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<br /> �.-.011111140 LAN DHSS-01 SRATCLIFF
<br /> ACORG1 DATE(MMlDDlYYYY)
<br /> ram, CERTIFICATE OF LIABILITY INSURANCE 1120/2022
<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 i
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER License#0C36861 CONTACTS
<br /> Seattle-Alliant Insurance Services,Inc. PHONE
<br /> Na,Eat):(206 204-9140 FAX
<br /> 1420 Fifth Ave 15th Floor ) (Arc,No):(206)204-9205
<br /> Seattle,WA 98101 EMAILADDRESS: ,
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:American Casualty Company of Reading,Pennsylvania 20427 -
<br /> INSURED INSURER B:Continental Insurance Company 35289
<br /> Landau Associates,Inc. INSURER C:Syndicate 26231623 at Lloyd's -
<br /> 155 NE 100th St.,Suite 302 INSURER D:
<br /> Seattle,WA 98125
<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 ADDL SUER POLICY EFF POLICY Se
<br /> LTR TYPE OF INSURANCE INSO INVD POLICY NUMBER IMM1DDNYYY) (MNUDDNYYY1 LIMITS .l
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR X X 7011944628 1213112021 12/31/2022 MASOiEa ocrT.uErrence) $ 1,000,000
<br /> MED EXP(Any one person) $ 15,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GENt AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2'000'000 ,
<br /> X POLICY X Tsif X LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> OTHER: $
<br /> COMBINED SINGLE LIMIT 1,000,000 •
<br /> B AUTOMOBILE LIABILITY (Ea accident) $
<br /> X ANY AUTO X x BUA 7011944631 12/31/2021 12131/2022 BODILY INJURY(Per person) $
<br /> - OWNED -SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> AUTOS ONLY PROPERTY DAMAGE
<br /> (Per accident) $
<br /> $
<br /> B X UMBRELLA 5,000,000
<br /> X OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAR ! CLAIMS-MADE X X CUE 7011944645 1213112021 12131l2022 AGGREGATE $ 5,000,000
<br /> DED X RETENTION$ 10,000 $
<br /> A WORKERS
<br /> ND EMPLOYERS'COMPENSATION
<br /> X STATUTE EERH
<br /> Y/N 7011944628 12/3112021 12/31/2022 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> QFFICERIMEMAEB EXCLUDED? N!A 1,000,oOO •
<br /> (Mandatary in NH) E.L.DISEASE-EA EMPLOYEE $
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> C Prof/Pollution Liab W13431211001 12/31/2021 12/3112022 Per Claim!Aggregate 5,000,000
<br /> C Prof/Pollution Liab W13431211001 12/31/2021 12/3112022 Deductible 150,000
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if mare space is required)
<br /> Re:Port of Everett Combined Sewer Main Improvement
<br /> City of Everett Is Additional Insured with respect to the General Liability and Automobile Liability performs attached.Waiver of Subrogation applies to the
<br /> General Liability and Automobile Liability per forms attached.General Liability and Automobile Liability are Primary and Non-Contributory per forms attached.
<br /> Due to Washington State being monopolistic in regards to Workers Compensation,Employers Liability is afforded through WA Stop Gap Coverage under the
<br /> General Liability.Umbrella follows form. •
<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 /> City of Everett ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attn:Souhell Nasr
<br /> 3200 Cedar Street '
<br /> Everett,WA 98201 AUTHORIZED REPRESENTATIVE
<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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