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ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(M IDD/YYYY) <br /> 06/13/2016 <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 /> Niehl Insurance Agency PHONE FAX <br /> 375 118th Ave Se#103 (arc,No,Frr)• (425)644-1600 (A/C,Nol:(425)644-2152 <br /> E-MAIL <br /> Bellevue WA 98005 ADDRESS* <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A;The Hartford Casualty Insurance Co <br /> INSURED INSURER B:Sentinel Insurance Co. Ltd. <br /> Associated Earth Sciences Inc INSURER C: <br /> 911 5Th Ave Suite 100 INSURER D: <br /> Kirkland WA 98033 INSURERE: <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 SUBR POLICY EFF POLICY EXP LIMITS <br /> LTRINAn wvn POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) <br /> A X COMMERCIAL GENERAL LIABILITY 52SBAVV7637 12/31/201512/31/2016 EACH OCCURRENCE _ $ 1,000,000 <br /> DAAGERETED <br /> CLAIMS-MADE X OCCUR PREM SFSO(Fa nnnurr nce) $ 300,000 <br /> MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY X TR- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 <br /> OTHER: $ <br /> B AUTOMOBILE LIABILITY 52UECJR8403 12/31/201512/31/2016 (aaBB.udeDno INGLELIMIT $ 1,000,000 _ <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> XX NON-OWNED PROPERTY DAMAGE <br /> HIRED AUTOS AUTOS (Per accident) <br /> A X UMBRELLALIAB X OCCUR 52SBAVV7637 12/31/201512/31/2016 EACH OCCURRENCE $ 5,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 <br /> DED RETENTION$ $ <br /> A WORKERS COMPENSATION 52SBAVV7637 12/31/201512/31/2016 STATUTE X FRH- <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE YIN WA STOP GAP E.L EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> RE:WATER MAIN REPLACEMENT-PROJECT#160309EEA <br /> CITY OF EVERETT IS INCLUDED AS ADDITIONAL INSURED PER POLICY. <br /> CERTIFICATE HOLDER CANCELLATION Al 114043 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> CITY OF EVERETT ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 3200 CEDAR ST <br /> EVERETT WA 98201- AUTHORIZED REPRESENTATIVE <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />