Landscape Structures Inc. 8/17/2022

'`` CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D/2022 ) OS/U3/2022 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. `m 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). _ a PRODUCER CONTACT V NAME: Aon Risk Services Central, Inc. PHONE FAX Minneapolis MN Office (A/C.No.Ext): (866) 283-7122 (A/c.Ne,), (800) 363-0105 a Z. 5600 West 83rd Street E-MAIL = 8200 Tower, Suite 1100 ADDRESS: Minneapolis MN 55437 USA INSURER(S)AFFORDING COVERAGE NAIC/ INSURED INSURER A: Markel American Ins Co 28932 Landscape Structures, Inc. INSURERB: Crum & Forster Indemnity Co 31348 601 7th Street South Delano MN 55328 USA INSURERC: United States Fire Insurance Co. 21113 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570094779304 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, Limits shown are as requested INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DONYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY MKLM6MMP1000475 06/01/2022 06/01/2023 EACH OCCURRENCE $2,000,000 CLAIMS-MADE X OCCUR GL & Products Liability DAMAGE10 RENTEDPREMISES(Ea occurs nce) $100,000 SIR applies per policy terms & conditions X Contractual Incl. MED EXP(Any one person) Excluded PERSONAL&ADM INJURY $2,000,000 .. 0 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $4,000,000 m r POLICY X Ee I f LOC PRODUCTS-COMP/OP AGG $4,000,000 V m 0 OTHER 0 B AUTOMOBILE LIABILITY 133-752022-2 06/01/2022 06/01/2023 COMBINED SINGLE LIMIT N (Ea accident) $1,000,000 X ANY AUTO BODILY INJURY(Per person) O SCHEDULED BODILY INJURY(Per accident) Z OWNED AUTOS 6t AUTOS ONLY PROPERTY DAMAGE is HIRED AUTOS NON-OWNED (Per accident) V ONLY AUTOS ONLY k X Comp Ted SOS X Collision Ded S500 t N A MKLM6MM70000514 06/01/2022 06/01/2023 EACH OCCURRENCE $S,000,OOOr ° X UMBRELLA LIAR X OCCUR EXCESS LIAR CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION $10,000 C WORKERS COMPENSATION AND 4087432314 06/01/2022 06/01/2023 X PER STATUTE I 10TTH- EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER I YNN N/A E.L.EACH ACCIDENT $1,000,000 EXECUTIVE OFFICER/MEMBER (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe'Orr OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 0 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached if more space is required) g▪a City of Everett is included as Additional Insured on General Liability policy as respects their interest in the operations of Landscape Structures Inc. regarding the Thornton A Sullivan Park Playground located in Everett WA. El 1 1 y CERTIFICATE HOLDER CANCELLATION � SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. g▪ ril ray city of Everett AUTHORIZED REPRESENTATIVE Attn: Insurance Compliance 2930 Wetmore Ave. ele Everett WA 98201 USA `I�1'� /J�v �i M 2!!LK J J IIIII_ ©1988-2015 ACORD CORPORATION.All rights reserved ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD