|
SeniSSC66
<br /> wz mre4-0 -34m.w • i(.,.,r.,4d.zB4..E� 1?. sl I a.i;ll p.Fi!i € ak�I.i , 7leZ l'Es�Fr 4a{!4E:}1dt lal g
<br /> Er Ii!l��.1E
<br /> il
<br /> 1.,
<br /> '
<br /> , 'r` a iE14 4.it = (F
<br /> o .: dgLttt#4 .ici t . uessiP 11 ,II 1(1' 4 k €ki )lt ,
<br /> ,tt � � 4��v r41s ti t l rftr
<br /> * M f41 en04..0-1T"!
<br /> k i i,f l,k ° ^;
<br /> !
<br /> � d11 . 3E 11 . t6 ii ' paFt ;RAN
<br /> #fw ' ,= 1011r',, E E , �3P0 ��0 E i I #? ff ;,� . a , .aAWAN
<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 CONSTITUE 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 x 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 /> IN UR b
<br /> 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 SH OWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> i.:
<br /> 41011410."Nti
<br /> ■�" =, fi 15!. xaaa1 xir, rq�l ,� .k�1 ` 4€�•1#3r(a9 1E €,fr
<br /> , .. ,r .� +.,.,., .&w..,_uL,Y. ,i.e tlNe9X+MCY.'•.y. •. '.:Ag.19rSP,fet.:.A.fy.:,e�c4 k0i ft4 Ef=.15fietA9",»H. ttG�,AtlW'L Y.t&=.:X .:4kTL CaM,>4A3, <.. .3.:3.3 tW143!)3tA2tlY.h,.l3Y. .fi,v,AVInC93=�ffi=t01t.�3' 33 tth3 tl3,3„rd3'3,.1411 [.tlt
<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 /> 1 we, 4 . +�{ nq,et,3�Y4 8,:F ff if bt�'C€7'. f.irib4'�3i�4£0 E -t £�' M1 W€k€tl31 W3 E,'k- C,1k;43 i�!n
<br /> �`�1 td w re a r,.M1,wYnr n v
<br /> ANY AUTO N1-A2-RL-0000013-09 H 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
<br /> 1 �
<br /> .,.
<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
<br /> MISCELL
<br /> A���� �SIONAL LIABILIT'�
<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 $40,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I SPO;,41%110.$
<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 /> F.EA,P 177E"'�"
<br /> CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE
<br /> City of Everett (?)1
<br /> 2930 Wetmore Ave A.41'
<br /> Everett, WA 98201
<br /> 3401115
<br />
|