2017/02/01 Council Agenda Packet

DYKEM-1 OP ID:J1 ``�C RE'e CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 01/16/2017 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 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), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. 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 endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME:CT Kevin G.Rabourn The Rabourn Company,Inc. PHONE 688- 425- 8600 FAX 11400 S.E.8th Street,STE 220 (tvc.No.Ext►: (Arc,No):425-688-9251 Bellevue,WA 98004 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Continental Casualty Company INSURED Dykeman, Inc. INSURER B 1716 W. Marine View Drive INSURER C: Everett,WA 98201-2098 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY 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. INSR TYPE OF INSURANCE AWL SUBR POLICY EFF POLICY EXP INSR WVD POLICY NUMBER JMM/DD/YYYYJ(MM/DD/YYYYL LIMITS GENERAL LIABIUY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY 2083209360 03/01/2016 03/0112017 DAMAGE TO RENTED PREMISES(Ea occurrence) $ 300,000 CLAIMS-MADE X OCCUR THERABOURNCOMPANYMAKESNO MED EXP(Any one person} $ 10,000 COMPLY WITHREPRESENIATIONTHATTHESECOVERAGES PERSONAL&ADV INJURY $ 1,000,000 NSURANCE OR INDEMNITY REQUIREMENTS GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: IN ANY CONTRACT.WR TTEN ORAL OR IMPLIR FULLY SATISFY ANY ODUCTS-COMP/OP AGG $ 2,000,000 7 POLICY F joT LOC • $ AUTOMOBILE LIABILITY CO aBBIN DtSINGLE LIMIT 1,000,000 A ANY AUTO 2083209360 03/01/2016 03/01/2017 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED accident(Per BODILY INJURY $ AUTOS _AUTOS ) X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS JPER ACCIDENT) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE _ $ DED RETENTION$WORKERS COMPENSATION WC $ TH- AND EMPLOYERS LIABILITY TORY LIMITSI X TU- OFR A OFFICER/MEMBER XRLNPROPRIETOR/PARTNER/EXECUTIVE Y/N N/A 2083209360 03/01/2016 03/01/2017 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory In NH) WA STOP GAP EL DISEASE-EA EMPLOYEE $ 1,000,000 if es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMrr $ 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) The City of Everett and its officers, employees and agents are Primary Additional Insured under the General Liability but only to the extent provided by SB-146932-E(6/11) . Form applies to the General Liability. RE: Evergreen Branch Library Expansion, job #2016-027 CERTIFICATE HOLDER CANCELLATION CITYO55 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 3103 Cedar Street Everett,WA 98201 AUTHORIZED REPRESENTATIVE • Q ©1988-2010 ACOR P CORPORATION. All rights reserved. nrnon ne 0111enmel