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Client#: 143840 VALDCONS
<br /> ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)SI30/2023
<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 any rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACTME Lisa Anderson
<br /> Propel Insurance PHONE FAX
<br /> (A/C,No,Ext):800 499 0933 (A/C,No): 866 577-1326
<br /> 1201 Pacific Avenue; Suite 1000 ADDRE-MAILESS: lisa.anderson@propelinsurance.com
<br /> COM Construction INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Tacoma,WA 98402-4321 Continental Insurance Company INSURER A: P Y 35289
<br /> INSURED INSURER B:Continental Casualty Company 20443
<br /> Valdez Construction Inc. Y Valle Forge Insurance Company INSURER C: P y 20508
<br /> 499 NE Midway BLVD,STE 2 Great American E&S Insurance Company
<br /> INSURER D: P
<br /> Oak Harbor,WA 98277
<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 ADDLSUBR POLICY EFF POLICY EXP
<br /> LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY 6072801575 10/31/2022 10/31/2023 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE X OCCUR PREMISESC Ea occurr nce) $100,000
<br /> X PD Ded: $2,000 MED EXP(Any one person) $15,000
<br /> PERSONAL 8 ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> PRO-
<br /> POLICY X JECT LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER: $
<br /> C AUTOMOBILE LIABILITY 6072801558 10/31/2022 10/31/2023 Ea COMBIaccidenq NED SINGLE LIMIT $1,000,000
<br /> (
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> X AUTOS ONLY X AUTOS ONLY (Per accident)
<br /> $
<br /> A X UMBRELLA LIAB X OCCUR 6072801561 10/31/2022 10/31/2023 EACH OCCURRENCE $5,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000
<br /> DED X RETENTION$$10,000 $
<br /> A WORKERS COMPENSATION 6072801575 10/31/2022 10/31/2023 PER X ERH
<br /> AND EMPLOYERS'LIABILITY STATUTE
<br /> Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE WA Stop Gap Only E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> B Installation FLTR 7011692430 10/31/2022 10/31/2023 $250,000 Limit
<br /> B Leased/Rent Equip 7011692430 10/31/2022 10/31/2023 $275,000 Limit
<br /> D Pollution Liabili CPBE50277203 10/31/2022 10/31/2023 $1mm Limit; $10K ded.
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE: Eclipse Mill Park Inductive Charging Infrastructure for Everett Transit
<br /> Additional Insured Status applies per attached form(s).
<br /> Waiver of Subrogation applies per attached form(s).
<br /> If required by Written Contract,Owner,Owners Representative,and each of their respective officers,
<br /> elected officials,employees,agents, representatives.Subconsultants and volunteers,and other entities
<br /> (See Attached Descriptions)
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> Cityof Everett-Everett Transit SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Attn:Vincent Bruscas ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 3201 Smith Avenue,STE 215
<br /> Everett,WA 98201 AUTHORIZED REPRESENTATIVE
<br /> ©1988-2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD
<br /> #S5943002/M5536124 LMA00
<br />
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