Boys and Girls Clubs of Snohomish County 2/1/2018

Client#: 326528 BOYSGIRI ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)6/22/2017 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 pollcy(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 f CONTACT Please send all requests by USI Kibble&Prentice " N fax or email FAX 610.362-8518 601 Union Street,Suite 1000O•E ) (Alp No s; CLCertRequest@usi.com Seattle,WA 98101 206-441-6300 INSURER�S)AFFORDING COVERAGE NAICi INSURER A_Great American Alliance Ina Co 26832 INSURED INSURER 5:Berkley Regional Insurance Co 29580 Boys&Girls Clubs of Snohomish County 950219th Ave SE,Ste F INSURER C: INSURER D: Everett,WA 98208 (.. INSURER E: IINSURER F: COVERAGES CERTIFICATE NUMBER: K2 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 CONTRACTOR 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. M. ADOLSUBR �._ �p_ LTR TYPE OF INSURANCE U'isR two POLICY NUMBER ,(MgIYYY) (M YYC),` UMITS A X.COMMERCIAL GENERAL LIABIUTY PACO52125704 07/06/2017 07/06/2018 EACH OCCURRENCE $1,000,000 QaraTQ.o ice)_ $300000 CLAIMS-MADE I�OCCUR I rS�cM1b�S(ED X l WA Stop Gap/EL MED EXP(Any one person) _ :15,800 PERSONAL 8,ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1 GENERAL AGGREGATE $2,000,000 _ IPOLICY I 1 JECT (X I LOC PRODUCTS-COMP/OP AGO $2,000,000 OTHER ! WA Stop Gap $1,000,000 A AUTOMOBILE LIABILITY GAP052125804 07/06/2017 1 07/06/2018 . a" um"' $1,000,000 _X__ ANY AUTO BODILY INJURY(Per person) $ • f ALL OWNED SCHEDULED j BODILY INJURY(Per accident) $ PROPERTY DAMAGE S NON-OWNEDAUTOS f _(F_ 1H).__ Al HIRED AUTOS I X ! # S 1. -_ - - — -' --- '-- A X!UMBRELLA UABI X OCCUR UMB052125904 07/06/2017 07/06/2018 EACH OCCURRENCE i19,OOO,DOO_ EXCESS UAB ICLAIMS-MADE XS of GL,Auto& [AGGREGATE _,- S1010_ 00,000 :DED + XIRETENTION s10,000._. Employers Liab. _ i_ $ WORKERS COMPENSATION P II AND EMPLOYERS'LIABIUTY Y 1 N 1 STAT.UTE_ _!. 3 ER ANY PROPRIETORIPARTNER/EXECUTIVE"- 1.E L.EACH ACCIDENT .S OFFICERMEMBER EXCLUDED? I 1N/A 1 r (Mandatory In NN) I E.L.DISEASE•EA EMPLOYEE$, descrr DECRIPTIObNuOeOPERATIONS below E.L.DISEASE-POLICY LIMIT `S_ B CRIME I FIDELITY BCCR4500149322 07/06/2017 07/06/2018 $400,000 Employee Theft $2,500 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Any and all grants.The City of Everett,its officers,employees and agents are Additional Insured as respects General Liability per attached endorsement CG2026 07104. CERTIFICATE HOLDER CANCELLATION Cityof Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Dept of Planning &Community Development ACCORDANCE WITH THE POLICY PROVISIONS. 2930 Wetmore,Suite 8A Everett,WA 98201 AUTHORIZED REPRESENTATIVE ePa?A..—)-t yfrit:ec27—W4;17 ©1988.2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S20824707/M20824682 CNMJU