2018/08/22 Council Agenda Packet

YD A CERTIFICATE OF LIABILITY INSURANCE DATE 1yQ8/zo„ 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 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 Phone:(425)771-5197 Far (425)673-4427 CONTACT Chris ORION INSURANCE GROUP,INC. =Nit 3405188TH ST SW Tac.No,Exit: (425)771-5197 IV.No„ (425)673-4427 SUITE#302 ADDR : ChrisDaypa OrionlnsGroup.com LYNNWOOD WA 98037 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A : RLI Insurance 13056 INSURED HWA GEOSCIENCES INC. INSURER S : Admiral Insurance Company 24856 21312 30TH DRiVE SE,SUITE 110 INSURER C : BOTHELL WA 98021-7010 INSURER D: INSURERE : INSURER F : COVERAGES CERTIFICATE NUMBER: 20866 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 POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDT SUER POLICY EFF POLICY EXP LTR INSR wVD POLICY NUMBER (MM,DD/YYYY) (MM/DD/YYYD LIMITS A GENERAL LIABILITY X X PSB0002638 12/01/17 12/01/18 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 300 000 PREMISES(Ea occuaence) $ CLAIMS-MADE X OCCUR MED.EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,005- -I. POLICY n JET n LOC A AUTOMOBILE LIABILITY X X PSA0001635 12/01/17 12/01/18 CAMBTNED SINGLE MU U (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED —SCHEDULED AUTOS _AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE _AUTOS (per accident) $ $ X UMBRELLA LIAR X OCCUR X X PSE0001834 12/01/17 12/01/18 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAR CLAIMS-MADE AGGREGATE $ 5,000,000 DED I RETENTION$ $ A WORKERSCOMPENSATION X PSB0002638 12/01/17 12/01/18 WCST'ATU• oTH ANO EMPLOYERS LIABI TTY TORY LIMITS ER $ ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N EL EACH ACCIDENT $ 1,000,000 OFPICERrMEMBER EXCLUDED? N/A EL DISEASE-EA EMPLOYEE (Mandatory in Mt $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 2,000,000 B Professional Liability Claims Made E000003589302 12/01/17 12/01/18 $2,000,000 Each Occurence $2,000,000 Aggregate $50,000 Deductible DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) City of Everett and all required parties are listed as additional insureds with primary non contributory wording. A waiver of subrogation applies in the favor of additional insureds. Cancellation has been modified to 30 days. Beverly Lake Sewer Replacement Project CERTIFICATE HOLDER CANCELLATION City of Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3200 Cedar St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Everett,WA 98201 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE r Attention: Christopher R. Day ACORD 25(2010/05) 1 4 ared marks©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are r gis of ACORD