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DreamBig for Kids LLC 11/21/2016
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DreamBig for Kids LLC 11/21/2016
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Last modified
12/5/2016 11:03:01 AM
Creation date
12/5/2016 11:02:51 AM
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Contracts
Contractor's Name
DreamBig for Kids LLC
Approval Date
11/21/2016
End Date
12/31/2017
Department
Parks
Department Project Manager
Jan Tanner
Subject / Project Title
Gymnastics instruction
Tracking Number
0000372
Total Compensation
$8,000.00
Contract Type
Agreement
Contract Subtype
Professional Services
Retention Period
6 Years Then Destroy
Contractor's Primary Email
tlgeverettwa@thelittlegym.com
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CERTIFICATE OF LIABILITY INSURANCE 10/13/2016 <br /> 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 <br /> 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), <br /> AUTHORIZED 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 the terms and conditions of the policy.certain policies may require an <br /> endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER <br /> American Specialty Insurance&Risk Services,Inc. <br /> 7609 W.Jefferson Blvd.,Suite 100 <br /> Fort Wayne,IN 46804 <br /> NAMED INSURED <br /> DreamBig for Kids LLC dba The Little Gym of Everett <br /> 7207 Evergreen Way Ste R INSURER(S)AFFORDING COVERAGE NAIC# <br /> I INSURER A: Greenwich Insurance Company 22322 <br /> Everett,WA 98203 I INSURER B: <br /> INSURER C: <br /> INSURER 0: <br /> INSURER E: <br /> I INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 1001353059 <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING ANY <br /> REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W1TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY <br /> 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. <br /> INSR INSURANCE POLICY POLICY <br /> LTR TYPE POLICY NUMBER EFFECTIVE EXPIRATION LIMITS <br /> General Aggregate 5,000,000 <br /> GL ASG090309801 08/01/2016 08/01/2017 Products-Completed Operations Aggregate 5,000,000 <br /> A12:01 a.m. 12:01 a.m. Personal and Advertising Injury 1.000.000 <br /> Each Occurrence 1.000.000 <br /> Damage to Premises Rented to You(Any One Premises) 1.000,000 <br /> Medical Expense Limit(Any One Person) 5,000 <br /> Each Occurrence 1,000,000 <br /> XS ASX0910260 08/01/2016 08/01/2017 Products-Completed Operations Aggregate 1,000,000_ <br /> A 12:01 a.m. 12:01 a.m. General Aggregate 1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES(Additional Remarks Schedule may be attached if more space is required) <br /> — Medical Expense limit excludes participants in Little Gym activities and birthday party participants. <br /> The Certificateholder is only an additional insured with respect to liability caused by the negligence of the Named Insured as per Form GXA L428-Additional Insured-Certificateholder, <br /> effective October 12,2016. <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF EVERETT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE <br /> CANCELLED BEFORE THE EXPIRATION DATE THEREOF, <br /> ITS OFFICERS,EMPLOYEES,AND AGENTS NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br /> 2930 WETMORE#9A POLICY PROVISIONS. <br /> EVERETT,WA 98201 <br /> AUTHORIZED REPRESENTATIVE <br /> GXA S03 0116 (>2016 X.L. America, Inc. All Rights Reserved. May not be copied without permission. Page 1 of 1 <br />
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