United Way of Snohomish County 6/3/2019

DATE(MM/DD/YYYY) ACS o® CERTIFICATE OF LIABILITY INSURANCE 1/7/2019 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: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must 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 CONTACT Debbie Cook NAME: PHOELeavitt Group Northwest (A/C,No,Sot): (800)726-8771 (A/C No)' (866)728-9168 PO Box 65770 E-MAIL debbie-cook@leavitt.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# University Place WA 98464 INSURER A:Philadelphia Indemnity Insurance Compel' A18058 INSURED INSURER B:Arch Insurance Company 11150 United Way of Snohomish County INSURER C: 3120 McDougall Ave #200 INSURER D: INSURER E: Everett WA 98201-4433 INSURERF: COVERAGES CERTIFICATE NUMBER:19-20 Master 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. NOTWITHSTANDING 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER IMM/DD/YYYYI (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE RENTED A CLAIMS-MADE X OCCUR PREM SESO(Ea occurrence) $ __100,000 X PHPK1907835 1/18/2019 1/18/2020 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED AUTOS AUTOS PHPK1907835 1/18/2019 1/18/2020 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per accident) $ . X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 1,000,000 EXCESS LIAB A CLAIMS-MADE AGGREGATE $ 1,000,000 DED X RETENTIONS 10,000 PHUB654899 1/18/2019 1/18/2020 $ WORKERS COMPENSATION PER X OTH- AND EMPLOYERS'LIABILITY Yl N _ STATUTE ER - ANY PROPRIETOR/PARTNER/EXECUTIVE WA Stop Gap E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A A (Mandatory in NH) PHPK1907835 1/18/2019 1/18/2020 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Professional Liability PHPK1907835 1/18/2019 1/18/2020 Aggregate 2,000,000 B Directors & Officers Liab. NFP012625301 7/29/2018 7/29/2019 D&O Liability/EPLI 3,000,000 DESCRIPTION OF OPERATIONS(LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Everett, its officers, employees and agents are additional insureds per terms and conditions of form CG2026 0413 attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Everett THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Department of Planning ACCORDANCE WITH THE POLICY PROVISIONS. and Community Development 2930 Wetmore Avenue, Suite 8A AUTHORIZED REPRESENTATIVE Everett, WA 98201 lit.i'.—/)O Jeff Olsen/DECOOK 49 �( I - ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)