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ACCMCP O CERTIFICATE OF LIABILITY INSURANCE D"E"""'°°' 08/02/231616 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(les)must have ADDITIONAL INSURED provisions or 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 endorsements). PRODUCER _....... ____. CONTACT NAME: Hiscox inc. PHONE 888-202-3007 : FAX 520 Madison Avenue . a,'No.Ur), — we,Nor. 32nd Floor • --_-_ INSURER(S)AFFG COVERAGE NAIL C New York,NY 10022 INSURER A: Hiscox Insurance Company Inc 10200 INSURED INSURER a: Daizy Logik,LLC INSURER c: 10595 NE 12th Pi Unit 101 INsuRER U: i INSURER E: Betievue WA 980434 INSURER F: COVERAGES CERTIFICATE NUMBER: 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. --- -- ADOLisueR1 --_.. _-- f._._._ CY EFF I POLICY EXP , LTR', TYPE OP INSURANCE )NSD'WVD y POLICY NUMBER (MiM/tPOL7DLYYYYL j IIII{DD/YYYY) -_... LIMITS. X4 COMMERCIAL GENERAL LIABIUTY i 1 EACH OCCURRENCE f$ 1,000,000 I-MIME'TE7TED - i j CLAIMs-MAUE j I 6tROCCUR I + manses(Ee occurrence) $ 100,000 . MED EXP(Any one Person) s 5.000 --i A — UDC-1633823-CGL-16 09/16/2016 09/16/2016 PERSONAL a ADV INJURY $ 1,000,000 XGENS.AGGREGATE LIMIT APPLIES PER: .GENERAL AGGREGATE $ 2,000,000 POL!LY JECT '=-�3:. PRODUCTS-COMe/OP AGG $ ST Gen Ag YOTHER: .._ _ $ AUFOMA08MLEUAeILRY ' F — ,j 'eOMFANF.0I1NCI.EUMIT ! $ ANY AUTO It BODILY INJURY(Per person) I S OWNED SCHEDULED 1 BODILY INJURY(Par sodden° $ . AUTOS ONLY __AUTOS HIRED NON-OWNW S .. _._ 1 AUTOS ONLY AUTOS ONLY I , er acgdent -- _ . $ I- •UMBRELLA DAB OCCUR '.EACH`.'.'+C;Cts,^�ft1=Nr:E $ EXCESS UAE icLANz.mtADE ` i AGGREGATE iiS 1 DED I I RETENTION$ I �t- ._... _— , WORKERS COMPENSATION i i I I PER I J OTH- AND EMPLOYERS'UAaIUTY Y/N _-�STATUTE I ER —__ ANYPROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ ME! OFFICERIMSEREXCLUDED? N/A - -- ----i flay In NH) E.L DISEASE-EA EMPL $ ) I' s,descnbe undue i O ECRIPTION OF OPERATIONS L;iuw { j E.L.DISEASE-POLICY L.iMI; $ Professional Liability i Each Claim $1,000,000 A ' UDC-1633823-EQ-1S i 09;18/2016!09118/2017 Aggregate $1,000,000 i i i i i 1 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) This insurance Is primary to any insurance or self insurance provided by the certificate holder CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE.ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH TtHE POLICY PROVISIONS. AU THORt2ED-REPRESE$TA' Vo t I \��, I ®1988-201 ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORN)