2008/10/15 Council Agenda Packet

FROM : PORT GARDNER FIRE WORKS CO. INC FAX NO. : 425 -258-6160 Oct. 08 2028 11:57AM P1 V R.S:r.�tiC.Nn,;trnvr.r v.l•:ti.:n•r:�t:/r:rniwn:n•/t G •G • • :.r r....o- PRODUCER THIS CERTIFICATE IS ISSUED AS A MAYI FR OF INFORMATION ONLY AND Debbie Merlin CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CFRTIFICATE Combined Spe4laltios International.Inc. DOES NO I AMEND,EXTEND OR LATER THE COVERAGE AFFORDED BY THE 205 San Marin Drive,Suite 5 POLICIES BELOW. Novato California 94945 INSURERS AI-FORDING COVERAGE INSURER A:Underwriters,Lloyds of London INSURED INSURER)3: Part Gardner Fireworks Co.,Inc INSURER C: 1819 Hoyt Avenue Everett WashIngtoh 98201 INSI IRFR D' COVERAGES THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NAMED INSURED ABOVE FOR THE 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 INCLUDING,BUT NOT LIMITED TO THOSE FOLLOWING;LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.ADDITIONAL CONDITIONS AND EXCLUSIONS:1)THE INSURANCE EVIDENCED BY THIS CERTIFICATE IS LIABILITY INSURANCE ONLY,IT 1S NOTA BOND OR ANY FORM OF SURETY AGAINST WHICH SOMEONE OTHER AN INSURED"MAY ASSERT A CLAIM OR BRING ANY ACTION,SUBJECT TO POLICY TERMS.CONDITIONS,DEFINITIONS AND EXCLUSIONS THE INSURANCE ONLY INDEMNIFIES AN INSURED AGAINST CERTAIN LEGAL LIABILITY.2) THE INSURANCE DOES NOT COVER CLAIMS FOR BODILY INJURY OR PROPERTY DAMAGE OF THE NAMED INSURED'S SHOOTER(S)ASSISTANT(S)OR ANY OTHER PERSONS)INCLUDING ANY VOLUTEER(S)PARTICIPATING IN ANY WAY IN ANY DISPLAY OR SPECIAL EFFECT PERFORMED OR EXECUTED BY THE NAMED INSURED.8)COVERAGE DOES NOT APPLY TO CLAIMS FOR BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF THE INSURED'S FAILURE TO FOLLOW NFPA OR OTHER APPLICABLE REQUIREMENTS,LAWS OR RECOMMENDATIONS,INCLUDING THOSE RELATING TO POST DISPLAY OR SPECIAL EFFECT SEARCHES OR CLEAN UP. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD 111) DATE(AAM/DA/YY) A GENERAL LIABILITY 1212142326/008 July 15,2008 July 15,2009 EACH ACCIDENT $1,000,000 CLAIMS MADE MEDICAL EXP $5,000 (any ono parson) FIRE LEGAL LIABILITY $50,000 GENERAL AGGREGATE $2,000,000 PRODUCTS-COMP/OPS AGG $1,000.000 AUTOMOBILE LIABiLrLY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ANY OWNED AUTO BODILY INJURY $ SCHEDULED AUTOS (PCI person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ 1 r — (Person) _ EXCESS LIABILITY EACH ACCIDENT $ FOLLOWING FORM 'AGGREGATE $ WORKERS COMPENSATION WC STATU- OTHER AND TORY LIMITS EMPLOYERS'LIABILITY E.L.EACH ACCIDENT _$ �E L.DISEASE-EA EMPLOYER $ EL DISEASE-POLICYUMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Jackson High School:Everett School District#2 and City of Everett.it's atrlcers,elected officials,agents$employees are Additional Insured as respects the October 17. 2008 FlroWorks Display at EVCrett Memorial Stadium,Everett,WA CERTIFICATE HOLDER CANCELLATION —Jackson High School SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE 1508 138th Street SE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE "MIII Creek,WA 98012 CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES _ •i e- a • S.eTA v v `�