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<br /> DATE(MM/DD/YYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 09/08/2017
<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 /> PRODUCER CONTACT Michael McNamara
<br /> NAME:
<br /> McNamara Insurance Services,Inc. PHOONJ,Ext): (415)457-7856 (AIX No): (415)457-7698
<br /> 1050 Northgate Drive,Ste 515 ADDRESS: Mike@4apolicy.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> San Rafael CA 94903 INSURER A: Philadelphia Insurance Companies 18058
<br /> INSUREDINSURER B: Hartford Property&Casualty Co. 30147
<br /> Tm Bowen,DBA:Play-Well TEKnologies INSURER C: '
<br /> 224 Greenfield Ave.Ste B INSURER D:
<br /> INSURER E:
<br /> San Anselmo CA 94960 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: CL179802496 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 NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR IN SD WVD (MM/DD/YYYY) (MM/DDIYYYY)
<br /> X COMMERCIAL GENERAL LIABILITYEACH OCCURRENCE $ 1,000,000
<br /> DAMAGE TO RENTED 100,000
<br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $
<br /> MED EXP(Any one person) $ 5,000
<br /> A Y PHPK1709165 10/01/2017 10/01/2018 PERSONAL BADV INJURY
<br /> $ 1,000,000
<br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY PRO n LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> JECT
<br /> OTHER Professional Liability $ 1,000,000
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
<br /> (Ea accident),
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> - OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY _ AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY _ AUTOS ONLY (Per accident) _ _ _
<br /> X UMBRELLA LIAB -
<br /> OCCUR _EACH OCCURRENCE $ 5,000,000
<br /> A EXCESS LIAB CLAIMS-MADE AGGREGATE 10/01/2017 10/01/2018 AGGREGATE $
<br /> DED RETENTION $ $
<br /> WORKERS COMPENSATION PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> Y/N 11,000,000
<br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE NIA 57WECKZ9403 10/01/2017 10/01/2018 E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> Abuse/Molestation
<br /> A PHPK1709165 10/01/2017 10/01/2018 EACH INCIDENT 1,000,000
<br /> AGGREGATE 1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Those usual to the Insured's Operations.The City of Everett,its officers,agents and employees are added as Additional Insured per the
<br /> General Liability Deluxe Endorsement:Human Services PI-GLD-HS attached to this policy.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> City of Everett,its officers,agents and employees ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 802 E.Mukilteo Blvd.
<br /> AUTHORIZED REPRESENTATIVE /
<br /> Everett WA 98203 ,Y!. It.
<br /> I
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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