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• <br /> AL.VK[J" I DATE(MM/DD/YY1flf7 <br /> CERTIFICATE OF LIABILITY INSURANCE E(MWDD7 <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 have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> °RODUCER <br /> CONTACT <br /> lub International Northwest LLC PHONE FAX <br /> 2100 NE 195th Street,Suite 200;Whe (ac,No,Ext):(425)489-4500 • <br /> 2100 l 1 5th S t' E-MAIL <br /> (a/c,No):(425)485-8489 <br /> , , <br /> now <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Scottsdale Insurance Company 41297 <br /> NSURED • <br /> INSURER B <br /> Hydrology Stand Up Paddle,LLC INSURER C: <br /> 4816 College Ave <br /> INSURER D: <br /> Everett,WA 98203 <br /> INSURER E: <br /> INSURER F: <br /> OVERAGES CERTIFICATE NUMBER: 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 /> NSR ADDL SUBR I IMOMID YDI YYY) (MMND YYYY) LIMITS <br /> TRI TYPE OF INSURANCE i D yUB POLICY NUMBEREXP <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE X OCCUR X CPS2727159 06/10/2017 06/10/2018 PDRE MISEs(E EEoa urr nce) $ 100,000 <br /> MED EXP(Any one person) $ 5,000 <br /> PERSONAL BADV INJURY $ 1,000,000 <br /> GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY LOC 2 000,000 <br /> PRODUCTS-COMP/OP AGG $ <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> _(tea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY AUTOS ONLY <br /> UMBRELLA UAB OCCUR EACH OCCURRENCE _ $ <br /> EXCESS UAB CLAIMS-MADE <br /> AGGREGATE $ <br /> DED RETENTION$ <br /> WORKERS COMPENSATION SPER TATUTE OTH- <br /> AND EMPLOYERS'LABILITY Y!N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ <br /> FFICER/MEMBER�EXCLUDED? N/A <br /> Mandatory in NH) <br /> If yes,describe under E.L.DISEASE-EA EMPLOYEE $ <br /> DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ <br /> )ESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> 1DDMONAL INSURED AS REQUIRED BY WRI I l tN CONTRACT:THE CITY OF EVERETT,ITS OFFICERS,AGENTS AND EMPLOYEES. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> CITY OF EVERETT PARKS&RECREATION THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 802 MUKILTEO BLVD ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Everett,WA 98203 <br /> AUTHORIZED REPRESENTATIVE <br /> • I <br />