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DIVE CENTER CERTIFICATE <br /> ADDITIONAL INSURED SCHEDULE <br /> Agent Information Certificate#: 201900373 <br /> Vicencia&Buckley A Division of HUB International Member#: 21778 <br /> Insurance Services Effective Date: 06/30/2018 <br /> 6 Centerpointe Drive,#350 Expiration Date: 6/30/2019 12:01:00 AM <br /> La Palma,CA 90623-2538 <br /> (714)739-3177 FAX (714)739-3188 Policy issued by Tokio Marine Specialty Insurance <br /> (800)223-9998 Company <br /> License#:151305 Policy#:PPK1830783 <br /> Insured's Name and Mailing Address <br /> EVERGREEN DIVE SERVICE LLC <br /> 4610 EVERGREEN WAY,SUITE 1 <br /> EVERETT,WA, 98203 <br /> * THE CITY OF EVERETT ITS OFFICERS,AGENTS AND EMPLOYEES. <br /> * DIVER'S DREAM CHARTERS, PHILLIP JENSEN, 102 DISCOVERY VIEW DR.,SEQUIM,WA 98382 <br /> * ODEGARD&BOSECK LLC(LANDLORD) <br /> * MWR ACTIVITY AND THE U.S. NAVY <br /> * SNOHOMISH AQUATIC CENTER <br /> * FORREST PARK <br /> Additional Insured coverage applies only with respect to liability arising out of the operations of the named insured. <br /> NOTE: Professional and Instructors Liability is EXCLUDED under this policy.This coverage must be purchased under a separate Instructors <br /> Liability Insurance Policy.This Insurance is subject to all terms and conditions of the master policy to and held by PADI.A copy of the policy <br /> wording is attached to this certificate. Please read this document including its limitations,conditions and wording. <br /> Issued on behalf of: Date Authorized Representative <br /> Tokio Marine Specialty Insurance Company 07/09/2018 <br /> Steve Vicencia CPCU <br />