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„...--'"..1100 MATETES-01 RRITTANYKOCIS
<br /> AC'ORE)' DATE(MMIDDIYYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 913012021
<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(les)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 C ACT Alexandra Garcia
<br /> NFP Property&Casualty Services,Inc. PHONE — FAx
<br /> 8201 North Hayden Road (ANC,No,EXth(4$ 874-4541 (Arc,Noy(928)302-2858
<br /> Scottsdale,AZ 85258 n RAIL ;alexandra.garcia@nfp.com
<br /> INSURER(5)AFFORDING COVERAGE NAIL#
<br /> —_....__ INSURER A:Valley Forge Insurance Company 20508
<br /> INSURED INSURER B:Continental Insurance Company 35289
<br /> Materials Testing and Consulting Inc. Continental,Casualty Company 20443___
<br /> 777 Chrysler Drive INSURER Dom,
<br /> BurlIngton,WA 98233
<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 ADDL SUER - POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE __IHSD WVD POLICY NUMBER „andagamummaxam LIMITS
<br /> -
<br /> A )( COMMERCIAL GENERAL UABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE XI OCCUR6046287574 7/1/2021 7/1/2022 DAMAGE TORENTEO _.� 500,000
<br /> LJ }( x PREMFSES IEg occurrences $__._,_
<br /> MED EXP(Any one person) $ 15,000
<br /> 1 PERSONAL&AOV INJURY $ 1,000,000
<br /> GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY i ”J jE L i LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER: STOP GAP LIAB $ 1,000,000
<br /> COMBINED SINGLE LIMIT 1,000,000
<br /> B AUTOMOBILE LIABILITY __(,Ea accidanD - .,.._.
<br /> X ANY AUTO X X 6046287588 7/112021 7/1/2022 BODILY INJURY(Per person} "y
<br /> —- OWNED SCHEDULED
<br /> _ AUTOS ONLY AUTOS BODILY INJURY(Per accident} $_
<br /> A11 PROPERTY DAMAGE
<br /> UTOS ONLY — AUT VA O ONLY Per accident $
<br /> $
<br /> B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> EXCESS LIAB —__-_CLAIMS-MADE 6046287591 7/112021 7/1/2022 AGGREGATE $ -V- 5,000,000
<br /> DED X RETENTIONS 10,000 $
<br /> A OTH-
<br /> WORKERS LO EMPLOYERS'LIAABILIITNY Y 1 N _QS7B TERi Cif .ER _
<br /> 6046287574-WA STOP GAP 711/2021 7/1/2022 1,000,000
<br /> ANY PROPRIETORIPACLUDEEXECUTIVE _E.L.,EACH ACCIDENT $
<br /> oFrig IMF 1462 EXCLUDED? N 1 A _.,--- 1,000,000
<br /> (Man story In hllj} E.L.DISEASE-EA EMPLOYEE $
<br /> Ilyen,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> C E&OlProfess Liab MCH591911371 7/1/2021 7/1/2022 Occ/Agg Limit 3,000,000
<br /> C Crime 596805415 7/1/2021 7/1/2022 Limit 250,000
<br /> I
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required}
<br /> Subject to Policy Terms,Conditions and Exclusions.
<br /> City of Everett,Its officers,employees and agents are Additional Insured with respects to Oeneral Liability per endorsement CNA74858XX(01 15)attached.
<br /> General Liability coverage Is primary&non-contributory per endorsement CNA74858XX(01 15)attached.Waiver of Subrogation applies to General Liability
<br /> per attached CNA74858XX(01 15)attached.
<br /> City of Everett,its officers,employees and agents are Additional Insured with respects to Auto Liability per endorsement CNA74858XX(01 15)attached.Auto
<br /> SEE ATTACHED ACORD 101
<br /> • CERTIFICATE HOLDER _- CANCELLATION
<br /> •
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> yACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attn:Dean Shaughnessy
<br /> 802 E Mukilteo Blvd
<br /> -
<br /> Everett,WA 98203 AUTHORIZED REPRESENTATIVE
<br /> 1
<br /> ACORD 25(2016/03) O 1988.2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br /> .
<br />
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