Northwest Corrosion Engineering 3/26/2019

®4aRDCERTIFICATE OF LIABILITY INSURANCE DATE A s Y)ro7/2o THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: lithe certificate holder is an ADDITIONAL INSURED,the pollcy(fes)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER N CONTACT Molly Saber Wycoff Insurance Agency Inc. RtiohlE (360)336112-2FAX 501 South 2nd Street moo,Eiel: (A1C,No): (360)336-5241 aDDRE :: MoliyS©wycoffinsurance.com P.O.Box 1010 INSURER(S)AFFORDING COVERAGE MAIC 0 Mount Vernon WA 98273 esu A: Ohio Security Insurance Co. 24082 INSURED INSURER B: The Ohio Casualty Insurance Co. 24074 Northwest Corrosion Engineering INSURER C: LANDMARK AMERICAN INS CO PO Box 905 INSURER D: INSURER E: Burlington WA 98233 INSURER F: COVERAGES CERTIFICATE NUMBER: 19-20 ALL REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIR TYPE OF INSURANCES gp www POLICY NUMBER POLICY EH- POLICY SAP tMMIDD/YYYY) (MMIDO/YYYY) LIMIT'S X COMMERCIAL GENERAL LIABILITY EACH OCCURRENE $ 1,000,000 CLAIMS-MADE OCCUR DAMAUEIURENTED 1,000,000 PREMISES(Ea 000urrenea) E —.__ MED EXP(Any one person) $ 15,000 A BKS57089885 01/21/2019 01/21/2020 PERSONAL 8,ADV INJURY $ 1,000,000 GEN'L AGGREGATE UMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 __ POLICY �ECaT n LOC PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER: LEXE $ AUTOMOBILE LJABILITY COMBINED SINGLE LIMIT v$ 1,000,000 (Ea sodden)) ANY AUTO BODILY INJURY(Per person) $ A _ xULED BAS57099885 01/21/2019 01/21/2020 BODILY INJURY(Per aoddent $ - AUTOS ONLY AUTOS HIRED X PROPERTY $X AUTOS ONLY AUTOSONLYY (Per aent) Underinsured motorist s X UMBRELLA UAB __ OCCUR EACH OCCURRENCE $ 2,000,000 B EXCESS UAB CLAIMS MADE USO57099885 01/21/2019 01/21/2020 AGGREGATE $ 2,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N i STATUTE EOR 1 ANY PROPRIETOR/PARTNER/EXECUTIVE 1 I OFFICERN/A E.L EACH ACCIDENT $ IMEMBER EXCLUDED? (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY UMIT $ PROFESSIONAL LIABILITY- EACH CLAIM $2,000,000 C CLAIMS MADE LHR836367 12/15/2018 12/15/2019 AGGREGATE $2,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If mon space Is required) CERTIFICATE HOLDER IS ADDED AS ADDITIONAL INSURED PER ATTACHED FORM CG8S10 04/13. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DEUVERED IN CITY OF EVERETT ACCORDANCE WITH THE POUCY PROVISIONS. 3200 CEDAR STREET AUTHORIZED REPRESINrATIVE EVERETT WA 98201 .1/1//' ^/(atty I CZ-, gc:5004,--".-\-----' 01888-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2015103) The ACORD name and logo are registered marks of ACORD