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HYDRSTA-01 AMICHEL <br /> ACORO DATE(MM/DD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 05/31/2018 <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 suchpendorsement(s). <br /> PRODUCER NOMEACT <br /> Hub International Northwest LLC (MC,r o,Ext):(425)489-4500 �FAX No):(425)4854489 <br /> 12100 NE 195th Street,Suite 200 IL <br /> Bothell,WA 98011 E MAADDRESS:now.info@hubinternational.com <br /> INSURER(S)AFFORDING COVERAGE NAIC 0 <br /> INSURER A:Scottsdale Insurance Company 41297 <br /> INSURED INSURER B: <br /> Hydrology Stand Up Paddle,LLC INSURERC: <br /> 4816 College Ave INSURERD: <br /> Everett,WA 98203 <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 /> INSRY EXP <br /> TYPE OF INSURANCE IINSD SUBRL D POLICY NUMBER (MPOLICY <br /> DY/YYYYI EFF I tMM/DD/YYYYI LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE X OCCUR CPS3053266 06/10/2018 06/10/2019 DAMAGE TO RENTED 100,000 <br /> X PREMISES(Ea occurrence) $ <br /> MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY jjRa LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> OTHER: STOP GAP $ 1,000,000 <br /> AUTOMOBILE LIABILITY (Ea ardentD)SINGLE LIMIT $ — <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED <br /> _ AUTOS��DONLY AUTOSNED _BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS ONLY (Per acEcident)DAMAGE <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATIONPER <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ERH <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE IN/A E.L.EACH ACCIDENT $ <br /> OFFICER/M n BE EXCLUDED? <br /> i ) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <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 /> Re:Project Service Agreement <br /> City of Mukilteo is included as Additional Insured per the attached forms/endorsements. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Cityof Mukilteo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 304 Lincoln Ave,Suite 108 <br /> Mukilteo,WA 98275 <br /> 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 />