CampFSC109
<br /> I�
<br /> k ' ( 3 s T
<br /> E 7 j
<br /> 3 � }
<br /> E� ^ i c ofts .,E e u 1�, it t r f!11,1
<br /> etfice.
<br /> ',
<br /> o- ICERTIFICATE O F COUP issuQ O4T 5/2 r s
<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,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF COVERAGE DOES NOT CONSTI TUE A CONTRACT
<br /> BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTAT IVE OR PRODUCER,AND THE CERT IFICATE 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 /> GENERAL LIABILITY
<br /> Clear Risk Solutions American Alternative Insurance Corporation, et al.
<br /> 451 Diamond Drive
<br /> Ephrata, WA 98823 AUTOMOBILE LIABILITY
<br /> American Alternative Insurance Corporation,et al.
<br /> SU O,
<br /> PROPERTY
<br /> Camp Fire Snohomish County American Alternative Insurance Corporation,et al.
<br /> 4312 Rucker Avenue MISCELLANEOUS PROFESSIONAL LIABILITY
<br /> Everett, WA 98203 Princeton Excess and Surplus Lines Insurance Company
<br /> GOi� RAES,
<br /> THIS IS TO 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 /> TYE E 0 INStJµ A{'CE POLICY NUMBER POLICY EFF POLICY EXP DESCRIPTION LII ITS
<br /> r k I 's r _ .' *�;' •�b ,r i ''.
<br /> r,a...
<br /> .
<br /> GENERAL LIABILITY
<br /> COMMERCIAL GENERAL LIABILITY N1-A2-RL-0000013.08 06/01/2017 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 TO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $50,000,000
<br /> ANY AUTO N1-A2-RL-0000013-08 06/01/2017 06/01/2018 COMBINED SINGLE LIMIT $5,000,000
<br /> (LIABILITY IS SUBJECT TO A$50//000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
<br /> N1-A2-RL-0000013-08 06/01/2017 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 SUBJECT TO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
<br /> MISCEt;LAME9V PJ?MASIQNA LIABIL1YY
<br /> N1-A2-RL-0000013.08 06/01/2017 06/01/2018 PER CLAIM $1,000,000
<br /> (LIABILITY IS SUBJECT TO A $50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $40,000,000
<br /> D SGRIf'T C t Q EhnrrOf� .1.,Oc,ATIONS/VEHICLES I SPECIAL ITEMS,
<br /> Regarding grant.City of Everett, its officers,employees and agents are named as Additional Insureds regarding this grant
<br /> only and is subject to policy terms,conditions and 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 POLICY PROVISIONS.
<br /> C RT(F(C FHQI�DE ... . AUTHORIZED REPRESENTATJVE w,
<br /> Attn: Rebecca McCrary ----
<br /> City of Everett, Dept of Planning and Comm Devlp
<br /> 2930 Wetmore Ave, Suite 8A
<br /> Everett,WA 98201-4044
<br /> 3369784
<br />
|