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SeniSSC66
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<br /> F _ . 05/181408,LI
<br /> )y11r 6 �1 ; r�6 ! e .. a14IPIssue Date
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES
<br /> NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF COVERAGE DOES NOT CONSTI TUE A CONTRACT
<br /> BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTAT IVE OR PRODUCER,AND THE CERT IFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGRATION IS WAIVED,subject to the terms and conditions of
<br /> the policy,certain coverage may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER �r_•� COMPANIES AFFORDING COVERAGE
<br /> GENERAL LIABILITY
<br /> Clear Risk Solutions American Alternative Insurance Corporation, et al.
<br /> 451 Diamond Drive
<br /> Ephrata, WA 98823 AUTOMOBILE LIABILITY
<br /> American Alternative Insurance Corporation, et al.
<br /> �. e• a� PROPERTY
<br /> Senior Services of Snohomish County American Alternative Insurance Corporation, et al.
<br /> dba Homage Senior Services
<br /> 11627 Airport Road, Suite B MISCELLANEOUS PROFESSIONAL LIABILITY
<br /> Everett, WA 98204 Princeton Excess and Surplus Lines Insurance Company
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
<br /> INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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.
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<br /> COMMERCIAL GENERAL LIABILITY N1-A2-RL-0000013-09 06/01/2018 06/01/2020 PER OCCURRENCE $5,000,000
<br /> OCCURRENCE FORM PER MEMBER AGGREGATE $10,000,000
<br /> INCLUDES STOP GAP PRODUCT-CO MP/OP $5,000,000
<br /> PERSONAL&ADV.INJURY $5,000,000
<br /> (LIABILITY IS SUBJECT TO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $50,000,000
<br /> AUT;OMdBIL LIAB1LfTY r" .ur RE 44 Eby Ed E44,4 4E14, EE NEEEPOW4a,4,41,4,-,, Ere nl E E ra€,EDEEMEE tt tV ru tt
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<br /> ANY AUTO N1-A2-RL-0000013-09 06/01/2018 06/01/2020 COMBINED SINGLE LIMIT $5,000,000
<br /> LIABILITY IS SUBJECT TO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
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<br /> N1-A2-RL-0000013-09 06/01/2018 06/01/2020 ALL RISK PER OCC EXCL EQ&FL $75,000,000
<br /> EARTHQUAKE PER OCC EXCLUDED
<br /> FLOOD PER OCC EXCLUDED
<br /> PROPERTY IS SUBJECT TO A$50 000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
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<br /> N1-A3-RL-0000060-09 06/01/2018 06/01/2020 PER CLAIM $1,000,000
<br /> (LIABILITY IS SUBJECT TO A $50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $40,000,000
<br /> DESCRIPTION OF OPERATIOf *1`jO :C a
<br /> Regarding Community Development Block Grant. City of Everett, its officers,employees,and agents are named as
<br /> Additional Insureds regarding this grant only and are subject to policy terms,conditions,and exclusions.
<br /> CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE
<br /> WITH THE POLI CY PROVISIONS.
<br /> " 44 - 444,4444044VM L, 27R 1 `3 k 97 BE4 3 P•Ui3:t� t4' ,.7 E .:.
<br /> City of Everett \% 54 a
<br /> 2930 Wetmore Ave
<br /> Everett,WA 98201
<br /> 3401115
<br />
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