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<br /> z �I lre 1 i„,,, ,;, 1s r:' Issue bate '0g/23/2016
<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 CONSTI TUE A CONTRACT
<br /> BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTAT IVE 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 /> PRODUCER COMPANIES AFFORDING COVERAGE
<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 /> Child Advocacy Center of Snohomish Co. American Alternative Insurance Corporation, et aI.
<br /> PO Box 3810 MISCELLANEOUS PROFESSIONAL LIABILITY
<br /> Everett WA, 98213
<br /> COVERAGES`
<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 SH OWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP DESCRIPTION LIMITS
<br /> •�..aW . .i3 .,u DATE DATE ”'€7 :041,lg 74i:isu,3€iF iia E€4a E€u
<br /> GENERAL LIABILITY ( 1 �
<br /> COMMERCIAL GENERAL LIABILITY N1-A2-RL-0000013-08 06/01/2016 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 /> AUTOMOBILE LIABILITY
<br /> ANY AUTO N1-A2-RL-0000013-08 06/01/2016 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 /> PROPERTY
<br /> N1-A2-RL-0000013-08 06/01/2016 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$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
<br /> MISCELLANEOUS PROFESSIONAL LIABILITY
<br /> 06/01/2016 06/01/2018 PER CLAIM
<br /> (LIABILITY IS SUBJECT TO A SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/SPECIAL ITEMS
<br /> Regarding funding source. City of Everett, its officers, employees and agents are named as Additional Insured regarding funding
<br /> only and are subject to policy terms, conditions, and exclusions. Miscellaneous Professional Liaiblity coverage is included in
<br /> the policy with a limit of$5,000,000. 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 POLI CY PROVISIONS.
<br /> CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE
<br /> OCityof Everett
<br /> AI
<br /> 2390 Wetmore Ave., Ste.8A • .
<br /> Everett,WA 982012
<br /> 3115898
<br />
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