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Page 1 of 1 A��® DATE(MMIDD/YYYY) C CERTIFICATE OF LIABILITY INSURANCE 03/26/2018 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 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). PRODUCER CONTACT NAME: Willis Insurance Services of California, Inc. PHONE FAX 1-877-945-7378 1-888-467-2378 c/o 26 Century Blvd (A/C,No_, E#1: (A/C,No): P.O. Box 305191 ADDRESS: certificates@willis.com Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Lexington Insurance Company 19437 INSURED INSURER B: The Salvation Army - Division 9 -- --- - - -180 East Ocean Blvd. INSURER C: Long Beach, CA 90802 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:W5584246 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. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF I POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MMIDDIYYYYI 1(MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY2,000,000 EACH OCCURRENCE $__ DAMAGE TO RENTED 1,000,000 CLAIMS-MADE x OCCUR 'i PREMISES(Ea occurrence) $ A ■ MED EXP(Any one person) $ 0 ■ y 027712409 10/01/201710/01/2018 2,000,000 PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY JECT x LOC PRODUCTS-COMP/OP AGG )_$ 4,000,000 I OTHER: I $ I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) _.._ ANY AUTO ', BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS ! BODILY INJURY(Per accident) $ HIRED NON-OWNED 1 PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY i ' (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE -S EXCESS LIAR CLAIMS-MADE AGGREGATE DED ', ' RETENTION$ $ WORKERS COMPENSATION PER I OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVEN/A E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? - - - (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $_---- --- --- -- If yes,describe under I DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Healthcare Professional 6791603 12/01/2017 12/01/2018Aggregate Limit: '.$10,000,000 Liability - Claims Made Each Medical Limit: 1$5,000,000 ;Retroactive Date 06/01/1990 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) This Voids and Replaces Previously Issued Certificate Dated 12/06/2017 WITH ID: W4563925. Division #09-030 Where required by written contract or agreement, The City of Everett, its officers, employees and agents are named as Additional Insureds as respects the operations of the Named Insured indicated herein. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Everett AUTHORIZED REPRESENTATIVE Attn: Jan Meston 2930 Wetmore Avenue, Suite 10-A Everett, WA 98201-4044 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR m: 15860329 BATCH: 647608