2005/04/27 Council Agenda Packet

ii DATE(MM/DD/YY) ACORD,. CERTIFICATE OF LIABILITY INSURANCE 06/01/2005 04/11/2005 • DDUCER Lockton Companies THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 444 W.47th Street,Suite 900 HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Kansas City Mo 64112-1906 ALTER THE COVERAGE AFFORDED BY THE POLICIES_BELOW.__ (816)960-9000 INSURERS AFFORDING COVERAGE .URED HDR ENGINEERING.INC. INSURER A: ZURICH AMERICAN INS CO-O.P. KS )13472 ATTN:LOUIS J. PACHMAN •INSURERB: AMERICAN GUARANTEE& LIAB(ZURICH) 8404 INDIAN HILLS DRIVE INSURER C; SENTRY INSURANCE A MUTUAL COMPANY OMAHA.NE 68114-4049 •INSURER D: CONTINENTAL CAS(V.O. SCHINNERER INSURER E: )VERAGES SA HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING NY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR IAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH OLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. RTYPE OF INSURANCE - POLICY NUMBER ! POLICY EFFECTIVE ;POLICY EXPIRATION' a ' DATE(MM/DD/YY) ' DATE(MM/DD/YYI LIMITS GENERAL LIABILITY .EACH OCCURRENCE L000.000 X COMMERCIAL GENERAL LIABILITY GL03504583 I 06/01/2004 ' 06/01/2005 , _any DAMAGE ny one IireL.s —_1000.000— —._ .. CLAIMS MADE ,_X OCCUR I • i;MED EXP!Any one perso j- 5 5.000 I PERSONAL 8 ADV INJURY � 1.000.000• -- .--- I I G ENERAL AGGREGATE `s2.000_000 i GENT-AGGREGATE LIMIT APPLIES PER:. Ir PRODUCTS.COMP/OP AG—.1.G• S 2.000.000 — _----- • POLICY ; X I ECO :( X (LOC . I , I I AUTOMOBILE LIABILITY ' I 1-.---- ANY AUTO BAP3504584 I 06/01/2004 i 06/01/2005 t lEaCOMBINED SINGLE OMIT !CO BINNED) I.000.000 .ALL OWNED AUTOS TAP3504586 06/01/2004 ? 06/01/2005 -- - F-- I BODILY INJURY I s XXXXXXX SCHEDULED AUTOS I (Per person) — I I 1 --- - -I--- `X :HIRED AUTOS BODILY INJURY �X NON-OWNED AUTOS I (Pet accident) I XXXXXXX •I I--';---- -.- I PROPERTY DAMAGE IS XXXXXXX I(Per accident) I ' FGARAGE LIABILITYI i 'AUTO ONLV_EA ACCIDENT .S XXXXXXX I ANY AUTO NOT APPLICABLE I--: I OTHER THAN EAACC js XXXXXXX I _ I I AUTO ONLY; AGG I S XXXXXXX I EXCESS LIABILITY _ EACH OCCURRENCE s 1.000.000 • X 'OCCUR I ,CLAIMS MADE : AUC3808400-00 06/01/2004 06/01/2005 ;AGGREGATE I s 1.000.000 IX UMBRELLA (EXCLUDES PROF.LIAB) .- I j s XXXXXXX r—I DEDUCTIBLE FORM i s XXXXXXX I • I RETENTION I ! I II S XXXXXXX TU- WORKERS COMPENSATION AND ! 90-14910-01 06/01/2004 06/01/2005 X �TTORY WC SUMTSI 0TH - I EMPLOYERS'LIABILITY I i I E.L.EACH ACCIDENT I S 1,0041000 E.L.DISEASE-EA EMPLOYEE S 1.000.000 I I E.L.DISEASE-POLICY LIMIT S 1.000.000 OTHER PLA I13978408 06/01/2004 06/01/2005 ARCHS&ENGS PROFESSIONAL PER CLAIM 51.000.000. AGG: •$1.000.000. LIABILITY 1 I I SCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 2E:CITY OF EVERETT WATER COMPREHENSIVE PLAN. THE CITY OF EVERETT,ITS OFFICERS,EMPLOYEES AND AGENTS ARE NAMED .S ADDITIONAL INSUREDS_AS RESPECTS GENERAL AND AUTOMOBILE LIABILITY COVERAGES BY ENDORSEMENT,WHICH IS ON .PRIMARY BASIS AND ALL OTHER INSURANCE SHALL BE NON-CONTRIBUTORY,ONLY AS REQUIRED BY CONTRACT. WAIVER IF SUBROGATION APPLIES. ERTIFICATE HOLDER I I ADDITIONAL INSURED;INSURER LETTER: _ CANCELLATION IM5509)1M6986) • 2271090 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF EVERETT DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR-T4 MAIL 30 DAYS WRITTEN ATTN:CITY ATTORNEY 2930 WETMORE AVENUE,STE 1 OC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, EVERETT WA 98201 AUTHORIZED REPRESENTATIVE / _digov I number 25-S(7/97) For questions regarding this certificate,contact the nuber listed in the'Producer'section above and specify the client cod.HORIN07'. @ ACO CORPORATION 1988 118