GeoTest Services, Inc. 2/10/2017

AC� DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 2/7/2017 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 CONTACT Sandi Jones NAME: Rice Insurance LLC (A/C.PHONE (360)734-1161(360)734-1161 (A/C,No): (360)734-1173 1400 Broadway ADMDRIESS:sandi@riceinsurance.com P.O. Box 639 INSURER(S)AFFORDING COVERAGE NAIC# Bellingham WA 98227 INSURER A:Hartford Casualty 29424 INSURED INSURER B:Hartford Ins Co of Midwest 37478 GeoTest Services, Inc. INSURERC:Hudson Specialty Insurance Co 741 Marine Dr INSURER D: INSURER E: Bellingham WA 98225 INSURER F: COVERAGES CERTIFICATE NUMBER:CL163333954 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER IMM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _$ 2,000,000 A _ CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES ,000 PREMISES(Ea occurrence) $ _ X Y 52SBAPS1329 4/2/2016 4/2/2017 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY X CrJERLOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) B X ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED 52UECPE6011 4/2/2016 4/2/2017 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS _ AUTOS (Per accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 8,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 8,000,000 DED X RETENTIONS 10,000 52SBAPS1329 4/2/2016 4/2/2017 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE X ER ANY PROPRIETOR/PARTNER/EXECUTIVE WA Stop Gap E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N I A A (Mandatory in NH) 52SBAPS1329 4/2/2016 4/2/2017 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C Professional Liability PKC103856 4/2/2016 4/2/2017 Limit 2,000,000 Pollution Liability Limit 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate Holder is Additional Insured as respects to attached form SS00080405 for General Liability. Coverage is Primary and Non Contributory and the Waiver of Subrogation is included. Professional/Pollution additional insured form ESB-COM-1108-279 is included and the Waiver of Subrogation form ESB-COM-1108-228. Auto additional insured per form HA9916 0312; Primary/Non Contributory applies. Waiver of Subrogation per form HA9913 0187. Pollution/Professional Addtional Insured form ENO111 attached along with the Primary and Non Contributory form EN01189 CERTIFICATE HOLDER CANCELLATION _ _ MKangas@everettwa.gov SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3200 Cedar Street ACCORDANCE WITH THE POLICY PROVISIONS. Everett, WA 98201 AUTHORIZED REPRESENTATIVE Troy Haskell/SAN ` Q- -( ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 0014011