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DATE(MM/DDIYYYY) ACOREP CERTIFICATE OF LIABILITY INSURANCE t.---- 06/29/2017 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 have ADDITIONAL INSURED provisions or 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 CONTNAME:ACT Kristie English English Insurance Group,LLC PHONE FAX (AIC.No.6cU: (425)673-7948 (A/C,No):(425)673-7942 5005 200th Street SW Suite 102 EMAIL LYNNWOOD,WA 98036 ADDRESS: kristie@englishinsurancegroup.com License#:245177 INSURER(S)AFFORDING COVERAGE NAIC N INSURERA: MUTUAL OF ENUMCLAW 14761 INSURED INSURER B: JANBO ASIA CUISINE LLC INSURER C: DBA JANBO CAFE 0125 EVERGREEN WAY INSURER 0. EVERETT,WA 98203 INSURER E: INSURER F: _ COVERAGES CERTIFICATE NUMBER: 00000000-0 REVISION NUMBER: 2 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. ILT R j TYPE OF INSURANCE ADDL SUER INSD WVD POLICY NUMBER (MM POUCDDYIYYYY) (MM IDEXP LIMITS LTR A X COMMERCIAL GENERAL LIABILITY Y BOP0007040 02/17/2017 02/17/2018 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR I PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 200,000 _GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY PES LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY BOP0007040 02/17/2017 02/17/2018 (Ee accideDn SINGLE LIMIT $ 2,000,000 1 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB I CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ I WORKERS COMPENSATION PER I AND EMPLOYERS'LIABILITY STATUTE ERH Y/N I ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) IE.L.DISEASE-EA EMPLOYEE $ If yes,describe under I DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A 'LIQUOR LIABILITY BOP0007040 02/17/2017 02/17/2018 OCCUR/AGG 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Everett,its officers,employees and agents arenamed as an additional insured as respect to the approximate 1,885 square feet of leasesd space behind the cafe. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Everett ACCORDANCE WITH THE POLICY PROVISIONS. 2930 Wetmore EVERETT,WA 98201 AUTHORIZED REPRESENTATIVE f ". -,., ..^ _.4 k (KRE) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by KRE on June 29,2017 at 03:46PM