Camp Fire of Snohomish County 12/6/2017

CampFSC11 Revised Non Profit Insurance Program CERTIFICATE OF COVERAGE Issue Date: 05/23/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF COVERAGE DOES NOT CONS1111JE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDn1ONAL INSURED,the policy(ies)must be endorsed. If SUBROGRATION IS WAIVED,subject to the terms and conditions of the policy,certain coverage may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER COMPANIES AFFORDING COVERAGE GENERAL LIABILITY Clear Risk Solutions American Alternative Insurance Corporation 451 Diamond Drive Ephrata,WA 98823 AUTOMOBILE LIABILITY American Alternative Insurance Corporation INSURED PROPERTY Camp Fire Snohomish County American Alternative Insurance Corporation, et al. 4312 Rucker Avenue MISCELLANEOUS PROFESSIONAL LIABILITY Everett WA, 98203 Princeton Excess and Surplus Lines Insurance Company Torus Specialty Insurance Company COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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 SH OWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP DESCRIPTION LIMITS DATE DATE GENERAL LIABILITY • COMMERCIAL GENERAL LIABILITY Ni A2-RL-0000013-08 06/01/2016 06/01/2018 PER OCCURRENCE $5,000,000 OCCURRENCE FORM • PER MEMBER AGGREGATE . $10,000,000 INCLUDES-STOP GAP PRODUCT-CO MP/OP • $5,000,000 • PERSONAL&ADV.INJURY $5,000,000. (LIABILITY IS SUBJECTTO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $50,000,000 AUTOMOBILE LIABILITY ANY AUTO N1-A2-RL-0000013-08 06/01/2016 06/01/2018 COMBINED SINGLE LIMIT $5,000,000 (LIABILITY IS SUBJECTTO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE PROPERTY N1-A2-RL-0000013-08 06/01/2016 06/01/2018 ALL RISK PER OCC EXCL EQ&FL $75,000,000 EARTHQUAKE PER OCC EXCLUDED FLOOD PER OCC EXCLUDED (PROPERTY IS SUBJECTTO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE MISCELLANEOUS PROFESSIONAL LIABILITY N1-A3-RL-0000060-07 06/01/2016 06/01/2018 PER CLAIM $2,000,000 (LIABILITY IS SUBJECTTO A $50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $40,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES I SPECIAL ITEMS Regarding Self Reliance classes at various City of Everett parks held on dates TBD. City of Everett, it's officers employees and agents are named as Additional Insureds regarding these classes only and are subject to policy terms, conditions&exclusions. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLI CY PROVISIONS. CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE e)Y.4 i City of Everett • . 802 E Muldteo Blvd. Everett,WA 98203 3116262