ARC 10/24/2016 - Laserfiche WebLink

A`CO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYW) \r.►----- 7/11/2016 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 CONTACT Select NAME: PLC Insurance, LLC (per No Ext): (425)712-3664 WC.No).(425)712-3786 4211 Alderwood Mall Blvd, #210 AAopREss:corrineplciao.com INSURER(S)AFFORDING COVERAGE NAIC N Lynnwood WA 98036 INSURER A:Philadelphia Indemnity Ins Co. INSURED INSURER B: The Arc of Snohomish County INSURERC: 6515 202nd St SW INSURERD: INSURER E: Lynnwood WA 98036 INSURERF: COVERAGES CERTIFICATE NUMBER:16/17 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LTR INSD 4WD POLICY NUMBER (MMIDD/YYYYUM/ MDD/YYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X OCCUR DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) $ PHPK1488926 6/22/2016 6/22/2017 MED EXP(Any one person) $ 5,000 PERSONAL BADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY 1 ZS- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER Employers Liability-Stop Gap $ 1,000,000 AUTOMOBILE LIABILITY SEOMaa`BINdED ent)SINGLE LIMIT $ 1,000,000 A ANY AUTO BODILY INJURY(Per person) $ UTOWNED ( SCHEDULED PHPX1488926 6/22/2016 6/22/2017 BODILY INJURY(Par accident) $ NON-OWNED PROPERTY DAMAGE X AUTOS (Per accident) $ X HIRED AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ YADVINCOMPeertiOM NASHINGTON STOP GAP PER OTH- (EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVEN/A A EMPLOYER'S LIABILITY E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) PHPK1488926 6/22/2016 6/22/2017 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 Idescribe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) City of Everett, its officers, agents and employees are additional insureds per the attached CG2026 (07/04) . RECEIVED AUG 16 2016 CERTIFICATE HOLDER CITY OF bVtRETT CANCELLATION PLANNING utPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Ross Johnson ACCORDANCE WITH THE POLICY PROVISIONS. 2930 Wetmore Avenue Suite 8A AUTHORIZED REPRESENTATIVE Everett, WA 98201 �! Mike Rucker/CORRIN ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 1NS025(2014011