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SNOHCOU-01 KGREEN <br /> ACOREY DATE(MM/DD/YYYY) <br /> �� CERTIFICATE OF LIABILITY INSURANCE 03/27/2018 <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 have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER License#224596 CONTACT <br /> ONT CT <br /> HBT Insurance HO <br /> P.O Box 833 (A//cC,No,Ext):(253)833-5140 FAX No):(253)939-9356 <br /> Auburn,WA 98071 E-MAILDESS:info@hbtinsurance.coro <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Foremost Signature 41513 <br /> INSURED INSURER B: <br /> Snohomish County Legal Services INSURER C: • <br /> PO Box 5675 INSURER D: <br /> Everett,WA 98206 • <br /> INSURER E: <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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTR INSD Vi/VD IMM/DDIYYYYI IMM/DD/YYYYI <br /> A X COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE _$ 1,000,000 <br /> CLAIMS-MADE X OCCUR PAS037663755 03/01/2018 03/01/2019 PREMISES IEa occurrence) $ <br /> MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY PROT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> JEC <br /> OTHER: CMBINE $ <br /> A AUTOMOBILE LIABILITY - (EaacccideDtSINGLE LIMIT $ 1,000,000 <br /> ANY AUTO PAS037663755 03/01/2018 03/01/2019 BODILY INJURY(Per person) $ <br /> AUTOSAONLY _ SCHEDULED <br /> BODILYINJURY(Per accident) $ <br /> X HIRAUEDTOS ONLY AUTX NONO WONLYNNEL? PROPERTY'DAMAGE <br /> accident) <br /> $ <br /> UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ _ <br /> EXCESS LIAB- CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> A WORKERS COMPENSATION STATUTEPER X OTTH- <br /> AND EMPLOYERS'LIABILITY PAS037663755 03/01/2018 03/01/2019 1,000,000 <br /> ANYY IPROPRIE OR EXRTNER/E ECUTIVE Y/N N/A E.L.EACH ACCIDENT $ <br /> (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) • <br /> Snohomish County,its officers,elected officials,agents and employees are named as Additional Insured,per attached Endorsement. <br /> • <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Snohomish CountyAttn: HSD Contracts THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED•IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 3000 Rockefeller Avenue, <br /> M/S 305 <br /> Everett,WA 98201 AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />