GeoTest Services Inc 12/3/2018 - Laserfiche WebLink

A�® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 10/29/2018 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 CONTACT Sandi Jones NAME: Rice Insurance LLC PHONE (360)734-1161 FAX (360)734-1173 (A/C,No,Ext): (A/C,No): 1400 Broadway E-MAIL sandi@riceinsurance.com ADDRESS: P.O.Box 639 INSURER(S)AFFORDING COVERAGE NAIC# Bellingham WA 98227INSURERA: American Hallmark 43494 INSURED INSURER B: Crum and Forster Specialty Insurance GeoTest Services,Inc. INSURER C: 741 Marine Dr INSURER D: INSURER E: Bellingham WA 98225 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1832850792 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. INSR ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR .INSD WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,DAMAGE T000 REN CLAIMS-MADE X OCCUR PREM SESO(Ea occED urrence) $ 300,000 MED EXP(Any one person) $ 5,000 A Y Y 44CL604875 04/02/2018 04/02/2019 PERSONAL&ADV INJURY $ 1,000,000 _ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X TET LOC PRODUCTS-COMP/OPAGG $ Included JEC OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y Y 44CL604875 04/02/2018 04/02/2019 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE Y Y 44CU605188 04/02/2018 04/02/2019 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER 0TH- AND EMPLOYERS'LIABILITY STATUTE X ER Y/N 1 000 000 A ANY PROPRIETOR/PARTNER/EXECUTIVE N I A 44CL604875-WA StopGap04/02/2018 04/02/2019 E.L.EACH ACCIDENT $ , , OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 10 , 00000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , Limit 2,000,000 Professional Liability B Pollution Liability Y Y PKC107374 04/02/2018 04/02/2019 Limit 2,000,000 Deductible DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Professional Services Agreement thru 12-31-2020 Certificate Holder is Additional Insured as respects to attached form A 01/10 for General Liability. Coverage is Primary and Non Contributory and the Waiver of Subrogation is included in form#MP9767 for General Liability.Completed Operations is included per form B 01/10. Professional/Pollution Additional Insured form EN0111-0211 is included and the primary and Non contributory/Waiver of Subrogation is form EN0118-0211. Auto Additional Insured per form#BA2060 04/11 Primary/Non Contributory applies with the Waiver of Subrogation for the Auto Liability. Umbrella is following form.30 days notice for cancellation,10 days non pay. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Everett ACCORDANCE WITH THE POLICY PROVISIONS. 3200 Cedar St. AUTHORIZED REPRESENTATIVE Everett WA 98201 �j•(J� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD