2018/10/17 Council Agenda Packet

r Lk ACERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD1YYyy) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.08/THIS 18 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 Valley Insurance Group LLC DBA:Soloman Insurance ONE tPdHA Araceli Torres 415 Berkeley AVE A/C No Ext: (253)566-1069 •►' na (AIC,No): 8665660991 ADDRESS: araceli@solomanius.com Fircrest WA 98466 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: HARTFORD CAS INS CO 29424 Bruce C.Allen&Associates,A Washington Corporation ENSURER B; DBA:Valbridge Property Advisors/Allen Brackett Shedd - 18728 Bothell Way NE Ste B INSURER D: - Bothell INSURER E: WA 98011 INSURER F COVERAGES CERTIFICATE NUMBER: EMI 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. DIRK TYPE OF INSURANCE uu `oma ICY EFF POLICY EXP INSD WVD POLICY NUMBER X COMMERCIAL GENERAL LIABILITY ( D/YYYY, (MM/DD1YYYy) LIMITS 111111 CLAIMS MADE X I OCCUR EACH OCCURRENCE $ 2,000,000 •'1'• •-o SPC PREMISES(Ea occurrence $ 300,000 A III 52SBAVX2197MED EXP(My one person) . $ 10,000 04/01:2018 04/01,2019 PERSONAL&ADV INJURY $ GEM_AGGREGATE1---�LIMIT APPLIES PER 2000,000 GE isPOLICY r "'1781, 1 LOC GENERAL AGGREGATE $ 4,000,000 OTHER PRODUCTS-COMP/OP AGG $ 4,000,000 AUTOMOBILE LIABILITY $ GUM8INED al ANY AUTO (Ea accidentUMI l $ 2,000,000 111 OWNED SCHEDULED BODILY INJURY(Per person) $ AUTOS ONLY AUTOS 52SBAVX2197 ©HIRED NON-OWNED 04/01/2018 04/01i2019 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIARI X OCCUR $ A ■EXCESS LIAR ■CLAIMS MADE 52SBAVX2197 EACH OCCURRENCE $ 1,000,000 DED X RETENTIONS 10,000 ()4/01, 018 04/01/2019 AGGREGATE $ 1,000,000 ORNERS COMPENSATION 'ND EMPLOYERS'LIABILITY $ • PROPRIETOR/PARTNER/EXECUTNE Y/N STATUTE ER A •FFICER/MEMBEREXCLUDED? I N/A 52SBAVX2197 r EL EACH ACCIDENT andatoryinNH) 04.01/2018 04/01/2019 $ 1,000,000 f yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-EA EMPLOYEE $ 1,000,000 EL DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:City of Everett-Certificate Holder is named as additional per written contract per attached form#SS00080405.Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008 attached to the policy. CERTIFICATE HOLDER CANCELLATION ( SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 3200 Cedar Street Everett WA 98201 AUTHORIZED REPRESENTATIVE !trak .TarrCt- ACORD 25(2015/03) ra_ 72 ©1988-2095 ACORD CORPORATION- an rinhf. .,