2812 Architecture 12/9/2021 - Laserfiche WebLink

l ® DATE(MMIDD/YYY1) A`GPR o CERTIFICATE OF LIABILITY INSURANCE 10/25/2021 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 poiicy(les)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 CONTACT Christopher Day NAME: Orion Insurance Group PHONE (425)771-5197 FAX Ne: (425)673-4427 (A/C.No.Ell: ( ) 10634 E Riverside Dr E-MAIL chrisday@orioninsgroup.com ADDRESS: Suite#300 INSURERS)AFFORDING COVERAGE NAIC 0 Bothell WA 98011 INSURERA: RLI Insurance INSURED INSURER B 2812 Architecture Inc INSURER C: 2812 Colby Ave INSURER D: INSURER E: Everett WA 98201 INSURER F: COVERAGES CERTIFICATE NUMBER: CL218906841 REVISION NUMBER: 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. INSR ADDLTYPE OF INSURANCE INSO SUER POUCY NUMBER MMM/DCY EFF POLICY EXP UM)TS LTR lNSA WVD ( D/YYYY) (MMlDDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 GE CLAIMS-MADE XI OCCUR PREMISESO(EaENTED occurrence) S 1,000,000 X Hired Non-Owned Auto Limits MED EXP(Any one person) S 10,000 A X Follow General Liability Y Y PSB0003093 08/16/2021 08/16/2022 PER50NAL&ADV INJURY 5 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 4,000,000 POLICY X jE 7 LOG PRODUCTS-COMP/OP AGG S 4,000,000 OTHER: S AUTOMOBILE UABIIJTY COMBINED SINGLE LIMIT S (Ea accident) ANY AUTO BODILY INJURY(Per person) S — OWNED SCHEDULED BODILY INJURY(Per accident) S _ AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) S UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE S RED RETENTION S WORKERS COMPENSATION PER TATUTE EORH Stop Gap AND EMPLOYERS'UABIUTY Y/N ANY PROPRIETOR/PARTNERIEXECLTIVE E.L.EACH ACCIDENT S 1,000,000 A OFFICERJMEMBER EXCLUDED? [I N/A Y PSB0003093 08/16/2021 08/16/2022 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S $2,000,000 Each cCaim $10,000 Professional Liability Claims Made A Y RDP0041181 09/27/2020 09/27/2022 $2,000,000 Aggregate Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addhlonal Remarks Schedule,may be attached If more space Is required) All required parties are listed as additional insureds with primary and non contributory wording as well as a waiver of subrogation in their favor for the general liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Everett ACCORDANCE WITH THE POLICY PROVISIONS. 3200 Cedar Street AUTHORIZED REPRESENTATIVE Everett WA 98201 �,p(,( j ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD