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ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4...------ 8/15/2019 8/16/2018 - 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 Lockton Companies NAOMTE CT 444 W.47th Street,Suite 900 PHONE FAX Kansas City MO 64112-1906 E MAIL Ext). (A/C,No): (816)960-9000 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC X INSURER A:Valley Forge Insurance Company 20508 INSUREDKDW Salas O'Brien,LLC INSURER B:National Fire Insurance Co of Hartford _ 20478 1441719 do Salas O'Brien Holdings,Inc. INSURER C:Continental Casualty Company 20443 3700 South Susan St,Ste 150 INSURER D:The Continental Insurance Company 35289 Santa Ana CA 92704 INSURER E: INSURER F: COVERAGES SALOBOI CERTIFICATE NUMBER: 15552862 REVISION NUMBER: XXXXXXX 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 ADDL SPOLICY EFF POLICY EXP TYPE OF INSURANCE INSD WVD POLICY NUMBER MI (MDDlYYYYO (MM/DD/YYYY) LIMITS D X COMMERCIAL GENERAL LIABILITY Y N 6050432756 8/15/2018 8/15/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $ 300,000 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: ', GENERAL AGGREGATE $ 2,000,000 POLICY X JECT [ _..1 LOC PRODUCTS-COMP/OP AGG s 2,000,000 OTHER: $ D AUTOMOBILE LIABILITY Y N 6050475025 8/15/2018 8/15/2019 COMBINED SINGLE LIMIT $ (Ea accident) 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED AUTOSNLY SCHEDULEDUTOBODILY INJURY(Per accident) $ XXXXXXX HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX AUTOS ONLY AUTOS ONLY (Per accident) $ XXXXXXX UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE AGGREGATE $ XXXXXXX DED RETENTION$ ! $ XXXXXXX WORKERS COMPENSATION ,, I PER OTH- A AND EMPLOYERS'LIABILITY 6050520979(AO ) 8/ 5/2018 8/15/2019 sTATU-TE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 6050432742(CA) 8/15/2018 8/15/2019 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C PROFESSIONAL N N AEH591877402 . 8/15/2018 8/15/2019 $1,000,000 PER CLAIM/AGG. LIABILITY DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:CITY OF EVERETT,ITS OFFICERS,EMPLOYEES AND AGENTS ARE ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY AND AUTO LIABILITY,AND THESE COVERAGES ARE PRIMARY AND NON-CONTRIBUTORY,AS REQUIRED BY WRITTEN CONTRACT.THIRTY(30) DAYS NOTICE OF CANCELLATION BY THE INSURER WILL BE PROVIDED TO THE CERTIFICATE HOLDER,TEN(10)DAYS NOTICE IN THE EVENT OF NONPAYMENT OF PREMIUM. CERTIFICATE HOLDER CANCELLATION See Attachments 15552862 CITY OF EVERETT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3101 CEDAR STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EVERETT WA 98201 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE/ I .1lam% 4rIA ©1988L�075 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD