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Client#: 326119 GEOENINC2
<br /> ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)10/31/2017
<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 ACT Please send all requests by
<br /> USI Kibble&Prentice PHONEFAX
<br /> (A/C,No,Ext):fax or email (A/C No): 610-362-8518
<br /> 601 Union Street,Suite 1000 ADORIEss: CLCertRequest@usi.com
<br /> Seattle,WA 98101
<br /> INSURER(S)AFFORDING COVERAGE NAIL
<br /> 206-441-6300
<br /> INSURER A Continental Insurance Company 35289
<br /> INSURED INSURER B:Liberty Insurance Corporation 42404
<br /> GeoEngineers, Inc. 20508
<br /> INSURER C:Valley Forge Insurance Company
<br /> 8410 154th Ave NE
<br /> INSURER D Natl Fire no Co of Hartford 20478
<br /> Redmond,WA 98052
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: K1 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 /> LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY)
<br /> A X COMMERCIAL GENERAL LIABILITY X X 6023113030 03/31/2017 03/31/2018 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE X OCCUR PREMISES(Ea RENTED
<br /> $500,000
<br /> X WA&ND Stop Gap MED EXP(Any one person) $15,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY X JECOT X LOC PRODUCTS-COMP/OPAGG $2,000,000
<br /> OTHER: Stop Gap/EL $1,000,000
<br /> D AUTOMOBILE LIABILITY X X 6023117823 03/31/2017 03/31/2018(Eeali dent SINGLE LIMIT $1'000,000
<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 PROPERTY DAMAGE $
<br /> -OWNED (Per accident)
<br /> AUTOS
<br /> B X UMBRELLA LIAB X OCCUR X X TH7661066735017 03/31/2017 03/31/2018 EACH OCCURRENCE $1,000,000
<br /> EXCESS LIAB CLAIMS-MADE XS of GL,Auto& AGGREGATE $1,000,000
<br /> DED X RETENTION$10,000 Employers Liab. $
<br /> C WORKERS COMPENSATION X WC6045639429 03/31/2017 03/31/2018 X SPERATUTE OTH-
<br /> AND EMPLOYERS'LIABILITY TER
<br /> Y/N
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ID LA MO NC NY OR UT USL&H/MELt.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N N/A
<br /> D (Mandatory in NH) X WC6045838328 03/31/2017 03/31/2018 E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> DESCRIPTIONIf EdescrN under CA incl USL&H/MEL *incl WA E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> OF OPERATIONS below
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> 0661-108-02,City of Everett-Smith Street Sawmill VCP Support,3600 Smith Avenue, Everett,Washington.
<br /> City of Everett,its officers,employees and agents are Additional Insureds,coverage is primary and
<br /> noncontributory and waiver of subrogation applies as respects General Liability and Automobile Liability if
<br /> required by written contract per attached endorsements.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ANYDESCR
<br /> City of Everett THE SHOULD XPIRATTIIONH DATE E VTHEREOFED NOTICEES WIBLL E CELLED BE CDELIVERED NE
<br /> 3200 Cedar Street ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Everett,WA 98201
<br /> AUTHORIZED REPRESENTATIVE
<br /> )1/ /i
<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 /> #S21829939/M20200859 SMPZP
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