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<br /> - refor4 0109 101.11A141
<br /> arsa iqii ' r.,
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES
<br /> NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUE A CONTRACT
<br /> BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERT IFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGRATION IS WAIVED,subject to the terms and conditions of
<br /> 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).
<br /> GENERAL LIABILITY
<br /> Clear Risk Solutions American Alternative Insurance Corporation
<br /> 451 Diamond Drive
<br /> Ephrata, WA 98823 AUTOMOBILE LIABILITY
<br /> American Alternative Insurance Corporation
<br /> INSURED
<br /> PROPERTY
<br /> Cocoon House American Alternative Insurance Corporation,et al.
<br /> 2929 Pine Street MISCELLANEOUS PROFESSIONAL LIABILITY
<br /> Everett, WA 98201 Princeton Excess and Surplus Lines Insurance Company
<br /> Torus Specialty Insurance Company
<br /> ,Cb%/E¢AGE$,_
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
<br /> INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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 /> „GENERAL LIABILITY «
<br /> COMMERCIAL GENERAL LIABILITY N1-A2-RL-0000013-08 04/01/2017 06/01/2018 PER OCCURRENCE $5,000,000
<br /> OCCURRENCE FORM PER MEMBER AGGREGATE $10,000,000
<br /> INCLUDES STOP GAP PRODUCT-CO MP/OP $5,000,000
<br /> PERSONAL&ADV.INJURY $5,000,000
<br /> (LIABILITY IS SUBJECT TO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS ANNUAL POOL AGGREGATE $50,000,000
<br /> ANY AUTO N1-A2-RL-0000013-08 04/01/2017 06/01/2018 COMBINED SINGLE LIMIT $5,000,000
<br /> (LIABILITY IS SUBJECT TO A$50 000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
<br /> max .
<br /> N1-A2-RL-0000013.08 04/01/2017 06/01/2018 ALL RISK PER OCC EXCL EQ&FL $75,000,000
<br /> EARTHQUAKE PER OCC EXCLUDED
<br /> FLOOD PER OCC EXCLUDED
<br /> (PROPERTY IS SUBJECT TO A$50000 SIR PAYABLE FROM PROGRAM FUNDS ANNUAL POOL AGGREGATE NONE
<br /> MISCELLAN6Q�JS PR4?1= � ,�1A - � A r, ,
<br /> N1-A3-RL-0000060.07 04/01/2017 06/01/2018 PER CLAIM $5,000,000
<br /> (LIABILITY IS SUBJECT TO A $504000 SIR PAYABLE FROM PROGRAM FUNDS ANNUAL POOL AGGREGATE $40,000,000
<br /> "bESCItl iON OF DistWIdNSitot oNS Vt=H14 ;it to 1' ,<. •
<br /> Regarding contract pertaining to 2929 Pine St., Everett and 2726 Cedar, Everett. City of Everett,its officers,employees,
<br /> agents, and mayor's office are named as Additional Insured regarding this contract only and are subject to policy terms,
<br /> conditions,and exclusions.Additional Insured endorsement is attached.
<br /> CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE
<br /> WITH THE POLICY PROVISIONS.
<br /> CERTIFICATE HQLDt;R ;. - '_ D 1.
<br /> City of Everett
<br /> 2930 Wetmore Ave., Suite 10-A
<br /> \(2(r
<br /> r4Everett, WA 98201-4067 ` `J
<br /> 3228662
<br />
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