D.K. Systems Inc. 10/25/2022 - Laserfiche WebLink

/ 1 ® DATE(MM/DD/YYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 10/12/2022 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. 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 Shellie Eubanks NAME: Smiley Insurance Services O (360)424-1772 FAX (360)424-0388 (A/ No,Extl: c,No): 1616 N 18th Street E-MAIL sheltie@smiley-ins.com ADDRESS: Suite 160 INSURER(S)AFFORDING COVERAGE NAIC# Mount Vernon WA 98273 INSURER A: Firemans Insurance Co 21784 INSURED INSURER B: Westchester Surplus Lines Insurance Company D.K.Systems Inc. INSURER C: PO Box 886 INSURER D: INSURER E: Burlington WA 98233 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2252015181 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMA TO REND EU CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 300,000 MED EXP(Any one person) $ 10,000 A Y Y CPA6031209-24 05/29/2022 05/29/2023 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PRO LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y Y CPA6031209-24 05/29/2022 05/29/2023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) Medical payments $ 5,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE Y Y CPA6031209-24 05/29/2022 05/29/2023 AGGREGATE $ 5,000,000 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION X SPER TATUTE ER" Wash Stop Gap AND EMPLOYERS'LIABILITY Y/N 1000 000 A ANY PROPRIETOR/PARTNER/EXECUTIVE NIA CPA6031209-24 05/29/2022 05/29/2023 E.L.EACH ACCIDENT $ , , OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1 , 0000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , Liability-$2,000,000 $2500 ded Pollution Liability B G73570037 001 06/01/2022 06/01/2023 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The certificate holder is additional insureds per signed contract and Forms included CLCA0149-Auto Endors;CLCG0020-GenAggLimit;CLCG0114-Primary-Non-Contibutory;CLCG0492-Blanket Waiver of Subro; CLCG0529-Blanket Al Ongoing Ops;CLCG2071-Al Completed Ops;CLCU2474-Umb. RE: #2022-047 Unit Price HVAC Services&Repairs 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. PO Box 12130 AUTHORIZED REPRESENTATIVE Everett WA 98201 er l ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD