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Client#: 326377 PERTEINC
<br /> ACORD-., CERTIFICATE OF LIABILITY INSURANCE DATE(Ms/16/2016
<br /> wDDrM/DD/YYYY)
<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 be endorsed.If SUBROGATION IS WAIVED,subject to
<br /> the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> NAME:
<br /> USI Kibble&Prentice PR PHONE 206441-6300 FAX 610-362-852
<br /> (AIC,No,Ext): (A/C,No):
<br /> 601 Union Street, Suite 1000 mass: PL.CertRequest@usi.com
<br /> Seattle,WA 98101
<br /> INSURER(S)AFFORDING COVERAGE NAIL
<br /> INSURER A:Travelers Indemnity Company of 25682
<br /> INSURED INSURER B:Travelers Casualty and Surety C 31194
<br /> Perteet, Inc. INSURER C:Phoenix Insurance Company 25623
<br /> P.O. Box 1186 —
<br /> Everett,WA 98206-1186 INSURER D:
<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 /> IN
<br /> TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXP M/ LIMITS
<br /> (MM/DD/YYYY) (MDD/YYYY)
<br /> A X COMMERCIAL GENERAL LIABILITY 6809A973147 06/27/2016 06/27/2017 EACHEAOCCURRENCEEC � $1,000,000
<br /> PRE
<br /> CLAIMS-MADE X OCCUR MISES(EaEoNccTu encs) $1,000,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY X ECOT LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER: $
<br /> C AUTOMOBILE LIABILITY BA9A974666 06/27/2016 06/27/2017 COMB
<br /> aaccident)INED SINGLE LIMIT 1,000,000
<br /> 000
<br /> (E
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS AUTOS
<br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS (Per accident)
<br /> UMBRELLA UAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED RETENTION$ $
<br /> A WORKERS COMPENSATION 6809A973147 06/27/2016 06/27/2017 PER X 2112-H-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> OFFICEWMEMBER EXCLUDED?ECUTIVE YN N/A (WA Stop Gap) E.L.EACH ACCIDENT $1,000,000
<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 Professional 106321064 06/27/2016 06/27/2017 $2,000,000 per claim
<br /> Liability $2,000,000 annl aggr.
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached K more space is required)
<br /> RE: Project No.20160158, Everett Parks Green Lantern Park Enhancements Biological Evaluation.
<br /> The General Liability policy includes an automatic Additional Insured endorsement that provides
<br /> Additional Insured status to the Certificate Holder,only when there is a written contract that requires
<br /> such status,and only with regard to work performed on behalf of the named insured.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> City of Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Attn: Dean Shaughnessy ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 802 E. Mukilteo Blvd.
<br /> Everett,WA 98203 AUTHORIZED REPRESENTATIVE
<br /> ©1988-2014 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br /> #S18036307/M18008808 MXTJU
<br />
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