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AWREP® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 2/17/2017 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). CONT PRODUCER r NAMEACT Jim Ledbetter Hall&Company PHONEFAX lac.No360-598-3703 19660 10th Ave NE (A/c,No,EK360-626-2019 ) Poulsbo WA 98370 E-MAIL jledbetter@hallandcompany.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:RLI INSURANCE COMPANY 13056 INSURED 1423 INSURER B:NAVIGATORS INSURANCE COMPANY 42307 CHS Engineers LLC INSURERC: 12507 Bel-Red Road#101 Bellevue WA 98005 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:622092800 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/YYYYI A x COMMERCIAL GENERAL LIABILITY PSB0003085 7/30/2016 7/30/2017 EACH OCCURRENCE $1,000,000 DAMAGE CLAIMS-MADE X OCCUR PREM SESO(Ea occurrence) $1,000,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X PE� LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY PSA0001137 7/30/2016 7/30/2017 (Ee aBINEDDSINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OSVNED SCHEDULED BODILY INJURY(Per accident) $ TS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) A UMBRELLA LIAB X OCCUR PSE0001153 7/30/2016 7/30/2017 EACH OCCURRENCE $2,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED RETENTION$ $ A WORKERS COMPENSATION PSB0003085 7/30/2016 7/30/2017 SPERTATUTE x OTH WA STOP GAP R AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2,000,000 B Professional Liab;Claims Made CM17DPL0574531V 1/20/2017 1/20/2018 $2,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if mom space is required) Certificate holder is/are an Additional Insured on the Commercial General Liability and Auto Liability when required by written contract or agreement regarding activities by or on behalf of the Named Insured.The Commercial General Liability insurance is primary insurance and any other insurance maintained by the Additional Insured shall be excess only and non-contributing with this insurance.A waiver of subrogation applies to the Commercial General Liability,Auto Liability, Umbrella/Excess Liability and Washington Stop Gap/Employers Liability in favor of the Additional Insured. 2017-2018 Survey Roster CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Shaun M.Bridge THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3200 Cedar Street ACCORDANCE WITH THE POLICY PROVISIONS. Everett WA 98201 AUTHORIZED REPRESENTATIVE / � I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD