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® DATE(MM/DD/YYYY)
<br /> AR L® CERTIFICATE OF LIABILITY INSURANCE
<br /> 11/15/2018
<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). 1
<br /> CONT
<br /> PRODUCER McGriff Insurance Services NAMEACT Memphis Certificates
<br /> 6000 Poplar Avenue, Suite 300 PHONE
<br /> NNQ Extl:
<br /> E-MAIL (901)684-3333 FAX
<br /> Memphis, TN 38119 No): (901)530-1963
<br /> ADDRESS:
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA: Fireman's Fund Insurance Company 21873
<br /> INSURED INSURER B: Navigators Specialty Insurance Company 36056
<br /> ASPI, LLC
<br /> 5205 S. 2nd Ave Ste. A INSURER C:
<br /> Everett WA 98203 INSURER D:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 45392022 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. NOTVNTHSTANDING 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 /> IPOLICY EFF POLICY EXP
<br /> NSR
<br /> TYPE OF INSURANCE NSD SUBRwvPOLICY NUMBER (MM/DD//YYYY) IMM DD/YYYYI
<br /> LIMITS
<br /> A / COMMERCIAL GENERAL LIABILITY / AZC80920311 10/19/2018 12/12/2018 EACH OCCURRENCE $1,000,000
<br /> DAMAGE CLAIMS-MADE s/ OCCUR PREM SESO(EaENTEoccu ence) $100,000
<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 ✓ JECT LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY ✓ MZA8039244 10/19/2018 12/12/2018 (Eo aBeNdeDtSINGLE LIMIT $1,000,000
<br /> ✓ ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY (Per accident) —
<br /> A / UMBRELLA LIAB / OCCUR AZC80920311 10/19/2018 12/12/2018 EACH OCCURRENCE $5,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000
<br /> DED RETENTION$ $
<br /> A WORKERS COMPENSATION WZC81043895 10/19/2018 12/12/2018 v/ STATUTE 0TH
<br /> ER
<br /> AND EMPLOYERS'LIABILITY Y/N MD,TN,FL,NV
<br /> ANYPR RPRIETO MEMBER ECUTIVE N N/A Stop Gap WA E.L.EACH ACCIDENT $1,000,000
<br /> OFFIC(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 Liability CE17MPL081739NC 10/19/2018 12/12/2018 Per Claim Limit-$2,000,000
<br /> Aggregate Limit-$2,000,000
<br /> Deductible Each Claim$25,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
<br /> City of Everett,its officers,employees and agents are included as Additional Insured with respect to General Liability and Auto Liability
<br /> on a primary basis with 30 Days Notice of Cancellation; 10 Days Notice for Non-Payment of Premium.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Attn: Shaun Bridge ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 3200 Cedar St.
<br /> Everett WA 98201
<br /> AUTHORIZED REPRESENTATIVE
<br /> ‘17atZ21Q YVe•CL&j/,
<br /> I Natalie Mc Gulley
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> 45392022 I ASPI, LLC Casualty 10.19.17-12.1 I Nerissa Bright 111/15/2018 7:50:57 AM (CST) I Page 1 of 1
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