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<br /> A�o® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 3/14/2018
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT TiffanyBrewster
<br /> NAME:
<br /> PLC Insurance, LLC IaC No.Ext): (425)712-3664 ( c,No):(425)712-3786
<br /> 4211 Alderwood Mall Blvd, #210 Mss,tiffany@plcins.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Lynnwood WA 98036 INSURERA:Philadelphia Indemnity Ins Co.
<br /> INSURED INSURER B:
<br /> Workforce Development Council Snohomish County INSURERC:
<br /> 808-134th St. SW Ste. 105 INSURERD:
<br /> INSURER E:
<br /> Everett WA 98204 INSURERF:
<br /> COVERAGES CERTIFICATE NUMBER:17/18 GL/AUTO/PROF REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR _PAD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY)
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> A CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES
<br /> 100,000
<br /> PREMISES(Ea occurrence)
<br /> PHPK1668090 8/1/2017 8/1/2018 MED EXP(Any one person) $ 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GENII AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY PRO-
<br /> JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER: Employee Benefits $ 1,000,000
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> (Ea accident)
<br /> A ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED PHPK1668090 8/1/2017 8/1/2018 BODILY INJURY(Per accident) $
<br /> AUTOS AUTOS
<br /> NON-OWNED PROPERTY DAMAGE
<br /> X HIRED AUTOS AUTOS (Per accident)
<br /> Uninsured motorist combined $ 1,000,000
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED RETENTION$ $
<br /> )1401006 )Q 01'X WA STOP GAP / EMPLOYER'S PER
<br /> STATUTE X 0TTH-
<br /> A (EMPLOYERS'LIABILITY Y/N
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE LIABILITY E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N/A
<br /> A (Mandatory in NH) PHPK1668090 8/1/2017 8/1/2018 E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> A PROFESSIONAL LIABILITY PHPK1668090 8/1/2017 8/1/2018 PER OCCURRENCE: $1,000,000
<br /> AGGREGATE: $2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Re: Bridges to Employment
<br /> City of Everett, its officers, employees and agents are included as Additional Insured when required by
<br /> contract or agreement per the attached PIGLDHS 10/11.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ramccrary@everettwa.gov
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 2930 Wetmore Ave, Suite 8A ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Everett, WA 98201
<br /> AUTHORIZED REPRESENTATIVE
<br /> Darwin Rieck/TRISHA
<br /> ©1988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
<br /> INS025(701401)
<br />
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