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<br /> ACC MC. DATE(MM/DD/YYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 10/06/2021
<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 Willis Towers Watson Certificate Center
<br /> NAME:_
<br /> c/o 26 Century Blvd PHONE 1 877-945-7378 ..., -- I(
<br /> Willis Towers Watson Midwest, Inc.
<br /> (A/C No,E)d): /C NoZ_1-888-467-2378
<br /> EMAIL certificates@willis.com
<br /> P.O. Box 305191 ADDRESS: -
<br /> Nashville, TN 372305191 USA INSURER(S)AFFORDINGCOVERAGE NAIC#
<br /> INSURER A: Travelers Indemnity Company of CT 25682
<br /> -INNS--- --------
<br /> INSURED INSURER B: Travelers Indemnity Company I 25658
<br /> I.
<br /> Perteet, Inc.
<br /> Po Box 1186 INSURER C Travelers Casualty and Surety Company of A 31194
<br /> 2707 Colby Avenue, Suite 900 INSURERD: I
<br /> Everett, WA 98201
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:W22431702 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 -IADDLJSUBR1 POLICY EFF OWE")
<br /> (MMIDD/YYYY) LIMITS
<br /> IL-X I COMMERCIAL GENERAL LIABILITY
<br /> LTR TYPE OF INSURANCE ' I POLICY NUMBER MM/DD/YYYY ,EACH OCCURRENCE $ 1,000,000
<br /> WVD 1
<br /> _ 1 CLAIMS-MADE X ' OCCUR I li I DAMAGE TO RENTED 1,000,000
<br /> � REMISES Ea occurrence
<br /> PERSONAL&ADV INJURY 5,000
<br /> A i06/27/2022 �$
<br /> 6805J284500 106/27/2021 r --I y � $ 1 000,000
<br /> GENII.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE !$ 2,000,000
<br /> GENII.
<br /> Fy� PRO -------- ---- ---
<br /> POLICY " !JECT X1 LOC 'i PRODUCTS-COMPIOPAGG=$ 2,000,000
<br /> , COMBINED SINGLE LIMIT
<br /> ll OTHER: WA STOP GAP $i 1,000,000
<br /> AUTOMOBILELIABILITY ICI 11 (Ea accident, $ 1,000,000
<br /> XiANY AUTO I { BODILY INJURY(Per person) $
<br /> B
<br /> OWNSUTO ONLY I SCHED
<br /> I AUTOS ONLY AUTOS ONLYD BODILY INJURY Per accident BA8R747064 �06/27/2021,06/27/2022.4_- ---
<br /> HIRED I NON-OWNED , I.P rOPERTY DAMAGE ) $
<br /> � $
<br /> accident)
<br /> 1 t I 1 $
<br /> �1 EXCESS L ABAB - i i_EACH OCCURRENCE $
<br /> DED RETENTION OCCUR
<br /> CLAIMS-MADE 1 AGGREGATE $
<br /> I ON$ F 1$
<br /> I i
<br /> IWORKERSCOMPENSATION 1 I , ;PER I X`OTH- WA Stop Gap
<br /> I STATUTE L_ER 1,.,
<br /> AND EMPLOYERS'LIABILITY Y/N I 1,000,000
<br /> A ANYPROPRIETOR/PARTNER/EXECUTIVE 1E L EACH ACCIDENT $
<br /> OFFICER/MEMBEREXCLUDED? ,N/A, 6805J284500 l06/27/2021 06/27/2022 - -- --- -- ""--
<br /> (Mandatory In NH) 1 ! I f El.DISEASE EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under l 1 1,000,000
<br /> 1 DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT ;$
<br /> C 1Professional Liability 106321064 j06/27/202106/27/2022IPer Claim 1$5,000,000
<br /> (Aggregate I$10,000,000
<br /> 1
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Per Project Aggregate applies when required by written contract. General Aggregate Capped at $8,000,000.
<br /> Project #20210234/Project Name: Silver Lake Trail SEPA and Shoreline Permit Assistance
<br /> City of Everett is included as an Additional Insured as respects to General Liability, as required by written
<br /> contract.
<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
<br /> AUTHORIZED REPRESENTATIVE
<br /> Attn: Dean Shaughnessy
<br /> 802 E. Mukilteo Blvd. f) (. %J
<br /> Everett, WA 98203 .- ,ce, dM1
<br /> ©1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> SR ID: 21681514 HATCH: 2262685
<br />
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