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• Client#: 1067386 1ALLIGEO
<br /> ACORD,„ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)11/14/2018
<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 PHONEFAX
<br /> (arc,No,Ext):206 441-6300 (ac,No): 610-3624528
<br /> 601 Union Street,Suite 1000 Mass: usi.certre ues usi.com
<br /> Q
<br /> Seattle,WA 98101
<br /> INSURER(S)AFFORDING COVERAGE NAIL#
<br /> INSURER A:Travelers Indemnity Company 25658
<br /> INSURED INSURER B:Alaska National Insurance Company 38733
<br /> 1 Alliance Geomatics, LLC
<br /> INSURER C BerkleyInsurance 32603
<br /> 1261A 120th Ave NE
<br /> INSURER D Travelers Indemnity Company of CT 25682
<br /> Bellevue,WA 98005
<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 /> IN TRR TYPE OF INSURANCE NSR WVD POLICY NUMBER M/POLICY EFF POLICY EXP LIMITS
<br /> (MM/DD/YYYI� (MDO/YYYIr)
<br /> A X COMMERCIAL GENERAL LIABILITY X X 6800J771491 01/08/2018 01/08/2019 EACHEpAqMMISES(p OCCURRENCEEECpp $1,000,000
<br /> CLAIMS-MADE X OCCUR PREEaEoccurrrrence) $1,000,000
<br /> X WA Stop Gap/E.L. MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $2,000,000
<br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000PRO-
<br /> _
<br /> POLICY X JECT LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER: WA Stop Gap $1,000,000
<br /> D AUTOMOBILE LIABILITY X X BA0J77113A 01/08/2018 01/08/2019 COMBaccident)NEDS
<br /> INGLELIMIT $1,000,000
<br /> {Ea
<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 /> UMBRELLA LIAB OCCUR EACH OCCURRENCE _ $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED RETENTION$ $
<br /> B WORKERS COMPENSATION X UB5K9941231847G 01/24/2018 01/08/2019 STATUTE ETH
<br /> AND EMPLOYERS'LIABILITY
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N (USL&H Coverage) E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N 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 /> C Professional X AEC901849003 01/08/2018 01/08/2019 $1,000,000 per claim
<br /> Liability $1,000,000 annl aggr.
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE: 2019-2020 On-Call Survey Roster.
<br /> The General Liability and Automobile Liability policies include an automatic Additional Insured endorsement
<br /> that provides Additional Insured status to City of Everett, its officers,employees and agents, only when
<br /> there is a written contract that requires such status,and only with regard to work performed on behalf of
<br /> the named insured.The General Liability and Automobile Liability policies contain a special endorsement
<br /> (See Attached Descriptions)
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> Cityof Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Attn: Public Works Department ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 3200 Cedar Street
<br /> Everett,WA 98201 AUTHORIZED REPRESENTATIVE
<br /> ©1988-2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD
<br /> #S24319110/M23514626 HZBZP
<br />
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