ASPI Land Surveying & Planning 3/1/2017

AL? CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 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 (AHO/C.No.ExtI: (360)794-7665 (A//C,No):(425)788-7070 15222 Woods Creek Rd E-MAIL @ ADDRESS: non ag g a filerinsurance.com _ INSURER(S)AFFORDING COVERAGE NAIC 8 Monroe WA 98272-1511 INSURERA:OhiO Security Ins Co ; 24082 INSURED INSURER B:Ohio Casualty Insurance Co 24074 Harmsen & Associates Inc, Fakkema and Kingma Inc and INSURER C: Alpha Subdivision Pros Inc, A Harmsen Subsidiary INSURERD: PO Box 516 INSURER E: Monroe WA 98272-0516 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1681913690 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) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE RENTED $ CLAIMS-MADE OCCUR PREM SESO(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ _ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS X BAS55194441 9/1/2016 9/1/2017 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) BACEE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 B x EXCESS LIAB CLAIMS-MADE I AGGREGATE $ 1,000,000 DED RETENTION$ X ES055194441 9/1/2016 9/1/2017 $ WAXIMIXXSKOEXIMOW PER OTH- XIXX MPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Certificate Holder is included as an additional insured if required by written contract or written agreement per form CA 88 10 01 10. 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 REPRESENTATIVE Angela Gagnon/ANGELA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)