|
FrieY53 Revised
<br /> - Cts mm -"Tit,Y '� P, Ett P Y.. S6. ;-.-;..,;,r;N' ,# '44- '' *' , 1,-tp -, A ID j EA t,
<br /> � '(sR r' ad � � {�{ �' i,-,',.3 ��t
<br /> { ,. j k x {� • 14P4 .fr4„ $, R -04.'".I:" % 5 1 I.1 t 71 . '
<br /> IT
<br /> e E� ' R $€ €�4' � j IV,
<br /> P 3, i •E i 1.6 i .I il
<br /> 14 i
<br /> Al
<br /> ,�_ :,-,,,,I.-:',. !,t,;;. 1 R r fittM.41:tlil . . � A� � allHirl: �
<br /> ddd
<br /> It
<br /> t;, t .1 hit, F
<br /> : :- .��€ I _ _ 11 _ a . Iasenre €�' t� € �, ds , '_ itrIr-
<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,EXTEN D OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUE A CONTRACT
<br /> BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE 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 /> "( S -, ,,,,,-,666.,£m W 6,6,—,664 PA#a tY t I.4V E :' $, y S - ow 1$R€£'`� GW!fbI6mr f&f661E E i£dfFANr'R rmkd1 H£, 6.r.
<br /> �FDpp��,p ,arq„�;_.�,mw.aemxamwra�avwxn •na=m x,,e rcn. yr®�.vz. ®f lf.t x.tti � f ,ci �i..to.
<br /> M• �mn. � �a?t.�n�sxa� tee,�f,e.,z br faF.eae rnL ees�nwnvm.
<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 /> � ,• , ,z..- - PROPERTY
<br /> Friends of Youth American Alternative Insurance Corporation,et al.
<br /> 13116 NE 132nd St MISCELLANEOUS PROFESSIONAL LIABILITY
<br /> Kirkland WA, 98034 Princeton Excess and Surplus Lines Insurance Company
<br /> Torus Specialty Insurance Company
<br /> 4_ - °.H - wum» s . . sem n�,x�asarr .,,AH e H x9.,r3. 4a s..B.s.a.M.AW H 3..nwan . r 4 a.. HE Heb E E 4 tHwe H tlti ra
<br /> �!-F,., Af �
<br /> THIS IS 10 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 /> ....... ..
<br /> ; " ''e "
<br /> '1-- Jn r r r xwax <s zu
<br /> .11,4.11fikillWM114011..:.-19,tit A 11-1111.101iNgelfitISL Irl wilt wiJii-Aiiftikktkif Alit:I l'1,11 iiiiti'll kii' ') '.1'...AP ii,II*—'
<br /> ,4, ,,,w,&,d .0 ,.,N...M .'';:SMS�Nr,.MR'iA,..i.•.H-H.H3.�tH H.N4,813Mbi..t?P%HA tis ti,16,4^P L3.Y.Igi....485.NWHHH ,91.1*4'PSS.4...31,. M.V PPH PHHH3.Mgii.•ENNMI.3310i.015HPfr.X1.34 PHtl'
<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-ID A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $50,000,000
<br /> ...a e V ,.�.... . � .fsRns.x �R : ..,0,, ,^7,,..,,.,. .-
<br /> ,.,@ P...t 1 A.A.IP PAPPIPT YHP It,'0,.� PP .94 m000,'� HPPH R# f'i @ H'f#kH 3 E tiP 5
<br /> ANY AUTO N1-A2-RL-0000013-08 06/01/2016 06/01/2018 COMBINED SINGLE LIMIT $5,000,000
<br /> LIABILITY IS SUBJECTTO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
<br /> `6• `K" ikh s H, f� HIB
<br /> Wtib H, 3A4- RAP 't.-roP.' 4RP'*pet4tP* PHPM H .k4 Pt4P.#-t,PtPW'P7PNM E414PMttt t Ea fBiRPHPP+
<br /> .--- vns;P4§$HP PP"H AZ'�.ofaa, F=a'<H a,.4.HH'PP P•1R3fi' '%Pu' «s<=A+�4e PPPPPP HPP a .,*p As,s. ' sT c,t�"/n,'PU 'PPPP f'f�i.�`f'HP P�'PA.SHSrmet.
<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 SUBJECTTO A '.50 000£SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
<br /> v ' [: -‘:-.,Nit zie 1f t.4 py ;t ili 'evil ^x4 ' "^. ''',,PPPPH ^I..la iHPH PH &uw'�R+=..,4.4P''ss ffitaHer...4..Yev.4§e t_.,Pp€H',Hz„ tPPPIA,a Ilatat44INPA%E cr k 2r PAMPItPH �rm
<br /> w _ ss..., % . .e,.. =��z.- 'x wo-n;�• _s aa'i,xt�MIEn�®i [m tt�..,.'�'.A
<br /> N1-A3-RL-0000060-07 06/01/2016 06/01/2018 PER CLAIM $2,000,000
<br /> (LIABILITY IS SUBJECTTO A $50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $40,000,000
<br /> S9 .,xa.« g---,gm__ •,- �fee.a P- .44,„,,,-.,-,4..----.--,..4. #HH 4 P PPPP Y„+4 f P Pf'i'AH PPE UN ?P IY P#9 PPM',POP 43kP,1PPP"'-'.
<br /> 'dsQ 0 a � ��- . �,
<br /> Regarding services provided. City of Everett-Department of Planning&Community, its officials,officers,agents and
<br /> employees are named as Additional Insured regarding services provided only and are subject to policy terms,conditions and
<br /> exclusions. 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 /> ATE HOLDER Er�� 6 .
<br /> Attn:Contract Administrator OV
<br /> /
<br /> City of Everett-Department of Planning&Community . ill
<br /> Wetmore Avenue,Ste. 10A
<br /> Everett,WA 982014044
<br /> 3104416
<br />
|