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Client#:25674 STRIRITE
<br /> ACORD,M CERTIFICATE OF LIABILITY INSURANCE DATE(M14/130/YYYY)4/10/2017
<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(les)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 NAOMNEACT Sharnel Di Vona
<br /> Propel Insurance PONE(Afc yip, 253.310.4047 ( No), 866 577-1326
<br /> Tacoma Commercial Insurance ADDRESS: Sharnel.0ivona@propelinsurance.com
<br /> 1201 Pacific Ave,Suite 1000 GCOV ,.____.
<br /> Tacoma,WA 98402
<br /> INSURER(S)AFFORDING COVERAGE I NAIL Y
<br /> INSURER A:Continental Western Ins.Co. 110804
<br /> INSURED INSURER B:Evanston Insurance Company ;35378
<br /> Stripe Rite Inc.
<br /> INSURER C:
<br /> 1813 137th Ave E
<br /> INSURER D:
<br /> Sumner,WA 98390
<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 /> INSR ADDL`:SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR .. ._TYPE OF INSURANCE 0448.SWI ----..-_ POLCY NUMBER (MWDDMMYY_)
<br /> YtMw DNYYYL
<br /> A X COMMERCIAL GENERAL LIABILITY X I X CPA6013651 04/11/2017 04/11/2018 EACH OCCURRENCE 51,000,000
<br /> CLAIMS-MADE X OCCUR p EireEo.Na.,_,r Ace)_ $500,000
<br /> X PD Ded:$1,000 MED EXP(Any one person) 510,000
<br /> PERSONAL 3ADV INJURY S1 00O,000
<br /> GENII AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000
<br /> PRO- I _1
<br /> POLICY I Xl JECT LOC PRODUCTS-COMP/OP AGG 52,000,000
<br /> OTHER S
<br /> - -.....-...-- COMBINED SINGLE LIMIT
<br /> — 1 OOO OOO
<br /> A AUTOMOBILE LIABILITY X X CPA6013651 04111/2017 04/11/201$ Ee accidemZ �. , ,
<br /> X ANY AUTO BODILY INJURY(Per person) S
<br /> X - ---
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) S
<br /> AUTOS AUTOS
<br /> X HIRED AUTOS X AUTO-0SWNED PROPERTY DAMAGE s
<br /> (PerPeccidentl
<br /> XpCA000110/13
<br /> A X UMBRELLA LIAB X OCCUR X X CPA6013651 04/11/2017 04/11/20181 EACH OCCURRENCE $10,000,000
<br /> EXCESS LUIS -- CLAIMS-MADE AGGREGATE S10,000,000
<br /> DED X RETENTION$0Pi-
<br /> AND
<br /> Q _ S
<br /> WORKERS COMPENSATION WA Stop Gap only: CTATUTF il-R
<br /> ANO EMPLOYERS'LIABILITY
<br /> A ANYIPRW PROPRIETOR/PARTNER/EXECUTIVE
<br /> EXRT E E ECUTIVE Y/Nj N/A CPA6013651 04/11/2017 04/11/2018 E.L.EACH ACCIDENT 51,000,000 _---_
<br /> (Mandatory in NH) 1 E.L.DISEASE-EA EMPLOYEE Si,000,000
<br /> yes,RIPTION under ..,._,.,_.._ E.L.DISEASE-POLICY LIMIT__51,000,000
<br /> DESCRIPTION OF OPERATIONS below ---..
<br /> B Contractor's 17CPLOWEO0525 04/11/2017 04/11/2018 $2,000,000 CPL&TPL
<br /> Pollution Liab $5,000 deductible
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE:2017 Pavement Marking Project.
<br /> The City of Everett is additional insured per the attached endorsement.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD OF
<br /> THE
<br /> ABOVE
<br /> City of Everett THE EXPIRATION DATE THEREOF,EPOLICIES BE CANCELLED BEFORE
<br /> NOTICE WILL BE DELIVEREDIN
<br /> 3200 Cedar Street ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Everett,WA 98201
<br /> AUTHORIZED/,�,�{yEREPRESENTATIVE
<br /> 6i :.Jy�' Yom_`
<br /> O 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 /> #S2664695/M2662386 SXHOO
<br />
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