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6920 SEAWAY BLVD 2018-01-01 MF Import
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6920 SEAWAY BLVD 2018-01-01 MF Import
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Last modified
11/4/2019 3:25:24 PM
Creation date
3/9/2017 5:32:17 AM
Metadata
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Template:
Address Document
Street Name
SEAWAY BLVD
Street Number
6920
Imported From Microfiche
Yes
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• . <br /> CXOfC1 . . <br /> ,..� ..� .�.�55 a .��. , � l5 0 l'/ L5 <br /> BRUNNI.COLBATH, ING Dy►AN1ES AiiORDIMG COYERACES <br /> 201 I PACIFIC BLDG., 720 iHIRD A ��'•�� A }�Z�D ACCIDfNf S INDII�49ITY 0p. <br /> SEATTI..� WA 98104 JUL 18 1984 ����p <br /> TEL:(20b)625-1123 ��.� <br /> '^–'–"�"'•---y-�•- ._. w�cA B CEKTRAL NATIONAL INSURANCE C0. <br /> _........... <br /> M�Y[ 41D ��OFf55 CI INSUAC[I 1 � V�'�—�RE /� <br /> �GW��IIY � _ <br /> JOHN FLUI� t�1FG. OJ. , INC. Pub!ic Waks Dep►. «ncw � <br /> P.O. BOX C�9090 CMw�Hr <br /> EVEREIT, WASHINGII�:I 93206 ���,�n � <br /> to�w�u�r c <br /> �lrne L <br /> T��s is lo<ert�ty Mat pohce�ol nsw��ce MifM Geb.�ave Lwen issued I�V�e insureE rymed a�we�M are rn lorte at ttns time. hotr�Ri�taMm�anr rrowrement.term n�erqrppn <br /> o�Inr Conir�ct p atMer OOGum�nl MtT�esplct to M�K�Mr�urLlciY rtNr�e nauM v rtu�pnt�n.the nsur�nc<o1brOM Dy t�e poKxs xxnoeC nnrm is w�ORct to aM tM <br /> Mms,e•c�usions�nE conaA�ons ol sVc�pWcies. <br /> mMo•a� ��«oriNsu�.�nct rroiKrnuui3ta m�kr <br /> lfiMls ul L CiMt M uu 1 <br /> tllilP fif-0N/.iqM1 D�t[ I�.w �gGH1.�tf <br /> OCf UN�fMf� <br /> GEME11111 LUlKITY <br /> A � 52 CLI2M}C 0300 4/1/85 ����VIh)UNv , , <br /> (puoq(N(n5�vi r(�wu <br /> Ovp!M5IS1�f4�tY]MS � Mpl'[MIYp�YpGC 4 S <br /> �I�YlOS104 �ND COIL��'Sf /� ��� <br /> HAIANp � <br /> OuM1pfRGPo)UNO N�I4RD � — — <br /> L�'�H�OiN:iSCOMPlf1f0 <br /> � �i�Y���'�ONS M�l�RO N(rO�IYIN/pN�INO <br /> Y S�M1'NYtU�I WSUH4NCE 4'{�'IPiYP1MlO1 { �oo� 1 �001 <br /> �y�, r;r+�.n r„au ruoncnrv [oyann� <br /> ^'yI GWG[ <br /> {� iNDCVtM1U[41 COHiPA[i�M: ��� � <br /> .QtiQ ,��«�., ���,��H. 500 <br /> r�rrson�i rv�uWv s + <br /> �UT0710&LE lU1dLITY � tK�onrw;uar <br /> LJ i�wrpl��lac�.vl iGuu �EKMCIPlOhi ti <br /> ��'i�' L+lilH �11G ���.����,w. s <br /> [_] ��NVIf) � � IUCHACCIUlN�I <br /> � pl�p(P1YC�NI@ ) <br /> ��a10 <br /> 1'� HOD1L Y IM�UBY�Rp <br /> u 40N4JWhIL t'NUPINIYU4NILI � <br /> CUMH�h�p <br /> E%CESS LUSIUTY <br /> �] 1 p tqmiv iw�u�rr•no <br /> B V`� �14PHlll� lOMl C(�U QQ g5 1� 4�1�05 pN()[`lFIY[1A4�G1 Slf��Of fl����� <br /> � OI��InIwNUMP{Rlln <br /> ��.VM COYNqF 0 <br /> WOPKERS'COMPENSATION <br /> st�iotow <br /> anA <br /> EMFLOYERS'LIABILI7Y ' <br /> ..•. <br /> OTHER <br /> I <br /> 11 <br /> U�[CI<ipiqN OI oPlflAIpMSLtKAilON5NC1�Kl6 <br /> ,1s respects Retention Pond to Ue constructed by .lohn Fluke Nfg. Co. , Ine. Por new facility <br /> ac 6920 Seaway Blvd. , Hverett, Washing[on, the City of Everett is an additional insured <br /> effecr_ive Ju7Y lb, 1984 <br /> GncNlation: Should any ot the ahove descnbed pohaes be cancelled belore the erpiration date ihereof. Ihe �ssmn4 com- <br /> pany will endeavor to mail 10— days written notice to the below named certdicate holder, b�t I�dure �o <br /> mad such noiice snall impose no obhgaLun or I�abihty ot any kmd upon ihe coinpany. <br /> rM�MC�M)�[WltlSSO�flqlilL�iElqtCN.R Pot. EFF: 4/1/S4 <br /> � Larry Crawford oer[ rssu�o_Crrr�__. +fi_�r� Fff 11�1G/Ak <br /> engineering Dept. BR[R�IIVI-COLBATli, IlVC. <br /> City oE Everett r� ' - ' <br /> 3200 Cedar S[. —�' "'1'��nn r`nr�scnr.rN���� <br /> Everett, Wa. 93201 <br /> _ Donald W. Bxinmi <br /> w��.��: ,�, <br />
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