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ACO Q DATE(MM/DD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 10/19/2021 <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 Marsh I U.S.Operations <br /> MARSH USA INC. NAME: FAx <br /> PHONE 866-966-4664 212-948-0770 <br /> 540 W.MADISON (A/C.No.Ext): (A/C,No): <br /> CHICAGO,IL 60661 E-MAIL Chicago.CertRequest@marsh.com <br /> ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> ADS _ INSURER A:Liberty Mutual Fire Insurance Company 23035 <br /> INSURED INSURER B:N/A N/A <br /> ADS LLC <br /> 340 The Bridge Street,Suite 204 INSURER C:Liberty Insurance Corporation 42404 <br /> Huntsville,AL 35806 INSURER D:Indian Harbor Insurance Company 36940 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: CHI-009952727-01 REVISION NUMBER: 3 <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 /> ADDL SUBR POLICY EFF POLICY EXP <br /> ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDNYYY) (MM/DD/YYYY) LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY TB2-681-004088-041 01/01/2021 01/01/2022 EACH OCCURRENCE $ 2,000,000 <br /> DAMAGE TO RENTED 1,000,000 <br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ <br /> MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> X JECT <br /> POLICY PRO LOC PRODUCTS-COMP/OPAGG $ <br /> 4,000,000 <br /> OTHER: <br /> A AUTOMOBILE LIABILITY AS2-681-004088-031 01/01/2021 01/01/2022 COMBINED SINGLE LIMIT $ 2000000 <br /> (Ea accident) <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> X OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> X HIRED x NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY (Per accident) <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> C WORKERS COMPENSATION WA7-68D-004088-511(AOS) 01/01/2021 01/01/2022 x PER STATUTE EORH <br /> AND EMPLOYERS'LIABILITY WC7-681-004088-011(WI,OR) 01/01/2021 01/01/2022 <br /> C ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 2,000,000 <br /> OFFICER/MEMBEREXCLUDED? N N/A 2,000,000 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under 2,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> D Professional and Contractors PEC002263314 12/31/2020 12/31/2021 Each Claim/Aggregate 1,000,000 <br /> Pollution Liability Retro Date:04/01/2007 SIR 100,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> The City of Everett,its officers,employees and agents are included as Additional Insured with respect to General and Automobile Liability coverages as required by written contract,subject to policy terms and <br /> conditions.This insurance is Primary and Non-Contributory over any existing insurance and limited to liability arising out of the operations of the Named Insured and where required by written contract.Waiver of <br /> Subrogation is applicable where required by written contract. <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 3200 Cedar Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Everett,WA 98201 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> I <br /> ©1988-2016 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />