2008/04/30 Council Agenda Packet

U ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) PRODUCER Lockton Companies, LLC Denver 8/31/200$ 4/18/2008 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 8110 E Union Avenue ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Suite 700 HOLDER. THIS CERTIFICATE DOES NOT AMEND, Denver CO 80237 EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (303)414-6000 INSURERS AFFORDING COVERAGE NAIC INSURED MWH Americas, Inc. It 1052589 (Formerly: Montgomery Watson Americas, Inc.) INSURER A: Traveler's Indemni Company 175 W. Jackson Blvd., Suite 1800 INSURER B: Traveler's Prop. Cas. Co. of Americ Chicago, IL 60604 INSURER C: St. Paul Fire &Marine Ins. Co. INSURER D: LEXINGTON INSURANCE COMPANY COVERAGES MWHGL01 VX INSURER E: THISCERTIFICATEOFINSURANCE GOES NOT CONSTITUTEACONTRACT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO BETWEEN THE ISSUING INSURERS ,AUTHORIZED REPRESENTATNE OR PRODUCER AND THE CERTIFICATE HOLDER. THE ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID INSR DD' CLAIMS. LTR NSRE TYPE OF INSURANCE POLICY NUMBER OLICYMM/DDM(E POLICY MM/DD� N LIMITS GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY VTC2KC05643B071IND07 8/31/2007 8/31/200$ EACH OCCURRENCE 1 000 000 OAMAGE TO RENTED CLAIMS MADE �X OCCUR PREMISES Ea occurence $ 500,000 MED EXP (Any one person) $ Excluded PERSONAL S ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PRO-- LOC PRODUCTS - COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY B X ANY AUTO VTC2JCAP5643B083TIL07 Ea aCOMBINEDISINGLE LIMIT $ 1,000,000 8/31/2007 8/31/2008 ( ) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ XXXXXXX X HIRED AUTOS X NON-OWNED AUTOS BODILY INJURY $ XXXXXXX (Per accident) PROPERTY DAMAGE $ (Per accident) xyxXXX}{ GARAGE LIABILITY ANY AUTO NOT APPLICABLE AUTO ONLY - EA ACCIDENT $ J{j{xxxxx OTHER THAN EA ACC $ XXXXXXX AUTO ONLY: EXCESS/UMBRELLA LIABILITY AGG $ XXXXXXX C X OCCUR CLAIMS MADE QK08300277 EACH OCCURRENCE $ 25,000,000 8/31/2007 8/31/200$ AGGREGATE $ 25,000,000 DEDUCTIBLE Xn UMBRELLA FORM $ XXXXXXX RETENTION $ $ XXXXXXX B WORKERS COMPENSATION AND VTC2JUB5026LI8107 (AOS) EMPLOYERS' LIABILITY $ XXXXX}C}C 8/31/2007 8/31/200$ X TORY LIMITS OTH B ANY PROPRIETOR/PARTNER/EXECUTIVE VTRJ-UB5643BO9507 B OFFICERIMEMBER EXCLUDED? ER 8/31/2007 8/31/2008 E.L. EACH ACCIDENT $ 1,000,000 (AZ,MA,OR,WI) If yes, describe under NO E.L. DISEASE - EA EMPLOYE $ 1,000,000 isPECIAL PROVISIONS below OTHER E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Professional Liability 5766131 10/1/2007 10/1/2008 $10,000,000 each claim $10,000,000 aggregate DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE: Sultan River Diversion Dam PSA Contract. Assess the current condition of the diversion dam and associated equipment. CERTIFICATE HOLDER CANCELLATION [M36412] 3630211 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Everett DATE THEREOF, THE ISSUING INSURER WILLX}]Q1iiC(iMAIL 60 Engineering and Public Services Department DAYS WRITTEN Attn: Jay Magil, P.E. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,.I$1MDX*XX0iD[0a0i6)MX 3200 Cedar Street 30X1XI41817B�JGX� Everett, WA 98201 �• AUTHO 0 PRESENTATIVE 1171,-A C r+v ACORD 25 (2001/08) For questions regarding this certificate, tooted the number listed In the 'Pro ducee section abov and specify the client code 'MW HGL01'. ACORD CORPORATION 1988 r t3 U