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<br /> ACORNCERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
<br /> k`"..---- 11/27/2018
<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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Cari Maciolek, CIC, ACSR
<br /> Bell Anderson Agency, Inc. PHONE (425)291-5200 FAx
<br /> No,Extl' (AIC.No1:(425)291-5100
<br /> 600 SW 39th St, Suite 200 E-MAIL
<br /> ADDRESS:carlmQbell-anderson.com
<br /> INSURERS)AFFORDING COVERAGE NAIC#
<br /> Renton WA 98057 INSURER A:Union Insurance Company 25844
<br /> INSURED
<br /> INSURER B:
<br /> All Around Fence Company INSURER C
<br /> PO Box 1029 INSURER D:
<br /> INSURER E
<br /> Ravensdale WA 98051 INSURERF:
<br /> COVERAGES CERTIFICATE NUMBER:CL18112732247 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 /> WR
<br /> LTR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP 1
<br /> INSD WVD POLICY NUMBER /MMIDDIYYYYI IMWIDD/YYYYI t UNITS
<br /> X COMMERCIAL GENERAL LIABILITY IEACH OCCURRENCE $ 1,000,000
<br /> A CLAIMS-MADE X OCCUR DAMAGE 70 RENTED
<br /> PREMISES(Ea occurrence) $ 300,000
<br /> CPA602961224 12/1/2018 12/1/2019 MED EXP(Any one person) S 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEM.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> x POLICY B a LOC
<br /> PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> OTHER: Employee Benefits $ 1,000,000
<br /> AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT $ 1,000,000
<br /> (Ea accident)
<br /> ANY AUTO person) S
<br /> A X BODILY INJURY(Per
<br /> ALL OWNED I SCHEDULED
<br /> AUTOS i AUTOS CPA602961224 12/1/2018 12/1/2019 ;BODILY INJURY(Peracddent) $
<br /> i
<br /> HIRED AUTOS AUTOSNED I i PROPERTYDAMAGE $
<br /> X UMBRELLA LIAR Underinsured motorist S 1,000,000
<br /> _ OCCUR EACH OCCURRENCE $ 2,000,000
<br /> A EXCESS LAB CLAIMS-MADE AGGREGATE $ 2,000,000
<br /> DED X RETENTIONS 10,000 CPA602961224 12/1/2018 12/1/2019 $
<br /> WORKERS COMPENSATION _
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE I ERH
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE
<br /> E.L.EACH ACCIDENT S 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N/A
<br /> A (Mandatory In NH) CPA602961224 12/1/2018 12/1/2019 E.L.DISEASE-EA EMPLOYEE S 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY UNIT S 1,000,000
<br /> i
<br /> i
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached I more apace Is required)
<br /> RE: PO 8SW17051, Chain Link Security Fencing, Lift Station #15 - The certificate holder is additional
<br /> insured per the attached endorsement CLCG5029 1018.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> schristie@everettwa.gov
<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 /> PO Box 12130 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Everett, WA 98206-2130
<br /> AUTHORIZED REPRESENTATIVE
<br /> Jason Webb/CEM ' ....."----,,,b L-,'.'
<br /> ®1988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
<br /> INS025'2mnn
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