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C DATE(MMIDD/YYYY) <br /> ® <br /> ACERTIFICATE OF LIABILITY INSURANCE 2/14/2017 <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 <br /> EPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <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). <br /> PRODUCER CONTACT Debbie Cook <br /> NAME: <br /> Leavitt Group Northwest (A/CNNo.Ext): (425)258-2300 (A/C,No):FAX (425)258-9363 <br /> PO Box 9068 E-MAIL <br /> ADDRESS:debbie-cook@leavitt.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> Tacoma WA 98490 INsuRERA:Philadelphia Indemnity Insurance A18058 <br /> INSURED INSURER B: <br /> Little Red School House Inc, INSURERC: <br /> DBA: dba Childstrive INSURER D: <br /> 14 E Casino Rd INSURER E: <br /> Everett WA 98208 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:2017-18 Master 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 SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP WLIMITS <br /> LTR INSR VD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,000 <br /> DAMAGE TO A CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000 <br /> X PHPK1597843 1/23/2017 1/23/2018 MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 <br /> X POLICY PRO- <br /> JECT LOC PRODUCTS-COMP/OPAGG $ 3,000,000 <br /> OTHER: <br /> Professional Liability- $ 3,000,000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 <br /> (Ea accident) <br /> A ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED PHPK1597843 1/23/2017 1/23/2018 BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS (Per accident) <br /> Underinsured motorist $ 1,000,000 <br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 <br /> A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000 <br /> DED X RETENTION$ 10,000 PHUB569567 1/23/2017 1/23/2018 $ <br /> WORKERS COMPENSATION PER X OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE WA Stop Gap E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? N/A <br /> A (Mandatory in NH) PHPK1597843 1/23/2017 1/23/2018 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 <br /> A Professional Liability PHSD1202943 1/23/2017 1/23/2018 Aggreggate$3,000,000 $ 1,000,000 <br /> A Directors & Officers Liab PHSD1202943 1/23/2017 1/23/2018 $ 4,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> City of Everett, its officers, employees and agents are added as additional insureds as per CG 2026 <br /> attached. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 2930 Wetmore St Suite 10A ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Everett„ WA 98201 <br /> AUTHORIZED REPRESENTATIVE , <br /> John Reynolds/DECOOK .14.e-__ co . #.-}:=,--a,. <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br /> INS025 12014011 <br />