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DATE <br />ACORD. CERTIFICATE OF LIABILITY INSURANCE 04129/10D <br />PRooucE!R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Kibble & Prentice, a USI Co. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />B 370 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />P.Q. ox <br />Seattle, WA 98111 <br />206 441-6300 <br />INSURED <br />Cosmopolitan Engineering Group, Inc. <br />711 Pacific Avenue <br />Tacoma, WA 98402 <br />INSURERS AFFORDING COVERAGE I NAIC # <br />INSURER A: Charter Oak Fire Insurance Company 25615 <br />INSURER B: U.S. Specialty Insurance Company29599 <br />INSURERc: Travelers Indemnity Co. of America d25666 <br />INSURER D: <br />INSURER E: <br />COVERAGES <br />LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ISSUED OR <br />THE POLICIES OF INSURANCE <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE <br />ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />/NSR DD' POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br />TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD <br />LTR NSR <br />68089451-418 03130/10 03/30/11 EACH OCCURRENCE $1 000 000 <br />GENERAL LIABILITY <br />A DAMAGE ETO RENTED <br />$1 000 000 <br />rr ^ <br />X COMMERCIAL GENERAL LIABILITY <br />MED EXP (Any one person) $10 000 <br />a <br />CLAIMS MADE OCCUR <br />PERSONAL & ADV INJURY $1 000 000 <br />GENERAL AGGREGATE $2.000,0"n <br />PRODUCTS - COMP/OP AGG $2 000 OOO <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY X JECT LOC <br />BA89451-511 03130/10 03130/11 COMBINED SINGLE LIMIT $1,000,000 <br />C AUTOMOBILE LIABILITY (Ea accident) <br />ANY AUTO <br />ALL OWNED AUTOS BODILY INJURY $ <br />(Per person) <br />SCHEDULED AUTOS <br />X HIRED AUTOS BODILY INJURY $ <br />(Per accident) <br />X NON -OWNED AUTOS <br />PROPERTY DAMAGE $ <br />(Per accident) <br />AUTO ONLY - EA ACCIDENT $ <br />GARAGE LIABILITY <br />EA ACC $ <br />OTHER THAN _ <br />ANY AUTO AUTO ONLY: AGG $ <br />EACH OCCURRENCE $ <br />EXCESS/UMBRELLA LIABILITY <br />OCCUR El CLAIMS MADE AGGREGATE $ <br />DEDUCTIBLE <br />RETENTION $ ACS AT �(TH- <br />68089451-418 03/30/10 03/30/11 <br />A WORKERS COMPENSATION AND <br />E.L. EACH ACCIDENT $1 000,000 <br />EMPLOYERS' LIABILITY (WA Stop Gap) <br />ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $1,000,000 <br />OFFICEEXCLUDED? <br />E.L. DISEASE - POLICY LIMIT $1,000,000 <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />USS1020237 03/25/10 03/25/11 $1,000,000 per claim <br />B OTHER Professional <br />$2,000,000 annl aggr. <br />Liability <br />OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />DESCRIPTION <br />RE:Recovered Water Outfall <br />The City of Everett, its officers, employees, and agents are named named <br />as an Additional Insured on the General Liability and Business Automobile <br />Liability Policy, with respects to operations of the Named Insured. <br />CANCELLATION <br />CERTIFICATE HOLDER <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _45_ DAYS WRITTEN <br />City of Everett <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO $0 SHALL <br />Attn:Jenifer Galatas <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />3200 Cedar Street <br />Everett, WA 98201 REPRESENTATIVES. <br />AU�T`HORIZED REPRESENTATIVE <br />MZBJU ©ACORD CORPORATION 1988 <br />ACORD 25 (2001108) 1 of 2 #S4343663/M4343662 <br />