Domestic Violence Services of Snoh County 12/22/2017

ACCPREP® �� DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 11/8/2017 '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 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 Debbie Cook NAME: Leavitt Group Northwest (AHIC No.Ext1: .(425)258-2300 FAiX,No): (425)258-9363 PO Box 9068 E-MAIL ADDRESS:debbie-cook@lean1tt.com INSURER(S)AFFORDING COVERAGE NAIC# Tacoma WA 98490 INSURERA:Great American Insurance CompanyC16691 INSURED INSURER B Domestic Violence Services of Snohomish County INSURERC: PO Box 7 INSURER D: INSURER E: Everett WA 98206-0007 INSURERF: COVERAGES CERTIFICATE NUMBER:2017-18 Master 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 POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR IADDLISUBRI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD•I X I COMMERCIAL GENERAL LIABILITY POLICY NUMBER ,(MMIDDIYYYY) (MMIDD/YYYY) LIMITS ' EACH OCCURRENCE $ 1,000,000 � DAMAGE TO RENTED A _ JI CLAIMS-MADE $X OCCUR ! j PREMISES(Ea occurrence) 100,000 X PAC059525504 10/10/2017 10/10/2018 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: ! GENERAL AGGREGATE $ 2,000,000 X POLICY JE PROCT- ILOC PRODUCTS-COMP/OP AGG $ 2,000,000 `_ OTHER: Stop Gap Employee BI by $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED I SCHEDULED AUTOS 'AUTOS CAP59525604 10/10/2017 10/10/2018 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS -(Per accident) I Underinsured motorist $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2 000,000 EXCESS LIAB CLAIMS-MADE i UMB059525704 10/10/2017 10/10/2017 AGGREGATE $ 2 000 000 A DED I RETENTION$ $ WORKERS COMPENSATION IPEPERTUTEI_XIOTERH- AND EMPLOYERS'LIABILITY — ——— Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE WA Stop Gap ! EEACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A .L. - -- — — A (Mandatory In NH) PAC059525504 10/10/2017 10/10/2018 E.L.DISEASE-EA EMPLOYE' $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I- E.L.DISEASE-POLICY LIMIT', $ 1,000,000 !I I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Everett, Its officers, employees and aigents .are named as an additional insured as per terms and conditions of form CG2026 04 13 attached. NOV 0 3 ; CITY OF EY.. PLANN CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2930 Wetmore Ave Ste #8A ACCORDANCE WITH THE POLICY PROVISIONS. Everett„ WA 98201 AUTHORIZED REPRESENTATIVE -�f Jeff Olsen/DECOOK � ` O ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025/2014nn