Andy Boos 12/6/2017 - Laserfiche WebLink

ACCORD® CERTIFICATE OF LIADATE BILITY INSURANCE 12/2/2016 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 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 CONTACT NAME: Graber Insurance Services PHONE FAX 5704 Evergreen Way Suite C E-MAIL xt} (AM.No): Everett,WA 98203 ADDRESS: INSURER(S)AFFORDING COVERAGE NA=i INSURER A: Scottsdale Insurance Company INSURED INSURER B: Andy Boos INSURER C: DBA Andy Boos Outdoor Leader 2310 Rainier Ave INSURER D: Everett,WA 98201 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ., SUBR POUCYEFF POLICY EXP LIMITSLTR TYPE OF INSURANCE , YY)}SR wvn POLICY NUMBER (MWDDIYYIMM/DD TYYY't) GENERAL LIABILITY X CPS-2600159 12/5/2016 12/5/2017 EACH OCCURRENCE _$ 1,000,000.00 GE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 100,000.00 A CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,000.00 PERSONAL&ADV INJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000.00 PRO- — $ n POLICY n.IFf:T LOC COMBINED SINGLE OMIT AUTOMOBILE LIABILITY C s - (Ea accident) $ANY AUTOT BODILY INJURY(Per person) $IALL OWNEDAUTOSHIRED AUTOSSCHEDULED .1 BODILY INJURY(Per accident) $ Ill AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) $ UMBRELLA L1AB OCCUR EACH OCCURRENCE $ EXCESS UAB CCAIMS MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- 0TH- TORY LIMITS ER AND EMPLOYERS'LIABILITY Y./N ANY PROPRIETOR/PARTNER/EXECUTIVEN/A EL.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $ If yes,describe under EL.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate holder is listed as an additional insured. CERTIFICATE HOLDER CANCELLATION City of Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE It's Officers, Employees and Agents THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2930 Wetmore, Suite A ACCORDANCE WITH THE POLICY PROVISIONS. Everett, WA. 98201 AUTHORIZED REPRESENTATIVE 722I 64,442.'1"-Rs"..-'*'` I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD