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1 • <br /> ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DOM(YY) <br /> 6/17/2008 <br /> PRODUCER (425) 357-1555 FAX: (425) 357-1551 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> InsuranceTek Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> CA Licence #0E32789 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> 13300 Bothell-Evrt Hwy #6129 <br /> Mill Creek WA 98012 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A:Western Natn'1 Assurance Company <br /> Cascade Materials & Aggregate LLC INSURER B: <br /> INSURER C: <br /> PO Box 1716 INSURER 0: _ <br /> Snohomish WA 98291 INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY <br /> REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, <br /> THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br /> AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADD'I POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY), DATEAMM/DD/YYI LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE s 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 <br /> PREMISES fEa occurrence) <br /> A CLAIMS MADE X OCCUR CP300008548 12/07/2007 12/07/2008 MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG_$ 2,000,000 <br /> "J POLICY n ( <br /> ECT I LOC <br /> AUTOMOBILE UABIUTY <br /> COMBINED SINGLE LIMIT $ 1,000,000 <br /> X ANY AUTO (Ea accident) <br /> A ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS CA300009081 12/7/2007 12/7/2008 (Per person) <br /> X HIRED AUTOS BODILY INJURY <br /> X NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO <br /> OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> • <br /> EXCESS/UMBRELLA LIABILITY <br /> EACH OCCURRENCE $ - <br /> OCCUR CLAIMS MADE AGGREGATE <br /> DEDUCTIBLE S <br /> RETENTION $ _ $ <br /> A WORKERS COMPENSATION AND CP300008548 12/7/2007 12/7/2008 WCSTATU- X OTH- <br /> EMPLOYERS'LIABILITY TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE WASHINGTON STOP GAP E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> EL DISEASE-EA EMPLOYEE S 1,000,000 <br /> If yes,describe under <br /> SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> The certificate holder is added as additional insured per form CG2033 07/04 attached. With respects to the City of <br /> Everett, biosolids haul and applicaiton contract as their interest may appear. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> City of Everett EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> Utilities Division, WPCF 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT <br /> 3200 Cedar Street <br /> Everett, WA 98201 FAILURE TO DO SO SHALL IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE <br /> INSURER,ITS AGENTS OR REPRESENTATIVES. <br /> 0 AUTHORIZED REPRESENTATIVE <br /> w Vicki Boser/KANE <br /> ACORD 25(2001/08) ©ACORD CORPORATION 1988 <br />