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DocuSign Envelope ID: 87A62A7A-FC32-4CDC-B206-9FB91AB3C6B6 IACORD® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD!YYYY)
<br />� 4/27/2023 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 AssuredPartners Design Professionals Insurance Services, LLC3697 Mt. Diablo Blvd Suite 230 Lafayette CA 94549
<br />License#: 60037 45 INSURED OACSERV-01 OAC Services, Inc. 2200 1st Avenue S, #200 Seattle WA 98134
<br />COVERAGES CERTIFICATE NUMBER· 1500507618
<br />��AAi�cT Jennifer Aauirre PHONE ,, 1\ I FAX JAiEJr.2._.Ext}· 510 465-3090 iAJc Nol: !�lJ�ss: DesinnProCerts@AssuredPartners.com INSURER/SI AFFORDING COVERAGE INSURER A: Valle" Forae Insurance Comoanv INSURER B: Continental Casualtv Comoanv INSURER C: National Fire Insurance of Hartford INSURER D: Continental Insurance Comoanv INSURER E: INSURERF: REVISION NUMBER·
<br />NAIC# 20508 20443 20478 35289
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N01WITHSTANDING ANY REQUIREMENT, TERM OR CONO!T!ON 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. lNSR LTR
<br />A
<br />A
<br />D
<br />C C
<br />B
<br />TYPE OF INSURANCE
<br />X COMMERCIAL GENERAL LIABILITY -� CLAIMS-MADE 0 OCCUR -X Contractual liab -X XCU Included -GEN'L AGGREGATE LIMIT APPLIES PER: 11 [8_J PRO POLICY JECT OTHER: AUTOMOBILE UABlLITY �-ANY AUTO -
<br />[J LOC
<br />OWNED � SCHEDULED AUTOS ONLY AUTOS -� X HIRED X NON-OWNED AUTOS ONLY � AUTOS ONLY -
<br />X UMBRELLA UAB EXCESS LIAB MOCCUR CLAIMS-MADE OED I X I RETENTION$ � n WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Professional liability
<br />YIN □
<br />��_D_L �.l!.�_R POLICY NUMBER ,�m-J%jy��l 1:gfJ%��1 y y 6080369577 5/20/2022 5/20/2023
<br />y y 6080369580 5/20/2022 5/20/2023
<br />6080369613 5/20/2022 5/20/2023
<br />y 6080369594 5/20/2022 5/20/2023 6080916671 5120/2022 5/20/2023
<br />N/A
<br />MCH591939512 5/20/2022 5/20/2023
<br />LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence' MED EXP (A�y one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS -COMP/OP AGG
<br />fOMBINED SINGLE LIMIT Ea accidentl BODILY INJURY (Per person) BODILY INJURY (Per accident) ilROPERTY DAMAGE Per accident
<br />EACH OCCURRENCE AGGREGATE
<br />X I �f{ruTE I I om. ER E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE E.l. DISEASE -POLICY LIMIT Per Claim Annual Aggregate
<br />$1,000,000 $1,000,000 S 10,000 $1,000,000 $2,000,000 $2,000,000 s $1,000,000
<br />s
<br />s
<br />s
<br />s $9,000,000 $9,000,000
<br />s WAStoo Gan $1,000,000 $1,000,000 $1,000,000 3,000,000 5,000,000
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Certificate Holder and any other party as required per written contract or agreement is an additional insured as respects general liability or as endorsed to the applicable policy and attached to this certificate. Waiver of Subrogation, Primary and Non-contributory, and Severability of Interest coverage applies as endorsed to each applicable policy and attached to this certificate. Additional Insured status does not apply to the professional liability policy.
<br />CERTIFICATE HOLDER
<br />City of Everett Attn: Joan Olsen 802 Mukilteo Blvd Suite 100 Everett WA 98203
<br />I
<br />ACORD 25 (2016/03)
<br />CANCELLATI 0 N 30 Dav Notice of Cance ation
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANC ELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS,
<br />��ATIVE
<br />© 1988-2015 ACORD CORPORATION. Al l nghts reserved, The ACORD name and logo are registered marks of ACORD
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