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AC CERTIFICATE OF LIABILITY INSURANCE DATE(MMVDDIYYYY) <br /> 07/30/2018 <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 be endorsed. If SUBROGATION IS WAIVED,subject to the <br /> terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT BVVI Program Support <br /> NAME: <br /> Veracity Insurance Solutions,LLC. IPnl No.Ext: (888)568-0548 !FAXNd)_801-763-1374 <br /> 260 South 2500 West,Suite 303 E-MAILinfo@insurebodywork.com <br /> Pleasant Grove UT 84062 _ INSURERIRAFFORDING COVERAGE NAICa <br /> INSURERA: Great American Alliance Insurance Company 26832 <br /> INSURED INSURER B: <br /> Megan McKenna,DBACIownarific INSURERC: Y_____ <br /> 322 171st st se INSURERD: <br /> bothell WA 98012 INSURERE: _ <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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 /> INSRLTYPE OF INSURANCE ADDL Swvo POUCY NUMBER i IPOLICY <br /> M D YDIYYYYI (MMDD!EXP <br /> LtITS <br /> GENERAL UABILITY EACH OCCURRENCE S 2,000,000 <br /> X DAMAGETO RENTED 300,000 <br /> COMMERCIAL GENERAL LIABILITY IT r PREMISES(Ea occurrence) $ <br /> ■ X CLAIMS-MADE I I OCCUR 'A I MED EXP(Any one person) S 5,000 <br /> A PL1743888-BWI119822X 106/11/2018 06/11/2019PERSONAL8ADVINJURY $ INCLUDED <br /> GENERAL AGGREGATE $ 3,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG S 3,000,000 <br /> X I POLICY rte'JEOT f LOC • ANIMAL BAILEE S <br /> AUTOMOBILE LIABILITY '., COMBINED SINGLE LIMIT <br /> ®ANY AUTO BODILY INJURY(Per person) S <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) S <br /> AUTOS AUTOS <br /> I NON-OWNED PROPERTY DAMAGE S <br /> HIRED AUTOS AUTOS (Per accident) <br /> S <br /> i <br /> UMBRELLA LIAR I OCCUR • <br /> I� EACH OCCURRENCE S <br /> i EXCESS LIAB CLAIMS-MADE .. AGGREGATE S <br /> DED I RETENTION S S <br /> WORKERS COMPENSATION WC STATU- I OTH- <br /> AND EMPLOYERS'LIABIUTYTORY LIMITS, ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N N/A E.L.EACH ACCIDENT S <br /> OFFICE/MEMBER EXCLUDED? <br /> (Mandatory In NH) ' EL.DISEASE-EA EMPLOYEE,S <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S <br /> A 'Professional Liability I n PL1743888-BWI119822X 06/11/2018 06/11/2019 INCLUDED <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> It is understood and agreed that the Certificate Holder is named as Additional Insured per attached CG 20 26(Ed.04 13)-Additional Insured <br /> -Designated Person or Organization subject to all policy terms,conditions,and exclusions. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Cit of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Y ACCORDANCE WITH THE POUCY PROVISIONS. <br /> 802 E.Mukilteo Blvd <br /> Everett,WA 98203 �/�''���� <br /> AUTHORIZED REPRESENTATIVE .1e / �J�` <br /> 61� <br /> I <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD <br /> INS025 1201401) <br />