2812 Architecture 8/22/2018 - Laserfiche WebLink

A ® GATE(MMIDD YYYY) CERTIFICATE OF LIABILITY INSURANCE 06/06/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS I CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 1 BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED 1 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 Christopher Day NAME: Orion Insurance Group PHONE.Ext): (425)771-5197 FA(A/X, No): (425)673-4427 IA/3405 188th ST SW E-MAIL chrisday@orioninsgroup.com ADDRESS: 1 Suite#302INSURER(S)AFFORDING COVERAGE NAIC U 3 Lynnwood WA 98037 INSURERA: RLI Insurance INSURED INSURER B: 2812 Architecture Inc INSURER C: 2812 Colby Ave INSURER D: INSURER E: Everett WA 98201 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1792201328 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 CONTRACTOR 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 ADDL SUB1T POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 �/ DAMAGE TO RENTED 1,000,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ X Hired non owned limits followMED EXP(Any one person) $ 10,000 A X General Liability limit Y Y PSB0003093 08/16/2017 08/16/2018 PERSONAL BADV INJURY $ 2.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY I Xl ROT LOC 0000 GG $ 4,0 i. OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Por person) $ OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLYAUTOS HIRED .— NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident UMBRELLA LIAB EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION I STATUTE I I 0TH AND EMPLOYERS'LIABILITY YIN 1 A ANY PROPRIETOR/PARTNER/EXECUTIVE N/A Y PSB0003093 08/16/2017 08/16/2018 E.L.EACH ACCIDENT $ , , OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ It yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ $1,000,000 Each Claim Professional Liability Claims Made A Y RDP0021479 08/16/2017 08/16/2018 $1,000,000 Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached if more apace is required) A waiver of subrogation is provided for all required parties by contract. All required parties are listed as an additional insured with coverage applying primary and non-contributory CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Everett ACCORDANCE WITH THE POLICY PROVISIONS. 3200 Cedar Street AUTHORIZED REPRESENTATIVE Everett WA 98201 C ( 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD eF il i