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DATE(MM/D <br /> 4c CERTIFICATE OF LIABILITY INSURANCE 3/22/2017�YVY) <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: H the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> NAME- <br /> THE SEXTON AGENCY PHONE (425)743-1122 IFA" 425 743-1122 <br /> 5920 Evergreen Way, Ste H Ao�s$psextonl@farmersagent.com <br /> Everett, WA 98203 <br /> INSURER(S) AFFORDING COVERAGE NAM# <br /> INSURER A:Truck Insurance Exchange 21709 <br /> INSURED Brian Hunt INSURER B: Farmers Insurance Exchange 21652 <br /> dba Alternative Technologies INSURERC Mid Century Insurance Company 21687 <br /> 6321 Broadway Apt 4 INSURER D: <br /> Everett, WA 98203 INSURERE <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 /> LTR EXP <br /> $e TYPE OF INSURANCE IND POLICY LUMBER IMMsmut IDD/YYYYI IMM/DDIYYYYI LIMITS <br /> COMMERCIAL GENERAL UABILf1Y EACH S <br /> I CLAIMS-MADE El OCCUR DAMAGECHOCCURRENCE IU HEN ItU <br /> PREMISES(Ea occurrence) $ <br /> MED EXP(Myon person) S <br /> PERSONAL 3 ADV INJURY S _ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S <br /> POLICY El PRO- <br /> JECT 0 LOC PRODUCTS-COMPIOP AGG $ <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a 1,000,000 <br /> f Ee arxident) _ <br /> -ANVAUTO BODILY INJURY(Per person) S <br /> OWNED SCHEDULED <br /> 606619618 03/13/2017 03/13/2018 <br /> C AUTOS ONLY X AUTOS BODILY INJURY(Per accident) S <br /> HIRED NON-OWNED PROPERTY DAMAGE S <br /> AUTOS ONLY AUTOS ONLY (Per accident) <br /> S <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE S _ <br /> EXCESS LIAR I CLAIMS-MADE AGGREGATE S _ <br /> —DEO I J RETENTIONS S <br /> WORKERS COMPENSATION I STATUTE I I W- <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S <br /> OFFICERAAEMBER EXCLUDED? NIA <br /> (Mandatory In NH) EL DISEASE-EA EMPLOYEE S <br /> If yea.deecnbe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT S <br /> DESCRIPTION OF OPERATIONS I LOCATIONS l VEHICLES(ACORD101,Additional Remarks Schedule,may be aaachedi more space is required) <br /> City of Everett is named as Additional Insured <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Attn: Ruben Sanchez / Facilities Department THE EXPIRATION DATE THEREOF, NOTICE YOU_ BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 3101 Cedar Street • <br /> Everett, WA 98201 AUTHORIZED REPRESENTATI 4111 i 4194.084b <br /> I <br /> 0 1988-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />