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2022/07/27 Council Agenda Packet
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2022/07/27 Council Agenda Packet
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1/24/2023 4:17:39 PM
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7/27/2022 3:59:04 PM
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Council Agenda Packet
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7/27/2022
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® ARQCERTIFICATE <br />ERTIFlCATE OF LIABILITY INSURANCE <br />l\\rri..---/ <br />DATE (MMIDD/YYYY) <br />06/14/2022 <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 po icy, 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 <br />Orion Insurance Group <br />10634 E Riverside Dr <br />Suite #300 <br />Bothell WA 98011 <br />CONTACT Christopher Day <br />NAME: <br />a/ONtu . Ext): (425) 771-5197 FAX <br />No): (425) 673-4427 <br />E-MAIL chrisday@orioninsgroup.com <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURERA: RLI Insurance <br />INSURED <br />2812 Architecture Inc <br />2812 Colby Ave <br />Everett WA 98201 <br />INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />COVERAGES <br />CERTIFICATE NUMBER: CL218906841 <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 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 <br />LTR <br />TYPE OF INSURANCE <br />ADOL <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />(MM/DD/YYYY) <br />POLICY EXP <br />(MM/DDIYYYY) <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />PSB0003093 <br />08/16/2021 <br />08/16/2022 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />1,000,000 <br />$ <br />CLAIMS -MADE <br />X <br />OCCUR <br />MED EXP (Any one person) <br />$ 10,000 <br />X <br />Hired Non -Owned Auto Limits <br />PERSONAL&ADV INJURY <br />$ 2,000,000 <br />X <br />Follow General Liability <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />GEN'L <br />AGGREGATE <br />X <br />LIMIT APPLIES <br />PRO- <br />JECT <br />PER: <br />LOC <br />PRODUCTS-COMP/OPAGG <br />4,000,000 <br />$ <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />OWNED <br />- <br />_ <br />SCHEDULED <br />AUTOS <br />NON -OWNED <br />AUTOS ONLY <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />s <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />$ <br />DED RETENTION $ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANYOFF PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />v I N <br />N /A <br />Y <br />PSB0003093 <br />08/16/2021 <br />08/16/2022 <br />PER art <br />STATUTE X ER <br />Stop Gap <br />E.L, EACH ACCIDENT <br />1,000,000 <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />10, 00000 <br />$ , <br />A <br />Professional Liability Claims Made <br />RDP0041181 <br />09/27/2020 <br />09/27/2022 <br />$2,000,000 Each cCaim <br />$2,000,000 Aggregate <br />$10,000 <br />Deductible <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />All required parties are listed as additional insureds with primary and non contributory wording as well as a waiver of subrogation in their favor for the <br />general liability policy. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />City of Everett <br />802 E Mukilteo Boulevard <br />Bldg 100 <br />Everett <br />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 />i <br />(01 <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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