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J ACORD CERTIFICATE OF LIABILITY INSURANCEDAT <br /> 110-27-2009 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> NORTHEA AGENCIES INC/PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 210500 P: (866) 467-8730 F: (800) 308-5459 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> 301 WOODS PARK DRIVE <br /> CLINTON NY 13323 INSURERS AFFORDING COVERAGE <br /> INSURED INSURER A:Hartford Casualty Ins Co <br /> INSURER B: <br /> ' JACKAREN CONSULTING LLC INSURER C: <br /> 4847 152ND PL. S .E. INSURER D: <br /> BELLEVUE WA 98006 • 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 <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 /> LTR I TYPE OF INSURANCE I POLICY NUMBER I D TE MM/DDIYY) I PATE(MMPIDDTmN I_ LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE k1, 000, 000 <br /> A COMMERCIAL GENERAL LIABILITY 01 SBA A10279 12/13/09 12/13/10 FIRE DAMAGE(Any one fire) s300,000 <br /> CLAIMS MADE I X I OCCUR MED EXP(Any one person) $10, 000 <br /> X General Liab PERSONAL&ADV INJURY $1, 000, 000 <br /> .I GENERAL AGGREGATE I s2 , 000, 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S2 , 000, 000 <br /> POLICY I I JECT I X I LOC _ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea accident) $ <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS ///��� (f I (Per person) $ <br /> HIRED AUTOS Y)YI ) U /UTA" 03).) 1 BODILY INJURY <br /> NON-OWNED AUTOS leer accident) $ <br /> PROPERTY DAMAGE 1$ <br /> (Per accident) <br /> GARAGE LIABILITY I AUTO ONLY-EA ACCIDENT I$ <br /> ANY AUTO Vc� I )U EA ACC $ <br /> OTHER THAN <br /> AUTO ONLY: AGG $ <br /> EXCESS LIABILITY EACH OCCURRENCE $ <br /> OCCUR I I CLAIMS MADE J} ^� AGGREGATE S <br /> I I$ <br /> DEDUCTIBLE <br /> RETENTION $ 9 $ <br /> WORKERS COMPENSATION AND I TORY LIMITS I IO R <br /> EMPLOYERS'LIABILITY <br /> E.L.EACH ACCIDENT $ <br /> EL.DISEASE-EA EMPLOYEE $ <br /> E.L.DISEASE-POLICY LIMIT $ <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> Those usual to the Insured' s Operations . The City of Everett is listed as <br /> additional insured per the Business Liability Coverage form SS 00 08 , attahed <br /> to the policy. <br /> CERTIFICATE HOLDER X ADDITIONAL INSURED;INSURER LETTER: A CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> The City of Everett 30 DAYS WRITTEN NOTICE(10 DAYS FOR NON-PAYMENT)TO THE CERTIFICATE <br /> Attn: Tom Fuchs HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO <br /> OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> 3101 Cedar Street REPRESENTATIVES. <br /> Everett, WA 98201 <br /> AUTHOR! 1 7 J <br /> 148 � /J <br /> ACORD 25-S (7/97) °ACORD CORPORATION 1988 <br />