SRV Construction Company 5/1/2018

I _____--.....N SRVCONS-01 ROCHOA AC-ORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD YYYY) ‘...../ 04/18/2018 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 I 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). t PRODUCER CONTACT • Hub International Northwest LLC PHONE FAX 12100 NE 195th Street,Suite 200 (A/C,No,Ext):(425)489-4500 (A/C,No):(425)485-8489 Bothell,WA 98011 E-MAIL now.info@hubinternational.com I INSURER(S)AFFORDING COVERAGE NAIL M INSURER A:BITCO National Insurance Company 20109 INSURED INSURER B: SRV Construction Inc. INSURER C: I P.O.Box 481 INSURER D: Oak Harbor,WA 98277 INSURER E: INSURER F: ICOVERAGES CERTIFICATE NUMBER: 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. IINSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYYI (MM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X X CLP3653536 05/05/2017 05/05/2018 pREM SES Ea occurrence) $ 300,000 X Per Proj/Per Loc MED EXP(Any one person) $ 5,000 X Wa Stop Gap PERSONAL 8 ADV INJURY $ 1,000,000 • GE 'L AGGREGATE LIMIT APPLIES PER' GENERAL AGGREGATE $ 2,000,000 POLICY X FiER0. LOC PRODUCTS-COMP/OP AGG $ 2,000,000 I OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO CAP3653535 05/05/2017 05/05/2018 BODILY INJURY(Per person) $ OWNED SCHEDULED I AUTOS ONLY _ AUTOS BODILY INJURY(Per accident) $ X AUTOS ONLY X AUTO ONLY (Perra�dentDAMAGE $ X Coil $1000 $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ I EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION STATUTEPER X ETH AND EMPLOYERS'LIABILITY Y/N CLP3653536 05/05/2017 05/05/2018 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ I OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ I1 yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1'000'000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:WO No.UP3612;Water Main Replacement"Q"-Evergreen Way Rebid ICity of Everett Public Works,its employess,agents and representatives are added as Additional Insureds per the attached endorsements.Primary and non-contributory and Waiver of Subrogation apply. I CERTIFICATE HOLDER CANCELLATION I Cit SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Everett Public Works ACCORDANCE WITH THE POLICY PROVISIONS. 3200 Cedar Street Everett,WA 98201 IAUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. IThe ACORD name and logo are registered marks of ACORD