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AC CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `'.-- 3/22/2017 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 POLICIES 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 Christopher Day Orion Insurance Group PHONE (425)771-5197 Fax 3405 188th ST SW JA/C.No.Ext): (425)673-4427 E-MAIL a chrisd ADDRESS: y@orioninsgroup.com(A/C,No): Suite #302 INSURER(S)AFFORDING COVERAGE NAIC# Lynnwood WA 98037 INSURER RLI Insurance 42846 INSURED INSURER B:SWETT - Admiral Insurance Company 24856 HWA GEOSCIENCES INC. INSURER C: 21312 30TH DRIVE SE, SUITE 110 INSURER D: INSURER E: BOTHELL WA 98021-7010 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1732200304 REVISION NUMBER: 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 ADDL SUBR LTR TYPE OF INSURANCE INSD.WVD POLICY NUMBER POLICYEFF POLICY EXP (MM/DD/YYYY) IMM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A CLAIMS-MADE x OCCUR PREMISES(Ea occurrence) $ 300,000 X Y PSB0002638 12/1/2016 12/1/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X jE 0 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY Ea aBINEDtSINGLE LIMIT $ 1,000,000 A x ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED PSA0001635 12/1/2016 12/1/2017 BODILY INJURY(Per $ AUTOS AUTOS X y ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ $ x UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 3,000,000 A x EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000 DED RETENTION$ X Y PSE0001834 12/1/2016 12/1/2017 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A 1 000,000 A (Mandatory in NH) PSB0002638 12/1/2016 12/1/2017 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 B Professional Liability E000003589301 12/1/2016 12/1/2017 $2,000,000 Each Claim $50,000 Claims Made $2,000,000 Aggregate Deductible DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Everett and all required parties are listed as additional insureds with primary non-contributory wording. 30-days notice of cancellation to certificate holder. A blanket waiver of subrogation applies in favor of additional insureds. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3101 Cedar Street ACCORDANCE WITH THE POLICY PROVISIONS. Everett, WA 98201 AUTHORIZED REPRESENTATIVE Christopher Day/CD Gam' •' 4J- ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401t