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<br /> .,°► CERTIFICATE OF LIABILITY INSURANCE DATO6 0/20/2WY)
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES =
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED 2
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. co
<br /> IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to m
<br /> the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the
<br /> certificate holder In lieu of such endorsement(s). 2
<br /> a>
<br /> PRODUCER CONTACT
<br /> NAME
<br /> 'D
<br /> Aon Risk Insurance Services West, Inc. PHONE (866) 283-7122 FAX (847) 953-5390 m
<br /> Los Angeles CA office (NC.No.Ext): (A/C.No.): -a
<br /> 707 Wilshire BoulevardE-MAIL 2
<br /> S • uite 2600 ADDRESS:
<br /> Los Angeles CA 90017-0460 USA INSURER(S)AFFORDINGCOVERAGE NAIC#
<br /> INSURED INSURER At National Union Fire Ins Co of Pittsburgh 19445
<br /> Tetra Tech, Inc. INSURER B: Insurance Company of the State of PA 19429
<br /> 1420 Fifth Avenue, Suite 600 •Seattle WA 98101 USA INSURER c; Chartis Specialty Insurance Company 26883
<br /> INSURER o: Lexington Insurance Company 19437
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:570046172494 REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCHPOLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested
<br /> INRADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTTYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYYYYYL�J{MMIDDDIlYYYYYY``��
<br /> A GENERAL LIABILITY GL4871170 1U/01/20111.0/U1/LO i EACH OCCURRENCE $1,000,000
<br /> _ DAMAGE TO RENTED $1,000,000
<br /> X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence)
<br /> CLAIMS-MADE X❑OCCUR MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000 rn
<br /> GENERAL AGGREGATE $2,000,000 N
<br /> t`
<br /> GENII AGGREGATE LIMIT APPLIESPER: PRODUCTS-COMP/OP AGG $2,000,000 v
<br /> �PRO- o
<br /> —I POLICY I"' L�lECT Fq LOC
<br /> •
<br /> A AUTOMOBILE LIABILITY CA 170 73 88 10/01/2011 10/01/2012 COMBINED SINGLE LIMIT $2,000,000
<br /> (Ea accident) ..
<br /> BODILY INJURY(Per person) O
<br /> )( ANY AUTO Z
<br /> ALL OWNED —SCHEDULED BODILY INJURY(Per accident) rU
<br /> AUTOS _ AUTOS PROPERTY DAMAGE V
<br /> X HIRED AUTOS X NON-OWNED (Per accident) L-
<br /> _AUTOS , • 'C
<br /> a)
<br /> D X UMBRELLALIAB X OCCUR TH1100027 10/01/2011 10/01/2012 EACH OCCURRENCE $5,000,000 C)
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE•
<br /> $5,000,000
<br /> DED RETENTION
<br /> B WORKERS COMPENSATION AND wc020635697 10/01/2011 10/01/2012 x wesT TS IER
<br /> B TORY EMPLOYERS'LIABILITY YIN WC20635698 10/01/2011 10/01/2012
<br /> B ANY PROPRIETOR/PARTNER I EXECUTIVE I N I N/A WC20635699 10/01/201110/01/2012 E.L.EACH ACCIDENT $1,000,000
<br /> (Mandatory in NH)ER IXCLUDED9 E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> (Mandatory in
<br /> If yes,describe under E.L.DISEASE-POLICY LIMIT $1,000,000_
<br /> DESCRIPTION OF OPERATIONS below
<br /> c Contractor Prof COPS1952583 10/01/2011 10/01/2012 Each Claim $5,000,000—
<br /> Prof/Poll Liab • Aggregate $5,000,000
<br /> Oic
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) rt`-
<br /> Project Start Date: May 2012; Project End Date: Until completion. RE: city of Everett Short circuit Report (#1350H EANDC).
<br /> City of Everett and its officers, employees and agents are included as Additional Insured as required by written contract, but _ •
<br /> limited to the operations of the Insured under said contract, per the applicable endorsement with respect to the General
<br /> Liability and Automobile Liability policies. General Liability policy evidenced herein is primary to other insurance available ---",L1-
<br /> to an additional insured, but only to the extent required by written contract with the insured. General Liability, Automobile
<br /> Liability and workers Compensation described policies be cancelled before the expiration date thereof, the policy.provisions
<br /> will govern how notice of cancellation may be delivered to certificate holders in accordance with the policy, provisions. Stop -Z:
<br /> .F
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE .*.--
<br /> 5,_111
<br /> EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THEA
<br /> POLICY PROVISIONS. 4_.—
<br /> city of Everett AUTHORIZED REPRESENTATIVE r1j
<br /> Attn: Peter Berger Z'
<br /> 3200 Cedar Street J � ��' ta 9' Off/'f
<br /> Everett WA 98201 USA �J fj!
<br /> IBM
<br /> ©1988-2010 ACORD CORPORATION.All rights reserved.
<br /> •
<br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
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