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i-.., ENVISCI-05 MCCOWANA <br /> 'AC-CORE) DATE(MM/DD/YYYY) <br /> 44.------ CERTIFICATE OF LIABILITY INSURANCE 9/2/2022 <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 <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER License#0E67768 CONTACT Ali Smith <br /> IAA Insurance ServicesE <br /> 4370 La Jolla Village Drive IA/CONNo,Ext):(619)788 5795 50206 1 <br /> FAX <br /> No):(619)574-6288 <br /> Suite 600 <br /> E-MAIDRESS:AIi.Smith@ioausa.com <br /> ...AD <br /> San Diego,CA 92122 <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURERA:RLI Insurance Company 13056 <br /> INSURED INSURER B:Crum&Forster Specialty Insurance Company 44520 <br /> Environmental Science Associates INSURER C: <br /> 550 Kearny St.,Suite 800 INSURER D: <br /> San Francisco,CA 94108 <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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTR INSD.WVD IMM/DD/YYYYI IMM/DD/YYYYI <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 <br /> CLAIMS-MADE X OCCUR PSB0007416 12/1/2021 12/1/2022 DAMAGETORENTED 1,000,000 <br /> X X PREMISES(Ea occurrence) $ <br /> X Cont Liab/Sev of Int MED EXP(Any one person) $ 10,000 <br /> X EXU/BFPO PERSONAL&ADV INJURY $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _$ 4,000,000 <br /> POLICY X JERa LOC PRODUCTS-COMP/OPAGG $ 4,000,000 <br /> X OTHER:Inc!Water Craft Liability Ded $ 0 <br /> COMBINED SINGLE LIMIT 1,000,000 <br /> A AUTOMOBILE LIABILITY (Ea accident) $ <br /> X ANY AUTO X X PSA0002468 12/1/2021 12/1/2022 BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ <br /> AUTOS ONLY NON-OWNEDUUO PROPERTY DAMAGE <br /> (Per accident) $ <br /> X Comp Ded$1,000 x Coll Ded$1,000 $ <br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 <br /> EXCESS LIAB CLAIMS-MADE PSE0003196 12/1/2021 12/1/2022 AGGREGATE __$ 3'000'000 <br /> DED X RETENTION$ 10,000 $ <br /> A WORKERS COMPENSATION X PERTUTE ER <br /> AND EMPLOYERS'LIABILITY Y/N ' X PSW0004135 12/1/2021 12/1/2022 1,000,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? N/A 1,000,000 <br /> (Mandatory 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 /> B Prof Liab/Ded.$25K PKC112401 12/1/2021 12/1/2022 Per Claim 5,000,000 <br /> B Poll Liab/Ded.$25K PKC112401 12/1/2021 12/1/2022 Aggregate 5,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Re:Edgewater Park(D202200928 Edgewater Park Cultural Resources Assessment) <br /> City of Everett is Additional Insured with respect to General and Auto Liability per the attached endorsements as required by written contract.Insurance is <br /> Primary and Non-Contributory.Waiver of Subrogation applies to General Liability and Workers'Compensation.Umbrella follows form. <br /> 30 Days Notice of Cancellation with 10 Days Notice for Non-Payment of Premium in accordance with the policy provisions. <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 /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> City of Everett AUTHORIZED REPRESENTATIVE <br /> Attn: Katherine Phillips / <br /> 802 E.Mukilteo Blvd. 1 oh <br /> (Everett.WA 98203 <br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />