Workforce Snohomish 7/19/2019 - Laserfiche WebLink

WORKDEV-01 TOSTER ARL DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 6/11/2019 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 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 CONTACT Tiffany Brewster PLC Insurance LLC 19401 40th Ave W,Suite 440 (A/C No,Ext):(425)275-0557 (A/C,FAX o): Lynnwood,WA 98036 E-MAIL tiffany@plcins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Philadelphia Indemnity Ins Co. 18058 INSURED INSURER B: Workforce Development Council Snohomish County INSURER C: 808-134th St.SW Ste.105 INSURER D: Everett,WA 98204 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 SUER WPOLICY NUMBER /YPOLICY EFF POLICY EXP LIMITS LTR INSD VD IMM/DDYYYI.IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY _EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PHPK18587158/1/2018 8/1/2019 DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 PERSONAL BADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: WA Stop Gap $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) ANY AUTO PHPK1858715 8/1/2018 8/1/2019 BODILYINJURY(Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED X NON WNED PROPERTY YDAMAGE AUTOS ONLY AUTO ONLY ( accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE _ $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under I DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liab PHPK1858715 8/1/2018 . 8/1/2019 Per Occurrence 1,000,000 A PHPK1858715 8/1/2018 8/1/2019 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:2019 Human Needs Grant City of Everett,its officers,employees and agents are included as Additional Insured when required by contract or agreement per the attached PIGLDHS 10/11.; CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Everett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Dept of Planning and Community Development Attn:Kembra Landry 2930 Wetmore Ave,Suite 8A AUTHORIZED REPRESENTATIVE Everett,WA 98201-4044 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserve . The ACORD name and logo are registered marks of ACORD