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Client#: 326377 PERTEINC <br /> ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)4/12/2017 <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 /> REPRESENTATIVE 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 <br /> NAME: <br /> USI Kibble& Prentice PR PHONE 206 441-6300 FAX 610-362-852 <br /> (A/C,No,Ext): (A/C,No): <br /> 601 Union Street, Suite 1000 AODAREss: PL.CertRequest@usi.biz <br /> Seattle,WA 98101 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Travelers Indemnity Company of 25682 <br /> INSURED INSURER B:Travelers Casualty and Surety C 31194 <br /> Perteet, Inc. <br /> INSURERC:Phoenix Insurance Company 25623 <br /> P.O. Box 1186 <br /> Everett,WA 98206-1186 INSURER D <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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 /> LTR TYPE OF INSURANCE 1DsDRLWVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> (MM/DD/YYYY) (MM/DD/YYYY) <br /> A X COMMERCIAL GENERAL LIABILITY 6809A973147 06/27/2016 06/27/2017 EACH OCCURRENCE $1,000,000 <br /> CLAIMS-MADE X OCCUR PREMISES(EaEoaaur soca) $1,000,000 <br /> MED EXP(Any one person) $10,000 <br /> PERSONAL 8 ADV INJURY $1,000,000 <br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> POLICY X JECOT LOC PRODUCTS-COMP/OP AGG $2,000,000 <br /> OTHER: $ <br /> C AUTOMOBILE LIABILITY BA9A974666 06/27/2016 06/27/2017Ea COMBaccident)SI � > >INED NGLE LIMIT 1 000 000 <br /> ( <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS (Per accident) <br /> UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> A WORKERS COMPENSATION 6809A973147 06/27/2016 06/27/2017 PER 2P <br /> - <br /> AND - <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> Y <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N (WA Stop Gap) E.L.EACH ACCIDENT $1,000,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) 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 /> B Professional 106321064 06/27/2016 06/27/2017 $2,000,000 per claim <br /> Liability $2,000,000 annl aggr. <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> RE: Project#20170045, City of Everett Preparedness Initiative. <br /> The General Liability policy includes an automatic Additional Insured endorsement that provides Additional <br /> Insured status to the Certificate Holder, only when there is a written contract that requires such status, <br /> and only with regard to work performed on behalf of the named insured. <br /> CERTIFICATE HOLDER CANCELLATION <br /> Cityof Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Attn: Grant Moen ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 3200 Cedar Street <br /> Everett,WA 98201 AUTHORIZED REPRESENTATIVE <br /> °4061N.1401— <br /> © <br /> i <br /> ©1988-2014 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD <br /> #S20293109/M18008808 DXKZP <br />