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<br /> Client#: 324516 WETHEASC
<br /> YYY)
<br /> ACORDTM CERTIFICATE OF LIABILITY INSURANCE 6/18DATE(M 6/18/2017
<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 610-362-8528
<br /> (AIC,No,Ext): (A/C,No):
<br /> 601 Union Street,Suite 1000 ADDRESS: PL.CertRequest@usi.com
<br /> Seattle,WA 98101
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA:Sentinel Insurance Company Ltd 11000
<br /> INSURED INSURER B:Starr Surplus Lines Insurance C 13604
<br /> Wetherholt and Associates, Inc.
<br /> INSURER C:
<br /> Post Office Box 816
<br /> INSURER D:
<br /> Kirkland,WA 98083
<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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTRINSR W /Y
<br /> VD POLICY NUMBER (MM/DDYYY) (MM/DDIYYYY)
<br /> A X COMMERCIAL GENERAL LIABILITY 52SBWPW8764 04/01/2017 04/01/2018 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE X OCCUR PREMISES(Eaocccurr nce) $1,000,000
<br /> X Business Liability - MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> PRO- PRODUCTS-COOMP/ PAGG $2000000
<br /> POLICY X JECT LOC > >
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY 52UEGJH7594 04/01/2017 04/01/2018 COMBIcNEideDS
<br /> nt) $INGLELIMIT 1,000,000
<br /> (Ea ac
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS AUTOS
<br /> NON OWNED PROPERTY DAMAGE $
<br /> AUTOS
<br /> X HIRED AUTOS X (Per accident) _
<br /> A X UMBRELLA LIAB X OCCUR 52SBWPW8764 04/01/2017 04/01/2018 EACH OCCURRENCE $4,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000
<br /> DED X RETENTION$10000 $
<br /> A WORKERS COMPENSATION 52SBWPW8764 04/01/2017 04/01/2018
<br /> AND EMPLOYERS'LIABILITY STATUTE X NH
<br /> -
<br /> AND N
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE (WA Stop Gap) E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N N/A
<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 1000199288171 05/14/2017 05/14/2018 $2,000,000 per claim
<br /> Liability $2,000,000 annl aggr.
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE: Everett Library-City of Everett.
<br /> The General Liability policy includes an automatic Additional Insured endorsement that provides Additional
<br /> Insured status to City of Everett,only when there is a written contract that requires such status,and
<br /> 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: Chris Lark ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 3101 Cedar Street
<br /> Everett,WA 98201 AUTHORIZED REPRESENTATIVE
<br /> .
<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 /> #S20788999/M20506367 SOPZP
<br />
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