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�� 1 COCOHOU-01 JRIORDAN
<br /> ACC)/Rif,' DATE(MM/DD/YYYY)
<br /> 04...------ CERTIFICATE OF LIABILITY INSURANCE 6/2/2021
<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 Jamie Riordan
<br /> WAFD Insurance Group,Inc. PHONE 360 629-2103 FAX
<br /> 360 629-9702
<br /> Thomas and Associates (A/c,No,Ext):( ) ( /c,No):( )
<br /> PO Box 457 nooRlEss:Jamier@thomasins.com
<br /> Stanwood,WA 98292
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Philadelphia Insurance Company
<br /> INSURED INSURER B:
<br /> Cocoon House INSURER C:
<br /> 3530 Colby Ave. INSURER D:
<br /> Everett,WA 98201
<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 SUER W POLICY NUMBER POLICY EFF POLICY EXP LINTS
<br /> LTR INSD VO (MM/DD/YYYYI (MM/DD/YYYYI 1,000,000
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
<br /> X CLAIMS-MADE I OCCUR PHPK2276855 6/1/2021 6/1/2022 DAMAGE TO RENTED 100,000
<br /> PREMISES(Ea occurrence) $
<br /> MED EXP(Any one person) $ 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY PRO-
<br /> JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> I,
<br /> OTHER: $
<br /> COMBINED SINGLE LIMIT 1,000,000
<br /> A AUTOMOBILE LIABILITY (Ea accident) $
<br /> X ANY AUTO PHPK2276855 6/1/2021 6/1/2022 BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> AUTOS ONLY NON-OWNEDUUO PROPERTY DAMAGE
<br /> (Per accident) $
<br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000
<br /> EXCESS LIAB CLAIMS-MADE PHUB768870 6/1/2021 6/1/2022 AGGREGATE $ 4,000,000
<br /> DED X RETENTION$ 10,000 $
<br /> A WORKERS COMPENSATION STATUTEPER X ER
<br /> OTTH-
<br /> AND EMPLOYERS'LIABILITY Y/N ,PHPK2276855 6/1/2021 6/1/2022 1,000,000
<br /> ANY
<br /> OFFICER/MEMBER
<br /> ECUTIVE N/A E.L.EACH ACCIDENT $
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A Prof.Liability PHPK2276855 6/1/2021 6/1/2022 Occurrence 1,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Regarding contract pertaining to 3530 Colby Ave.,Everett and 2726 Cedar,Everett.City of Everett,its officers,employees,agents,and mayor's office are
<br /> named as Additional Insured regarding this contract only and are subject to policy terms,conditions,and exclusions.Additional Insured endorsement is
<br /> attached.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF,
<br /> City of Everett ACCORDANCE WITH THE POLICY P OVISIONSCE WILL BE DELIVERED IN
<br /> 2930 Wetmore Ave.,Ste.10A
<br /> Everett,WA 98201
<br /> AUTHORIZED REPRESENTATIVE
<br /> l^U 1-____,
<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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