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'`' LIABILITY INSURANCE I CERTIFICATE OF DATE(MMIDD/YYTY) <br /> 5/16/2017 <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 /> BRENT W SATERN(19344) NAME: BRENT W SATERN <br /> 204 W.MAIN ST (jam 503-874-8434 <br /> SILVERTON,OR 97381-0000 E MNL f fa c,No 5M-874-0414 <br /> ADDRESS:- BRENT-SATERN@COUNTRYFINANCIAL.COM <br /> INSURER(S)AFFORDING COVERAGE NAIC I <br /> ——-- )�A: COUNTRY Mutual Insurance Company 120990 <br /> INSURED 9586549 — --_-- — — —_-- <br /> CADAPULT SOFTWARE SOLUTIONS INC INSURERIN <br /> B— ( <br /> 702 JUNE DR suRER C: —MOLALLA,OR 97038 INSURER D_ — — <br /> INSURER E: ---- -- <br /> INSURER F: <br /> COVERAGES — — — <br /> 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 - --- ,A�DL'SUBR[ <br /> POUCY LTR TYPE Of GENERAL LIABILITY INSURANCE I(NSR E W VD I POLICY NUMBER y)F( Y)POLICY EXP --- .—.. <br /> € ! LIMITS <br /> A ,AB9028744 9/1/2016 9/1/2017 EACH OCCURRENCE 52,000,000 <br /> ( 1 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED p! f CLAIMS-MADE 'OCCUR I PREMISES(Ea occurrence) _`S 10Q.Q�. <br /> MED EXP(My one person) 5 5,000 _ <br /> --- i i t €PERSONAL&ADV INJURY s 2.000,000 -_. <br /> GENI AGGREGATE LIMIT APPLIES PER: p I GENERAL AGGREGATE S 4.000 <br /> V' POLICY P1 JFCaT i LOC " :PRODUCTS-COMP/OP AGG I$4,000,000 <br /> IAUTOMOBILE LIABILITY g S <br /> I COMBINED SINGLE LIMIT <br /> ':ANY AUTO (Ea accident) ,S <br /> I <br /> ALL OWNED SCHEDULED <br /> i BODILY INJURY(Per(BODILY INJURY(Per person) $ <br /> NON-OWNEDt).$ <br /> HIRED AUTOS AUTOS PROPERTY DAMAGE <br /> R�. MB <br /> .(Per accident) $ <br /> I C UMBRELLA B __`,OCCUR IE s <br /> EXCESS LAB f ,CLAIMS-MADE ° :EACH OCCURRENCE <br /> S <br /> { `AGGREGATE S <br /> 1 I DED I I RETENTIONS i IS <br /> --- <br /> WORKERS COMPENSATION I I <br /> I AND EMPLOYERS'LIABILITY WC STATU- DTH_ <br /> 1 ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E - 111 'TORY LIMITS I. EER <br /> OFFICERRAEMBER EXCLUDED? IN/A { EL EACH ACCIDENT S <br /> (Mandatory In NH) ( ttt <br /> B describe tinder 'E.L.DISEASE-EA EMPLOYE S <br /> DESCRIPTION OF OPERATIONS below <br /> I <br /> €EL DISEASE-POLICY LIMIT S <br /> EIII <br /> i <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks <br /> ADDITIONAL INSURED(S): Schedule,a mom space is required) <br /> CITY OF EVERETT <br /> 2930 WETMORE AVE,STE 6A <br /> EVERETT,WA 98201 <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 AVE STE 6A ACCORDANCE WITH THE POLICY PROVISIONS. <br /> EVERETT,WA 98201 <br /> AUTHORIZED REPRESENTATIVE <br /> T <br /> ©1988-2010 A •RD C► 1.ORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />