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® ACORDCERTIFICATE OF LIABILITY INSURANCE GATE(MMlDD/YYYY) ‘ftp...----' 6/25/2021 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 policy(Ies)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 Stephen Erni Arthur J. Gallagher Risk Management Services, Inc. HONX c.K Exti:425-586-1002 (ac,No):425-451-3716 777 108th Ave NE,#200 EMAIL Bellevue WA 98004 ADDRESS: Stephen_Erni(W,ajp.com INSURER(S)AFFORDING COVERAGE T NAIC# INSURER A:Great American Insurance Company 16691 INSURED voLUOFA-11 INSURER S:Travelers Casualty and Surety Co of America 31194 Volunteers of America Western Washington INSURERC: P.O. Box 839 2802 Broadway INSURER D: Everett WA 98206-0839 INSURER E: INSURER F: I , COVERAGES CERTIFICATE NUMBER:639919684 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. TYPEOFINSURT POLICY _�_ _. ._.:. _ �.__. ILTR I ADd�'OBR � -�'' '•"•m POLICY EFF POLICY EXP LIMITS, INSURANCE INSD WVD POUCY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY Y PAC396479800 6/30/2021 6/30/2022 EACH OCCURRENCE $1,000,000 DAMAGETORENTED _ CLAIMS-MADE LX OCCUR PREMISES(Ea occurrence) 1,000,000 v $ „„__OCCUR MED EXP(Any one person) $20,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- X' LOC PRODUCTS•COMP/OP AGG $2,000,000 OTHER: $ COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY _(Ea_accdent) �_� _ —____— ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY _,(Per accident) .,,___,__ _..uv_. ___ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $_ DED RETENTION$ $ WORKERS COMPENSATION PER ERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE N/A _EL.EACH ACCIDENT $ • OFFICERJMEMBEREXCLUDED? (Mandatory In NH) E.L.DISEASE•EA EMPLOYEE $ If yes,describe under E.L.DISEASE•POLICY LIMIT DESCRIPTION OF OPERATIONS below B Crime-Employee Theft 107113411 6/30/2021 6/30/2022 Limit $2,000,000 I DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) City of Everett,its officers,employees,and agents are included as Additional Insured as respects General Liability policy, pursuant to and subject to the policy's terms,definitions,conditions and exclusions. 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. Dept. of Planning&Community Development 2930 Wetmore Ave., Suite 8A AUTHORIZED REPRESENTATIVE Everett WA 98201 USA 16111 .r I ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 15*of15 687