Robin Kirschbaum Inc 1/31/2018 - Laserfiche WebLink

� l ® Acs o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 2/1/2018 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 have ADDITIONAL INSURED provisions or 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: Melissa Canestro Hall&Company PHONE FAX 19660 10th Ave NE (A/C.No.Ext): 360-626-2008 (A/c,No):360-598-3703 Poulsbo WA 98370 ADDRESS: mcanestro@hallandcompany.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:LIBERTY INSURANCE UNDERWRITERS 19917 INSURED ROBIKIR-01 INSURER B:RLI INSURANCE COMPANY 13056 Robin Kirschbaum, Inc. 425 30th Ave INSURER C: Seattle WA 98122 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:151642967 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. INSRUBR POLICY EFF POLICY EXP TYPE OF INSURANCE INS ,Sw vD POLICY NUMBER (MM/DD//YYYY) (MM/DD/YYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY PSB0007109 7/20/2017 7/20/2018 EACH OCCURRENCE $2,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $1,000,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $2,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY X jR8, LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER: $ B AUTOMOBILE LIABILITY PSB0007109 7/20/2017 7/20/2018 COMBINED SINGLE LIMIT $ (Ea accident) 2,000 000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ g WORKERS COMPENSATION PSB0007109 7/20/2017 7/20/2018 PER STATUTE X OERH WA Stop Gap AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2,000,000 A Professional Liab Claims Made AEXNYABHQXP001 7/15/2017 7/15/2018 $2,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The certificate holder is an additional insured per the attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Everett 3200 Cedar Street Everett WA 98201 AUTHORIZED REPR 641" E SE ENNT )ATIVE �7 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD