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ENVISCI-05
<br />MCCOWANA
<br />ACCU? O
<br />�� CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />11/30/2021
<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 License # 0E67768
<br />IOA Insurance Services
<br />4370 La Jolla Village Drive
<br />Suite 600
<br />San Diego, CA 92122
<br />CONTACT Ali Smith
<br />NAME:
<br />PHONEFAX
<br />(A/c, No, Ext): (619) 788 5795 50206 (A/C, Ne):(619) 574-6288
<br />E-MAIL
<br />D RIESS: Ali.Smith@ioausa.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: RLI Insurance Company
<br />13056
<br />INSURED
<br />Environmental Science Associates
<br />550 Kearny St., Suite 800
<br />San Francisco, CA 94108
<br />INSURER B : Crum & Forster Insurance Company
<br />42471
<br />INSURER C :
<br />INSURER D :
<br />INSURER E :
<br />INSURER F :
<br />•
<br />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 POLIC ES 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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD(MMIDD/YYYYI
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />IMM/DD/YYYYI
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />X
<br />X
<br />PSB0007416
<br />12/1/2021
<br />12/1/2022
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />PREM SESO(Ea Eolccurrrence1
<br />$ 1,000,000
<br />X
<br />CLAIMS -MADE
<br />OCCUR
<br />MED EXP (Any one person)
<br />$ 10,000
<br />X
<br />Cont Liab/Sev of Int
<br />PERSONAL & ADV INJURY
<br />$ 2,000,000
<br />X
<br />EXU
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES
<br />POLICY 1 Xi JECT
<br />I OTHER:
<br />PER:
<br />_1 LOC
<br />PRODUCTS - COMP/OPAGG
<br />$ 4,000,000
<br />Ded
<br />$ 0
<br />A
<br />AUTOMOBILE
<br />X
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />OWNED
<br />x
<br />SCHEDULED
<br />AUTOS
<br />NON -OWNED ONLYY
<br />Coll Ded $1,000
<br />X
<br />X
<br />PSA0002468
<br />12/1/2021
<br />12/1/2022
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY aERTY DAMAGE
<br />(Per accident)
<br />$
<br />$
<br />A
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />PSE0003196
<br />12/1/2021
<br />12/1/2022
<br />EACH OCCURRENCE
<br />$ 3,000,000
<br />AGGREGATE
<br />$ 3,000,000
<br />$
<br />DED
<br />X
<br />RETENTION $ 10,000
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />Y / N
<br />NIA
<br />X
<br />PSW0004135
<br />12/1/2021
<br />12/1/2022
<br />X
<br />PER
<br />STATUTE
<br />OTH-
<br />ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />B
<br />B
<br />Prof Liab/Ded. $25K
<br />Poll Liab/Ded. $25K
<br />PKC112401
<br />PKC112401
<br />12/1/2021
<br />12/1/2021
<br />12/1/2022
<br />12/1/2022
<br />Per Claim
<br />Aggregate
<br />5,000,000
<br />5,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />City of Everett, its officers, employees and agents are Additional Insured with respect to General and Auto Liability per the attached endorsements as required
<br />by written contract. Insurance is Primary and Non -Contributory. Waiver of Subrogation applies to General Liability, Auto Liability and Workers' Compensation.
<br />30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisions.
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />City of Everett
<br />Attn.: Cindy Cullen
<br />3200 Cedar St
<br />(Everett. WA 98201
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016/03)
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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