH OCCURRENCE $ 2,000.000 CLAIMS-MADE X OCCUR PREMISEGE S(EaoccccuE RENTED $ 300,000 MED EXP(Anyone person) $ 1 0,000 PERSONAL&PDV INJURY $ 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY X PE LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ A AUTOMOBILE LIABLITY y y BAP 3088737 00 1/1/2021 1/1/2022 COMm deDtSINGLE LIMIT $ 1.000,000 X ANY AUTO BODILYINJURY(Perperson) $ XXXXXXX OAUTOS _AUTOSULED BODILY INJURY(Peracadent $ XXXXXXX HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX ONLY _AUTOS ONLY (Per accident) _ $ XXXXXXX B X UMBRELLA LIAB X OCCUR Y Y SXS 3109785 00 I/1/2021 1/1/2022 EACH OCCURRENCE $ 5,000.000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5.000.000 DED RETENTION$ Pro-Corn Ops Agg $ 5,000.000 WORKERS COMPENSATION A AND EMPLOYERS'LIABLITY Y/N Y WC 3002388 00 1/1/2021 1/1/2022 STATUTE XIV- ANY ANYIPROPRIETOR EXCLUDER/EXECUTIVE *' N/A E.L.EACH ACCIDENT $ 1.000,000 (Mandatory in NH) lV E.L.DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:AAL#142A6393-SWR#2021-043 PAVEMENT MARKINGS.ADDITIONAL INSURED IN FAVOR OF CITY OF EVERETT, ITS OFFICERS, EMPLOYEES AND AGENTS ON ALL POLICIES(EXCEPT WORKERS'COMPENSATION/EL)WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 17701530 AUTHORIZED REPRESENTATIVE CITY OF EVERETT 3200 CEDAR ST DOOR#5 EVERETT WA 98201 c— ACORD 25(2016/03) ©1988-2015 ACORD CORPORATI .All rights reserved The ACORD name and logo are registered marks of ACORD