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DATE (MMIDDIYYYY) AC Ro' CERTIFICATE OF LIABILITY INSURANCE 04/13/2016 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 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 Phone: (425)771-5197 Fax: (425)673-4427 CONTACT Chris NAME: ORION INSURANCE GROUP,INC. PHONE FAX 3405 188TH ST SW INC.No.Ems; (425)771-5197 INC No) (425)673-4427 SUITE#302 E-MAILDaChrisDay@OrionlnsGroup.com LYNNWOOD WA 98037 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A : RLI Insurance 42846 INSURED HWA GEOSCIENCES INC. INSURERS 21312 30TH DRIVE SE,SUITE 110 INSURERC : BOTHELL WA 98021-7010 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 16738 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 ADD'L SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A GENERAL LIABILITY X X PSB0002638 12/01/15 12/01/16 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMPREMI E TO )RENTEDEa occurence) $ 300,000 ( CLAIMS-MADE X OCCUR MED.EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 —1 POLICY X PRO- — LOC ___-- JECT A AUTOMOBILE LIABILITY X X PSA0001635 12/01/15 12/01/16 COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ _ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ _AUTOS (per accident) A UMBRELLA LIAB X OCCUR X X PSE0001834 12/01/15 12/01/16 EACH OCCURRENCE $ 3,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000 DED RETENTION$ $ WORKERS COMPENSATION PSB0002638 12/01/15 12/01/16 WTO YLIMI OTH A AND EMPLOYERS' LIABILITY X TORY LIMITS ER $ ANY PROPRIETOR/PARTNER/EXECUTIVE IY/NI E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A E.L.DISEASE-EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below A Professional Liability Claims Made RDP0013009 12/01/15 12/01/16 $2,000,000 Each Occurence $2,000,000 Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) City of Everett and all required parties are listed as additional insureds with primary non contributory wording. A waiver of subrogation applies in the favor of additional insureds. Cancellation has been modified to 30 days. Beverly Lake Sewer Replacement Project CERTIFICATE HOLDER CANCELLATION City of Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3200 Cedar St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Everett,WA 98201 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Attention: Christopher R. Day ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD