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DIVE CENTER CERTIFICATE OF INSURANCE <br /> Agent Information Certificate#: 201700378 <br /> Vicencia&Buckley A Division of HUB International Member#: 21778 <br /> Insurance Services <br /> Effective Date: 06/30/2016 <br /> 6 Centerpointe Drive,#350 Expiration Date: 6/30/201 7 1 2:01:00 AM <br /> La Palma,CA 90623-2538 <br /> (714)739-3177 FAX (714)739-3188 Policy issued by Lexington Insurance Company <br /> (800)223-9998 <br /> License#:151305 Policy#:015375041 <br /> Insured's Name and Mailing Address <br /> EVERGREEN DIVE SERVICE LLC <br /> 4610 EVERGREEN WAY,SUITE 1 <br /> EVERETT,WA, 98203 <br /> Store Location:4610 EVERGREEN WAY, EVERETT,WA <br /> !SECTION I:LIABILITY COVERAGES Limits <br /> Commercial General Liability(Each Occurrence Limit): $1,000,000 <br /> Personal Injury(per Occurrence): $1,000,000 <br /> General Liability Aggregate: $2,000,000 <br /> Products and Completed Operations Aggregate: $2,000,000 <br /> Damage to premises rented to you: $1,000,000 <br /> Medical Expense: Not Included <br /> NON-Owned Auto: Not Included <br /> NON-Diving Pool Use: Not Included <br /> Travel Agent E&O(Each wrongful act&Aggregate): Not Included <br /> (Claims made form) <br /> Certificate has Additional Insureds(See Attached) <br /> The insurance afforded by this policy is a master policy issued to PADI Worldwide Corporation,30151 Tomas Street, Rancho Santa Margarita,CA 92688. <br /> The insurance is provided under terms and conditions of the master policy which is enclosed with this certificate.Please read the policy for a full description <br /> of the terms,conditions and exclusions of the policy.This certificate does not amend,alter or extend the coverage afforded by the policy referenced on this <br /> certificate. <br /> Notice of cancelation:If the company cancels this policy,45 days notice will be given to the certificate holder unless cancellation is for nonpayment of <br /> premium,then 10 days notice will be provided,and any premium not earned will be returned to the certificate holder. <br /> "THIS CONTRACT IS REGISTERED AND DELIVERED AS A SURPLUS LINE COVERAGE UNDER <br /> THE INSURANCE CODE OF THE STATE OF WASHINGTON, TITLE 48RCW. IT IS NOT PROTECTED <br /> BY ANY WASHINGTON STATE GUARANTY ASSOCIATION LAW." <br /> Issued on behalf of: Date Authorized Representative <br /> Lexington Insurance Company 07/1 2/201 6 <br /> u,t ��ea•`� � <br /> Page: 1 of 1 Steve Vicencia CPCU <br />