Laserfiche WebLink
• <br /> A ® CERTIFICATE OF LIABILITY INSURANCE DATE <br /> 06/22i2016 ' <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(les) 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 Kevin <br /> NAME: <br /> Brett Bakken Insurance Agency tAlCONNo.Eatl:2t)6-244'2522 IA/C,No1:206-244-8875 <br /> State Farm 14242 Ambaum Bfvd SW aaMDREss:brett.bakken.ickv@statefarm.com <br /> Burien WA 98166 INSURER(S)AFFORDING COVERAGE NAIL <br /> State Farm Fire and Casualty Company 25143 <br /> INSURER A: <br /> INSURED MICHAEL E PURDY ASSOCIATES LLC INSURERS State Farm Mutual Automobile Insurance Company 26178 <br /> PO BOX 46181 INSURERC: <br /> SEATTLE WA 98146-0181 INSURERD: <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 ADDL SUER POLICY EFF POLICY EXP LIMITS <br /> LTR INS() WVD POLICY NUMBER (MMIDD(YYYY1 (MMIDD/YYYY) <br /> A X COMMERCIAL GENERAL UABILITY Y Y 98-BF-K616-4 02107/2016 02!07/2017 EACH OCCURRENCE $ 2,000,000 <br /> DAMAGE <br /> CLAIMS-MADE X OCCUR PREMISES(ETO aENTED occurrence) $ 300,000 <br /> MED EXP(Any one person) $ 5,000 <br /> PERSONAL 8 ADV INJURY $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> POLICY X CrELOC PRODUCTS-COMP/OP AGG $ 4,000,000 <br /> OTHER: $ <br /> B AUTOMOBILE UABILJTY Y Y 337'1780-C09-47T 03/09/2016 09/0912018 COMBINED SINGLE LIMIT $ <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ 250,000 <br /> I ALL OWNED Ne SCHEDULED BODILY INJURY(Per accident) $ 500,000 <br /> AUTOS NON-OWNED PROPERTY DAMAGE 100,000 <br /> HIRED AUTOS AUTOS (Per accident) <br /> A X UMBRELLA LIAB X OCCUR47�q�651_5 12128/2016 12/2812016 EACH OCCURRENCE $ 2,000,000 <br /> EXCESS UAB CLAIMS-MADE AGGREGATE $ 2,000,000 <br /> `` <br /> DED RETENTION$ $ <br /> [WORKERS COMPENSATION PER <br /> ANO EMPLOYERS'LIABIUTY STATUTE EO <br /> Y f N ER <br /> !ANY PROPRIETOR/PARTNER/EXECUTIVE N!A El.EACH ACCIDENT $ <br /> OFFICERIMEMBER EXCLUDED? <br /> (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS f VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF EVERETT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 3101 CEDAR STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> EVERETT,WA 98201 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> ___-- s5--A <br /> .1988-2014 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 1001486 132849,9 02-04-2014 <br />