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ENVISCI-05 POKHARKARA
<br /> .4`CO. CERTIFICATE OF LIABILITY INSURANCE DA8/18120221 TE )
<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 License#0E67768 CONTACT All Smith
<br /> IOA Insurance Services
<br /> 4370 La Jolla Village Drive (a/c°O,,"N,Ext):(619)788-5795 50206 jvc,No(619)574-6288
<br /> Suite 600 ADDRESS:Ali.Smith@ioausa.com
<br /> San Diego,CA 92122
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA:RLI Insurance Company 13056
<br /> INSURED INSURER B:Crum&Forster Specialty Insurance Company 44520
<br /> Environmental Science Associates INSURERC:
<br /> 550 Kearny St.,Suite 800 INSURERD:
<br /> San Francisco,CA 94108
<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 NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD IMM/DD/YYYY1 (MM/DD/YYYY)
<br /> A X COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE $ 2,000,000
<br /> CLAIMS-MADE X OCCUR X X PSB0007416 12/1/2020 12/1/2021 PREM SESO(Eaoccu enee) $ 1,000,000
<br /> X Cont Liab/Sev of Int MED EXP(Any one person) $ 10,000
<br /> X XCU PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> POLICY X JECT LOC PRODUCTS-COMP/OPAGG $ 4,000,000
<br /> OTHER: Deductible $ 0
<br /> A AUTOMOBILE LIABIUTY (Ea acccaeDn ESINGLE LIMIT $ 1,000,000
<br /> X ANY AUTO X X PSA0002468 12/1/2020 12/1/2021 BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILYBODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUUTOS ONLY (Per PROPERTY
<br /> tDAMAGE $
<br /> X Comp.:$1,000 x Coil.:$1,000 $
<br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000
<br /> EXCESSLIAB CLAIMS-MADE PSE0003196 12/1/2020 12/1/2021 AGGREGATE $ 3,000,000
<br /> DED X RETENTION$ 10,000 $
<br /> A WORKERS COMPENSATION X STATUTE OTH-
<br /> ER
<br /> AND EMPLOYERS'UABILITY
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N X PSW0004135 12/1/2020 12/1/2021 E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N/A 1,000,000
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> B Prof Liab/Ded.$25K PKC110515 12/1/2020 12/1/2021 Per Claim/Aggregate 5,000,000
<br /> B Poll Liab/Ded.$25K PKC110515 12/1/2020 12/1/2021 Occurrence/Aggregate 5,000,000
<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,employees and agents are Additional Insured with respect to General and uto Liability per the attached endorsements as required
<br /> by written contract.Insurance is Primary and Non-Contributory.Waiver of Subrogation applies to General Liability,Auto Liability and Workers'Compensation.
<br /> 30 Days Notice of Cancellation with 10 Days Notice for Non-Payment of Premium in accordance with the policy provisions.
<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 /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Everett AUTHORIZED REPRESENTATIVE
<br /> Attn.:Cindy Cullen r T"' �/dT1 �t�IL% t
<br /> 3200 Cedar St l
<br /> Everett,WA 98201
<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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