YMCA of Snohomish County 2/22/2017

AC © CERTIFICATE OF LIABILITY INSURANCE DATE MM/DD/YYYY)RI 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 Michelle Parker NAME: Leavitt Group Northwest aCONNo.Ext): (425)317-3570 FAC,No): (425)328-1615 PO Box 9068 AIL ADDRess:michelle-parkerQleavitt.com INSURER(S)AFFORDING COVERAGE NAIC# Tacoma WA 98490 INsuRERA:Zurich American Insurance Company f16535 INSURED INSURERBNeW Hampshire Insurance Company 023841 YMCA of Snohomish County INSURER C: 2720 Rockefeller Ave INSURERD: Scott Washburn INSURERE: Everett WA 98201 INSURERF: COVERAGES CERTIFICATE NUMBER:16-17 Master 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 rLTR TYPE OF INSURANCE NSD WVD POLICY NUMBERPOLICY EFF POLICY EXP LIMITS (MM/DD/YYYY) (MMIDD/YYYY) X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $ A CLAIMS-MADE X OCCUR DAMAGEaEcTED 100,000 _; PREMISES ((Ea occurrence) $ X 506-882492-1 9/1/2016 9/1/2017 MEDEXP(Anyoneperson) $ 10,000 _ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ 1,000,000 OTHER: To You $ I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X I ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 506-882492-1 9/1/2016 9/1/2017 BODILYINJURY(Peraccident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) Underinsured motorist $ 1,000,000 - UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B I EXCESS LIAB CLAIMS-MADE 5821041618 9/1/2016 9/1/2017 AGGREGATE $ 10,000,000 DED I X j RETENTION$ 0 $ WORKERS COMPENSATION PER X OTH- AND EMPLOYERS'LIABILITYY/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A A (Mandatory in NH) 506-882492-1 9/1/2016 9/1/2017 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below WA Stop Gap E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Everett, its officers, employees and agents as additional insureds per terms and conditions by form CG2026 0413. CERTIFICATE HOLDER CANCELLATION ramccrary®everettwa.gov SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department of Planning and Community Deve ACCORDANCE WITH THE POLICY PROVISIONS. Attention: Rebecca McCrary 2930 Wetmore Avenue, Suite 8A AUTHORIZED REPRESENTATIVE Everett, WA 98201 Sean King/MIPARK �/ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 i2m4m t