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ACG CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
<br /> L,..� 02/17/2017
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTNAME:ACT Sky Hamilton
<br /> Brayer Insurance Services,LLC (NC. .EM); 360.424-3000 NE FAX No):866-419-3909
<br /> E-M1501 Parker Way, Suite 108 ADDRESS: sky@brayerinsurance.com
<br /> Mount Vernon,WA 98273 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA: Travelers Indemnity Company 25658
<br /> INSURED INSURER B: Travelers Indemnity Company
<br /> DUANE HARTMAN&ASSOCIATES,INC. INSURER C: Continental Casualty Company
<br /> 16928 WOODINVILLE-REDMOND ROAD#6107 INSURER D:
<br /> WOODINVILLE,WA 98072 INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 00000000-1759291 REVISION NUMBER: 110
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR TYPE OF INSURANCE ADDL'SUBR POLICY EFF POLICY EXP WLIMITS
<br /> LTR INSD VD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY).
<br /> A �( COMMERCIAL GENERAL LIABILITY Y Y 680-3H6853771647 10/22/2016 10/22/2017 EACH OCCURRENCE $ 4,000,000
<br /> DAMAGE TO D
<br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 1,000,000
<br /> MED EXP(Any one person) __$ 2,000,000
<br /> PERSONAL&ADV INJURY $ 2,000,000
<br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> POLICY I xi JELL: L__1 LOC PRODUCTS-COMP/OP AGG $ 4,000,000
<br /> OTHER: -- $
<br /> B AUTOMOBILE LIABILITY Y Y BA7A37139816GRP 10/22/2016 10/22/2017 (Ea aeddeDn SINGLE LIMIT $ 1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY _ AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY _ AUTOS ONLY (Per accident)
<br /> A UMBRELLA LIAB )(, OCCUR CUP-7A371699-16-47 10/22/2016 10/22/2017 EACH OCCURRENCE $ 2,000,000
<br /> X EXCESS LIAB CLAIMS-MADE _AGGREGATE $ 2,000,000
<br /> DED X I RETENTION$ 10000 Following Form $
<br /> A ANDEMPLOYERSEWORKERS LABIIl1TY IN Y 680-3H6853771647 10/22/2016 10/22/2017 X STATUTE EERH Stop Gap
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 2,000,000
<br /> OFFICER/MEMBER EXCLUDED? N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 2,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000
<br /> C Prof Lia-retro 11/93 LSH113801454 10/22/2016 10/22/2017 Per claim Limit 1,000,000
<br /> Aggr Limit 2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Everett Public Works,its subsidiaries,representatives,directors,officers,agents and employees are added as an
<br /> Additional Insured,per written contract.In respect to insured's operations; Primary&Non-Contributory,Waiver of
<br /> Subrogation,and Per Project Aggregate endorsements are included per attached forms.
<br /> **On-Call Surveying Services
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Everett THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> Public Works Department ACCORDANCE WITH THE POLICY PROVISIONS,
<br /> 3200 Cedar Street
<br /> Everett,WA 98201 AUTHORIZE,REPRESENTATIVEATIVE
<br /> t V (SCH)
<br /> 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> Printed by SCH on February 17,2017 at 03:48PM
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