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'ACCORD• CERTIFICATE OF LIABILITY INSURANCE DATE D/YYYY) 12/12/2016 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 POUCIES 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). PRODUCER CONTACT NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY PHONE FAX HOME OFFICE: P.O.BOX 328 (A/C,No,Ext):888-333-4949 (A/C,No):507-446-4664 OWATONNA,MN 55060 ADDRESS:CLI ENTCONTACTCENTER(cr�FEDINS.COM INSURERS)AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 358-493-5 INSURER B: SWICKARD CORPORATION INSURER C: 25035 SW PARKWAY AVE WILSONVILLE,OR 97070 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:6 REVISION NUMBER:0 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 NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD IMMIDDIYYYY) (MMIDDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $500,000 DAMAGE TO RENTD CLAIMS-MADE X OCCUR PREMISES Ea occurrence) $100'000 MED EXP(Any one person) EXCLUDED A N N 9185987 04/30/2016 04/30/2017 PERSONAL&ADV INJURY $500,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $1,000,000 POLICY PRO-JECT LOC PRODUCTS•COMPIOP AGO $1,000,000 X PRO- OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED AUTOS _AUTOS BODILY INJURY(Per accident) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $10,000,000 A EXCESS LIAB CLAIMS-MADE N N 9185988 04/30/2016 04/30/2017 AGGREGATE DED RETENTION PER STATUTE OER AMB EMPLOYERS'LIABILITY y/N ANY PROPRIETORIPARTN ERIEXECUTIVEE.L.EACH ACCIDENT $1,000,000 A OFFICER/MEMBER EXCLUDED? I NIA N 9185987 04/30/2016 04/30/2017 (Mandatory in NH) E.L.DISEASE•EA EMPLOYEE $1,000,000 It yes,describe under E.L DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below $1,000,000 AUTO DEALER LIABILITY Y N 9185987 04/30/2016 04/30/2017 AUTO LIAB-EA ACCIDENT $500,000 GENERAL LIABILITY A -EACH ACCIDENT $500,000 -AGGREGATE $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) STOP-GAP (EMPLOYER'S LIABILITY) COVERED STATE(S) WA CERTHOLDER IS ADDITIONAL INSURED UNDER THE GARAGE LIABILITY CERTIFICATE HOLDER CANCELLATION 358-493-5 6 0 CITY OF EVERETT SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE 2930 WETMORE AVE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EVERETT,WA 98201-4067 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C��r��'_171-" © 1988-20142ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD