Laserfiche WebLink
5 <br /> • <br /> ACORD DATE(MMlDDmnY) <br /> TM. CERTIFICATE OF LIABILITY INSURANCE 12/14/2005 <br /> PRODUCER Phone: (360)598-3700 Fax (360)598-3703 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> MICHAEL J.HALL&COMPANY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 19578 10TH AVENUE N.E. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> POULSBO WA 98370 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> Agency Lid#:91-1461089 <br /> INSURED INSURER A: St.Paul Fire&Marine Insurance Co. <br /> CHS ENGINEERS,LLC INSURER B: <br /> 12507 BEL-RED ROAD#101 INSURER C: <br /> BELLEVUE WA 98005 <br /> INSURER D: <br /> INSURER E <br /> COVERAGES <br /> THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR AWL TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> LTR INSRC DATE(MMIDD/YY( DATE(MM/DO/YY) <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> • <br /> COMMERCIAL GENERAL LIABILITY - <br /> DAMAGE TO RENTED $ <br /> PREMISES(Ea o¢urence) <br /> CLAIMS MADE OCCUR MED.EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. $ <br /> PRO- <br /> POUCY JECT LOC <br /> AUTOMOBILE UABIUTY <br /> COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea accident) $ <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) $ <br /> HIRED AUTOS BODILY INJURY <br /> NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE UABIUTY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR f j CLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE <br /> RETENTION$ W $ <br /> WORKERS COMPENSATION AND LIY <br /> T OTHER <br /> EMPLOYERS'LIABILITY ORy LIMITS <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? - EL DISEASE-EA EMPLOYEE $ <br /> If yes,desaUx under <br /> SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ <br /> OTHER:PROFESSIONAL UABIUTY QP03805033 01/20/05 01/20/06 $2,000,000 EACH CLAIM <br /> A. CLAIMS MADE FORM $2,000,000 AGGREGATE <br /> DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> RE:NORTHEND BASEMENT FLOOD REDUCTION"F"WORK ORDER#UP3189 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 <br /> DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT <br /> CITY OF EVERETT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br /> 3200 CEDAR STREET INSURER,ITS AGENTS OR REPRESENTATIVES. <br /> EVERETT,WA 98201 • <br /> AUTHORIZED REPRESENTATIVE • <br /> Attention: MS.JENIFER GALATAS Matthew L.Copus <br /> ACORD 25(2001/08) 5 Certificate# 37098 ©ACORD CORPORATION 1988 <br />