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BHE DATE(MM/DD/YYYY) A`=R0 CERTIFICATE OF LIABILITY INSURANCE R045 2/5/2018 THIS CERTIFICATEIS 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: HUB INTL NORTHWEST LLC/PHS (FOC,No, (866) 467-8730 FAX (NC, (888) 443-6112 809341 P: (866) 467-8730 F: (888) 443-6112 ADDRIEss, PO BOX 33015 INSURER(S)AFFORDING COVERAGE NAIC# SAN ANTONIO TX 78265 INSURERA: Hartford Casualty Ins Co 29424 INSURED INSURER B: INSURER C ROGER C. ROEN DBA ROEN ASSOCIATES INSURERD: 121 S WALL ST INSURERE: SPOKANE WA 99201 INSURERF: 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 POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MM/DD/YYYI) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1, 000, 000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED $1, 000, 000 PREMISES(Ea occurrence) A X General Liab X 52 SBA UK7576 01/07/2018 01/07/2019 MED EXP(Any one person) $10, 000 PERSONAL&ADV INJURY $1, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2, 000, 000 POLICY PRO- X LOC PRODUCTS-COMP/OP AGG $2, 000, 000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1, 000, 000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED 52 SBA UK7576 01/07/2018 01/07/2019 BODILYINJURY(Peraccident) $ AUTOS ONLY AUTOS X HIRED x NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $4, 000, 000 A EXCESS LIAB CLAIMS-MADE 52 SBA UK7576 01/07/2018 01/07/2019 AGGREGATE $4, 000, 000 DED X RETENTION$10,0 0 0 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A EMP STOP GAP 52 SBA UK7576 01/07/2018 01/07/2019 $1,000,000/$1,000,000/$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Those usual to the Insured' s Operations. City of Everett, its officers, employees and agents is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. 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 AUTHORIZED REPRESENTATIVE 3101 CEDAR ST EVERETT, WA 98201 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD