Laserfiche WebLink
• <br /> DATEE(MM OD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE <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 /> Aon Risk Insurance Services West, Inc. <br /> Los Angel es CA Office (A/C.NNo.Ext): (866) 283-7122 FAX <br /> No): (800) 363-0105 <br /> 707 Wilshire Boulevard E-MAIL <br /> Suite 2600 ADDRESS: <br /> LOS Angeles CA 90017-0460 USA INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A National Union Fire Ins CO of Pittsburgh 19445 <br /> Tetra Tech, Inc. INSURER B: The Insurance Co of the State of PA 19429 <br /> 1420 Fifth Avenue, Suite 600 INSURER C: AIG Europe Limited AA1120841 <br /> Seattle, WA 98101 USA <br /> INSURER O: Lexington Insurance Company 19437 <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. Limits shown are as requested <br /> INSR ADDL SUBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD (MMIDDIYYYY) LIMITS <br /> A - GL6051604 10/01/201 10/01/2017 <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $1,000,000 <br /> X Contractural Liability MED EXP(Any one person) $10,000 <br /> X X,C,U PERSONAL&ADV INJURY $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 54,000,006 <br /> POLICY X JECT X LOC PRODUCTS-COMP/OPAGG $4,000,000 <br /> OTHER: <br /> A AUTOMOBILE LIABILITY CA3194511 10/01/2016 10/01/2017 COMBINED SINGLE LIMIT <br /> $2,000,000 <br /> (Ea accident) <br /> X ANY AUTO BODILY INJURY(Per person) <br /> ALL OWNED —'SCHEDULED BODILY INJURY(Per accident) <br /> AUTOS AUTOS <br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE <br /> _AUTOS (Per accident) <br /> C X UMBRELLA UAB X OCCUR TH1600053 10/01/2016 10/01/2017 EACH OCCURRENCE 55,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE 55,000,000 <br /> DED RETENTION <br /> B WORKERS COMPENSATION AND WC014629374 10/01/2016 10/01/2017 xI SERTUTE I IOTTH- <br /> EMPLOYERS'uABILITY Y/N WC014629378 10/01/2016 10/01/2017 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N WC014629379 10/01/2016 10/O1/2D17 E.L.EACH ACCIDENT $1,000,000 <br /> OFFICER/(Mandatory in R EXCLUDED? NIA 10/01/2016 10/01/2017 <br /> (Mandatory in NH) WC014629380 E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes,describe under Includes USL&H <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> D Professional Liability 028182375 10/01/2015 10/01/2017 Each Claim $5,000,000 <br /> Aggregate $5,000,000 <br /> DESCRIPTION OF OPERATIONS)LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) <br /> Includes Stop Gap:OH,ND,WA,WY. <br /> Job Description: Everett WFP PLC Replacement Project (#135-12589-12002) <br /> city of Everett and its officers, employees and agents are included as Additional Insured as required by written contract, but <br /> limited to the operations of the insured under said contract, per applicable endorsement with respect to the General Liability <br /> and Auto Liability policies. General Liability evidenced herein is primary to other insurance available to an additional <br /> insured, but only to the extent required by written contract with the insured. See attached endrosements. Includes 30 days <br /> notice of cancellation (exceot 10 days for non-navmentl. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br /> POLICY PROVISIONS. <br /> City of Everett <br /> Attn: Mike Robinson AUTHORIZED REPRESENTATIVE <br /> 3200 Cedar Street <br /> Everett, WA 98201 USA eievn g eirnorateMW �" <br /> teezt <br /> ©1988-2014 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />