Snohomish County Legal Services 12/1/2021

CERTIFICATE OF LIABILITY INSURANCE D02104/202211 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 policy(ies) must be endorsed. If SUBROGATIONIS 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 NAME: LEAVITT GROUP NORTHWEST PHONE (425)258-2300 FAX (425)258-9363 52813305 (Arc,No,Ext): (A/C.Nor 201 AUBURN WAY N SUITE C AUBURN WA 98002 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Sentinel Insurance Company Ltd. 11000 INSURED INSURER SNOHOMISH COUNTY LEGAL SERVICES INSURERC: 2731 WETMORE AVE STE 410 EVEREI I WA 98201-3581 INSURERD: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MMIODIVYYY) IMM/DD/YYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED $1,000,000 PREMISE (Ea occurrence) x General Liability MED exP(Any one person) $10,000 A X 52 SBA AC4585 03/01/2021 03/01/2022 PERSONAL&ADV INJURY $1,000,000 GENT.AGGREGATE L1MITAPPUES PER GENERAL AGGREGATE $2,000,000 POLICY JECOT X LOC PRODUCTS-COMP/OP AGG $2,000,000 • OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED A 52 SBA AC4585 03/01/2021 03/01/2022 BODILY INJURY(Per accident) AUTOS AUTOS HIRED - NON-OWNED PROPERTY DAMAGE AUTOS X AUTOS (Per accident) UMBRELLA DAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- AGGREGATE MADE DED RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY Y/N E.L EACH ACCIDENT PROPRIEFORIPARTNER/E<ECUTIVE OFFICER/MEMBER EXCLUDED? Nf A EL DISEASE-EA EMPLOYEE (Mandatory in Nil) If yes,describe under E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below A DATA BREACH-BUS INC&EX 52 SBA AC4585 03/01/2021 03/01/2022 Limit $10,000 EXP DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD lei,Additional Remarks Schedule,may be attached If more space is required) Those usual to the Insured's Operations.City of Everett,its officers,employees and agents are an additional insured per the Business Liability Coverage Form SS0008,attached to this policy. CERTIFICATE HOLDER CANCELLATION City of Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 2930 WETMORE AVE BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED EVERETT WA 98201-4067 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE deL/7 o (7626- ./Z. CL> ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD