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Client#: 333229 HARGIENG
<br /> ACORDWM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)11/16/2018
<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 any rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> NAME:
<br /> USI Kibble & Prentice PR PHONE 206 441-6300 FAX
<br /> (A/C,No,Ext): (A/C,No): 610-362-8528
<br /> 601 Union Street,Suite 1000 ADDRESS: usi.CertRequest@usi.com
<br /> Seattle,WA 98101
<br /> INSURER(S)AFFORDING COVERAGE NAIL#
<br /> INSURER A:Travelers Property Cas.Co.of Americo 25674
<br /> INSURED INSURER B:Berkley Insurance Company 32603
<br /> Hargis Engineers, Inc. PhcenixlnsuranceCom an 25623
<br /> INSURER C: P y
<br /> 1201 Third Avenue,Suite 600
<br /> INSURER D:
<br /> Seattle,WA 98101-1217
<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 EFF POLICY EXP LIMITS
<br /> LTRINSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY)
<br /> A X COMMERCIAL GENERAL LIABILITY X X 6808H956484 03/14/2018 03/14/2019 EACHOCCURRENCE $1,000,000
<br /> I CLAIMS-MADE I X I OCCUR PREMISESO(Ea occurr nce) $1,000,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 000 000
<br /> POLICY I XI JECOT LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> IOTHER: $
<br /> c AUTOMOBILE LIABILITY X BA0D183887 03/14/2018 03/14/2019 COMaaccidBINEDent) $SINGLE LIMIT 1, �000 000
<br /> (E
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> X AUTOS ONLY X AUTOS ONLY (Per accident)
<br /> $
<br /> UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE _$
<br /> DED _RETENTION$ $
<br /> A WORKERS COMPENSATION 6808H956484 03/14/2018 03/14/2019 STATUTE X KH-
<br /> AND EMPLOYERS'LIABILITY
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N (WA Stop Gap) E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? I N I N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> B Professional AEC902136200 03/14/2018 03/14/2019 $2,000,000 per claim
<br /> Liability $2,000,000 annl aggr.
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> The General Liability and Automobile Liability policies include an automatic Additional Insured endorsement
<br /> that provides Additional Insured status to the Certificate Holder, its officers,employees and agents, only
<br /> when there is a written contract that requires such status,and only with regard to work performed on
<br /> behalf of the named insured.The General Liability and Automobile Liability policies contains a special
<br /> endorsement with Primary wording,when required by written contract.The General Liability policy includes
<br /> a Waiver of Subrogation endorsement in favor of the Certificate Holder as referenced above.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> City of Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Attn: Ruben Sanchez ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 3101 Cedar Street
<br /> Everett,WA 98201 AUTHORIZED REPRESENTATIVE
<br /> I `� —Ct. Ij''`
<br /> ©1988-2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br /> 44C7A111 Z1 G/R11711 Al A7A VIZI 170
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