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ACJ DATE(MM/DD/YYYY)
<br /> L.------ CERTIFICATE OF LIABILITY INSURANCE 1/26/2018
<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 Debbie Cook
<br /> NAME:
<br /> Leavitt Group Northwest ,PAHHCNE ext): (425)258-2300 FAC,No): (425)258-9363
<br /> PO Box 9068 E-MAIL
<br /> ADDRESS:debbie-cook@leavitt.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> -
<br /> Tacoma WA 98490 INSURERA:Philadelphia Indemnity Insurance A18058
<br /> INSURED INSURER B:
<br /> Little Red School House Inc, DBA: dba Childstrive INSURERC: _
<br /> 14 E Casino Rd INSURER D:
<br /> INSURER E:
<br /> Everett WA 98208 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:2018-19 Master 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 WLIMITS
<br /> LTR INSD, VD POLICY NUMBER (MMIDD/YYYYI (MM/DD/YYYY)
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> DAMAGE RENTED
<br /> A CLAIMS-MADE X OCCUR PREM SESO(Ea occurrence) $ 100,000
<br /> X PHPK1768811 1/23/2018 1/23/2019 MED EXP(Any one person) $ 10,000_
<br /> PERSONAL&ADV INJURY _$ 1,000,000
<br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
<br /> X POLICY PRO-
<br /> JECT LOC PRODUCTS-COMP/OPAGG $ 3,000,000
<br /> OTHER: Professional Liability- $ 3,000,000
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> (Ea accident)
<br /> A X ANY AUTO BODILY INJURY(Per person) $
<br /> ALLOWNED SCHEDULED PHPK1768811 1/23/2018 1/23/2019 BODILY INJURY(Per accident) $
<br /> AUTOS AUTOS —
<br /> NON-OWNED PROPERTY DAMAGE $
<br /> HIRED AUTOS _ AUTOS (Per accident)
<br /> -
<br /> Underinsured motorist $ 1,000,000
<br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000
<br /> A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000
<br /> DED X RETENTION$ 10,000 PHUB615651 1/23/2018 1/23/2019 $
<br /> WORKERS COMPENSATION PER X OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N/A WA Stop Gap E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED?
<br /> A (Mandatory in NH) PHPK1768811 1/23/2018 1/23/2019 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 PHSD1315845 1/23/2018 1/23/2019 Aggregate $3,000,000 $ 1,000,000
<br /> A Directors & Officers PHSD1315845 1/23/2018 1/23/2019 $ 4,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Everett, its officers, employees and agents are added as additional insureds as per CG 2026
<br /> attached.
<br /> CERTIFICATE HOLDER CANCELLATION
<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 St Suite 1OA ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Everett„ WA 98201
<br /> AUTHORIZED REPRESENTATIVE ,(�
<br /> John Reynolds/DECOOK �` `— � ' �
<br /> ©1988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
<br /> I N S025/2014011
<br />
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