ASPI Land Surveying & Planning 3/1/2017

DATE(MM/DD/YYYY) A�o® CERTIFICATE OF LIABILITY INSURANCE 8/19/2016 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 e An la Gagnon NAME: g g C Don Filer Agency (PHONE o.Ext): (360)794-7665 FAX(A/C,No)'(425)788-7070 15222 Woods Creek Rd E-MAIL ADDRESS: g a agnon@filerinsurance.com INSURER(S)AFFORDING COVERAGE NAIL# Monroe WA 98272-1511 INSURER A:Hartford Fire Ins Co _ 19682 _ INSURED INSURER B:Hartford Casualty Ins Co .29424 Harmsen & Associates Inc, Fakkema & Kingma Inc and INSURER C: Alpha Subdivision Pros Inc, A Harmsen Subsidiary INSURERD: PO Box 516 INSURER E: Monroe WA 98272 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1681913694 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 (MM/DD/YYYY),(MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE RENTED A CLAIMS-MADE X OCCUR PREM SESO(Ea occurrence) $ 300,000 X Y 52UUNJR3001 9/1/2016 9/1/2017 MED EXP(Any one person) $ 10,000 i PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X !pi LOC PRODUCTS-COMP/OP AGG_$ 2,000,000 OTHER: Stopgap $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS '` AUTOS (Per accident) I $ X UMBRELLA LIAB i OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAB CLAIMS-MADEI AGGREGATE $ 1,000,000 DEC1X RETENTION$ 10,000 X 52XHUJR2868 9/1/2016 9/1/2017 $ I (EMPLOYERS'LIAB Y/N STATUTE EERH ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER anda ory in NH) EXCLUDED? N/A A M52UUNJR3001 9/1/2016 9/1/2017 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS belowI E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Those usual to insured operations. Certificate holder is included as an additional insured per form HG 00 01 06 05. Coverage is Primary and Non-Contributory. Waiver of Subrogation, Per Project Aggregate, Products Completed Operations included. CERTIFICATE HOLDER CANCELLATION sbridge@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 St ACCORDANCE WITH THE POLICY PROVISIONS. Everett, WA 98201 . AUTHORIZED REPRESENTATIVECII ,+^� Angela Gagnon/ANGELA =' ^^- -" - ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD NS025(201401)