Volunteers of America Western Washington 2/7/2018 (2)

• A�oRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/19/2017 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 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). CONT PRODUCER NAMEACT Stephen Erni Arthur J. Gallagher Risk Management Services, Inc. PHONE 425-586-1002 FAX 425-451-3716 P.O.Box 367 (A/CJlo.F:t)• (A/C.No): Bellevue WA 98009-0367 E-MAIL DRESS:Stephen_Erni@ajg.Com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Philadelphia Indemnity Insurance Company 18058 INSURED VOLUOFA-11 INSURER B: Volunteers of America Western Washington INSURER C: P.O. Box 839 2802 Broadway INSURER D: Everett WA 98206-0839 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:899609216 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. INSRADDL SUER POLICY EFF POLICY EXP TYPE OF INSURANCE LTRINSD WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y PHPK1669744 6/30/2017 6/30/2018 EACH OCCURRENCE $1,000,000 DGE TO RENTE CLAIMS-MADE X OCCUR PREM SES(Ea occur ence) $1,000,000 X Prof.Liability MED EXP(Any one person) $20,000 PERSONAL 8 ADV INJURY $1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- CT X LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: - $ A AUTOMOBILE LIABILITY PHPK1669744 6/30/2017 6/30/2018 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X ANY AUTO - BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS -- HIRED NON-OWD PROPERTY X AUTOS ONLY X AUTOS ONLYY (Per accident)DAMAGE $ $ A X UMBRELLA LIAB X OCCUR PHUB588323 6/30/2017 6/30/2018 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED X RETENTION$10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) City of Everett, its officers,employees,and agents are named as Additional Insureds under General Liability policy per Form No.PI-GLD-HS (10/11)but only as respects written contract,subject to policy terms,conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Dept.of Planning&Community Development ACCORDANCE WITH THE POLICY PROVISIONS. 2930 Wetmore Ave.,Suite 8A Everett WA 98201 USA AUTHORIZED REPRESENTATIVE I � art ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD