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s <br /> LAWYERS PROFESSIONAL LIABILITY INSURANCE <br /> Policy No: 17B01328163 <br /> DECLARATION PAGE Unique Market Reference Number: B113517B01328 • <br /> • <br /> CLAIMS MADE FORM/DEFENSE WITHIN LIMITS <br /> THIS IS A CLAIMS MADE FORM. COVERAGE IS LIMITED TO LIABILITY FOR ONLY THOSE CLAIMS THAT ARE I <br /> FIRST MADE AGAINST THE INSURED AND REPORTED TO THE COMPANY DURING THE POLICY PERIOD. i <br /> t <br /> Please Read Carefully i <br /> 1 <br /> 1. Policy Issued To: <br /> Snohomish County Legal Services <br /> 2731 Wetmore Ave,Suite 410 <br /> Everett,WA 98201 - 1 <br /> 2. Period of Coverage: 2/1/2018 to 2/1/2019 <br /> i <br /> 3. Coverages,Deductibles,Limits of Liability,and Retroactive Dates: i. <br /> (Optional Coverage Described in the Policy Only Applicable If So Indicated Below With Listed Premium) <br /> i <br /> i <br /> Coverage Type Limit of Limit of Retro- - - <br /> Deductible Liability Per Liability Active Premium • I <br /> Claim Aggregate Date <br /> 1 <br /> Professional Liability(Art I, Sec A) $1,000 $1,000,000 $1,000,000 7/1/83 $1,687.00 <br /> Including The Following Optional <br /> Coverages <br /> (Strikethrough As Not Applicable) <br /> Disciplinary Proceedings(Defense <br /> Coverage)(Art I,Section B) f <br /> Defense of Contempt Proceedings <br /> (Art I,Sec. C) <br /> Outside Practice of Law(Art. I, Sec A(6) N/A None None None N/A <br /> Personal Injury(Sublimits) $1,000 $100,000 $300,000 7/1/83 Included <br /> 1 <br /> Management Liability(Art I,Sec D) $1,000 $1,000,000 $1,000,000 2/1/11 $493.00 <br /> i <br /> Employment Liability (Art I,Sec E) N/A None None None N/A <br /> Punitive Damages(Art IV, Sec A 6) N/A None None None N/A <br /> 1 <br /> Injunctive Relief N/A None None None N/A1. <br /> Total Premium: $2,180.00 <br /> WA Surplus Lines Tax: $43.60, E <br /> WA Stamping Fee: $2.18 i <br /> Total Due: $2,225.78 • <br /> This contract is registered and delivered as a surplus line coverage under the insurance code of the state of 1 <br /> Washington, Title 48 RCW. It is not protected by any Washington state guaranty association law. Laurie S. <br /> z <br /> Coleman <br /> z <br /> I <br /> I <br /> IJ <br /> i <br /> 1 <br /> t <br /> } <br /> i <br /> i <br /> i <br />