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L <br /> ACORD. CERTIFICATE OF LIABILITY INSURANCE 4/1/2009 DATE(MINDINYTYY) <br /> 3/25/2008 <br /> PRODUCER Lockton Insurance Brokers,LLC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> License#0F15767 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 4275 Executive Square,Suite 600 HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> La Jolla CA 92037 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> (858)587-3100 <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED The KleinfelderGroup,Inc. INSURER A: National Union Fire Ins Co Pittsburgh PA 19445 <br /> 1056887 (see attached named insured schedule) INSURER B: Insurance Company of the State of PA 19429 <br /> 15 Shoreham Place <br /> San Diego CA 92122 INSURE C: Lexington Insurance Company 19437 <br /> INSURER D: <br /> I INSURE E: <br /> COVERAGES KLEGRO3 UR THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING <br /> INSURER(S).AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING <br /> ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADD% POUCY EFFECTIVE POLICY EXPIRATION <br /> LTR INSRD TYPE OF INSURANCE POUCY NUMBER DATE(MM/DD/YY) DATE(MM/ODIYY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> A X COMMERCIAL GENERAL LIABILITY GL 161 7612 4/1/2008 4/1/2009 DAMAGE TO RENTED <br /> PREMISES(Ea occurenee) $ 250,000 <br /> CLAIMS MADE n OCCUR MED EXP(Any one person) S 5,000 _ <br /> X XCU Included PERSONAL&ADV INJURY $ 1,000,000 <br /> X Cross Liab.Applies GENERAL AGGREGATE $ 2,000,000 <br /> GEM_AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> —I POLICY n IJECT El <br /> A AUTOMOBILE LIABILITY CA 826 29 87(AOS) 4/1/2008 4/1/2009 COMBINED SINGLE LIMIT <br /> $ 2,000 000 <br /> A X ANY AUTO CA 826 29 86(OR) 4/1/2008 4/1/2009 (Ea accident) _ r <br /> A ALL OWNED AUTOS CA 826 29 85(MA) 4/1/2008 4/1/2009 BODILY INJURY <br /> _ SCHEDULED AUTOS (Per person) <br /> $ XXXXXXX <br /> X HIRED AUTOS BODILY INJURY <br /> X NON-OWNED AUTOS <br /> (Per accident) <br /> $ XXXXXXX <br /> PROPERTY DAMAGE <br /> $ XXXXXXX <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S XXXXXXX <br /> ANY AUTO NOT APPLICABLE OTHER THAN FA ACC $ XXXXXXX <br /> AUTO ONLY: AGG $ XXXXXXX <br /> FXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ XXXXXXX _ <br /> —I OCCUR n CLAIMS MADE AGGREGATE S XXXXXXX <br /> UMBRELLA NOT APPLICABLE - $ XXXXXXX <br /> DEDUCTIBLE FORM $ XXXXXXX <br /> s _ $ XXXXXXX <br /> A WORKERS COMPENSATION AND WC 159 38 27(CA) 4/1/2008 4/1/2009 X TORY LIMITS OTH- <br /> ER <br /> B EMPLOYERS'LABILITY WC 159 38 28(FL) 4/1/2008 4/1/20091 000 000 <br /> ANY PROPRIETORIPARTNERJEXECUTNE E.L.EACH ACCIDENT $ r r <br /> B OFFICERIMEMBER EXCLUDED? WC 159 38 30(TX) 4/1/2008 4/1/2009 EL.DISEASE-EA EMPLOYEE 1 1,000,000 <br /> B if yet.describe under <br /> SPECIAL PROVISIONS below No WC 159 38 31(AOS) 4/1/2008 4/1/2009 EL DISEASE-POLICY LIMIT $ 1,000,000 <br /> C - OTHER 1205850 4/1/2008 4/1/2009 II,000,000Each Claim' <br /> Professional Liability& SI,000,000 Annual Aggregate <br /> Contractors Pollution Li <br /> DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> Additional Insured status does not apply to Professional Liability coverage. Project:Bond Street&Kromer Ave.City of Everett,its officers,employees and <br /> agents are named as Additional Insuzcd for General and Auto Liability as respects Insured's work perforated on behalf of Certificate Holder.Coverage is primary <br /> for GL where req'd by contract,and any other insurance issued to such Add'l Insured shall apply as excess and noncontributory. • <br /> Site ID:BELLEV.- <br /> CERTIFICATE HOLDER CANCELLATION {M360365] <br /> 2383347 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION <br /> City of Everett DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> I-,n Heather Griffin NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL <br /> ti 3200 Cedar Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> Everett WA 98201 <br /> REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> J <br /> I <br /> ACORD 25(2001/08) For pterion.nyudina the certif.M contest the number fisted In the Produce?section above and client code KLEGR . ORD CORPORATION 1988 <br />