Triangle Associates Inc 5/24/2017

ACC GRDDATE(MM/DDIYYYY)CERTIFICATE OF LIABILITY INSURANCE 5/2/2017 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 CL Central NAME: Leavitt Group Northwest PHONE NN Ext): 866-298-0570 (AIC,No 966-688-5709 PO Box 9068 E-MAIL ADDRESS:cicnorthwest@leavitt.com INSURER(S)AFFORDING COVERAGE NAIC# Tacoma WA 98490 INSURER A:Chi° Security Insurance Company 024082 INSURED INSURERB:American Fire & Casualty Company 24066 Triangle Associates Inc INsuRERc:Underwriters at Lloyds of London 15792 811 First Ave #255 INSURERD: INSURER E: Seattle WA 98104 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 TYPE OF INSURANCE ADDL SUBR W POLICY EFF POLICY EXP LIMITS LTR INSD VD POLICY NUMBER IMM/DDIYYYY) IMMIDDIYYYY) X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $ A CLAIMS-MADE X OCCUR PATO RENTED PREEMMGEISES(Ea occurrence) $ 1,000,000 X Y BKS55302282 10/23/2016 10/23/2017 MED EXP(Any one person) $ 15,000 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 $ 3,000,000 OTHER: Damage to Rental Premises $ 100,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED HAS55302282 10/23/2016 10/23/2017 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION • PER X OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE __.. ER ANY PROPRIETOR/PARTNER/EXECUTIVE WAS Stop Gap E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED'? N/A B (Mandatory in NH) HXA55302282 10/23/2016 10/23/2017 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $- 2,000,000 C Professional Liability MPL1033805 7/13/2016 7/13/2017 PerClaim 1,000,000 Deductible 5,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Everett School Project City of Everett is named additional insured with respects to general liability on primary and non-contributory basis and waiver of subrogration per written contract with the named insured form CG88100413, completed operations form CG85830413. CERTIFICATE HOLDER CANCELLATION ltobin@everettwa.gov SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Public Works Dept ACCORDANCE WITH THE POLICY PROVISIONS. 3101 Cedar St Everett, WA 98201 AUTHORIZED REPRESENTATIVE D zcTramme11/DITRAM �—�tCxau �C343cr�.DA�`SLX� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(2014011