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ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE Y) <br /> 5/6/2016 <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT CL Central <br /> NAME: <br /> Leavitt Group Northwest PH No Exit 866.298.0570 (A/C ,No):866.688.5709 <br /> PO Box 1127 E-MAIL cicnorthwest@leavitt.coin <br /> ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# _ <br /> Everett WA 98206 INSURER AMutual of Enumclaw 14761 _ <br /> INSURED <br /> INSURER B <br /> Metron And Associates Inc INSURERC: <br /> Thomas E & Shannon C Barry INSURER D <br /> 307 N Olympic Suite 205 INSURERE: <br /> Arlington WA 98223 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:16.17 REVISION NUMBER: <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 /> I 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 /> 1NSR ADDL SUER POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/OD/YYYY) (MMIOD/YYYY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE 15 - 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGETO RENTED 0. <br /> PREMM300, 00ISES(Ea occurrence) S 1 <br /> A CLAIMS-MADE LX I OCCUR X CPP000478205 4/25/2016 4/25/2017 MED EXP(Any one person) S 10,000 <br /> PERSONALS ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE 5 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER; PRODUCTS-COMP/OP AGG $ .. 2,.000,000 <br /> POLICY PRO LOC I J $ <br /> JECT <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (Ea accident) 1,000,000 <br /> A X ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED CPP000478205 4/25/2016 4/25/2017 BODILY INJURY(Peraccident) $ <br /> AUTOS AUTOS <br /> X HIRED AUTOS x NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS (Per accident) <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE S <br /> DEO REtLNTIONS ' $ <br /> A WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY YIN TORY I EMITS X FR <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? N/A 4/25/2016 4/25/2017 <br /> (Mandatory in NH) CPP000478205 E.L.DISEASE-EA.EMPLOYEE $ 1,.000 000 <br /> If yes,describe under WA StopGap OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,00_0 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> City of Everett, its officers, employees and agents is Additional Insured with respects to General <br /> Liability per written contract with Named Insured per form CG2010 04.13. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> City of Everett ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 3200 Cedar Street <br /> Everett, WA 98201 AUTHORIZED REPRESENTATIVE <br /> M zcHaynes/MOHAYNOh�J ����itWd <br /> l I <br /> ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> INS025mmnnsm Thn Ar'.r1Rf mama anrf Innn aro raniefararf marks of Ar:r1RIl <br />