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DATE(MM/DD/YYYY) <br /> AWRD® CERTIFICATE OF LIABILITY INSURANCE <br /> 6/5/2019 <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 have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> NAME: <br /> HUB International Northwest LLC PHONE FAX <br /> 110 Unity Street .1A/C,No,Ext:360-647-9000 (Am,No):360-734-8496 <br /> Bellingham WA 98225 ADDRESS: now.bellinghaminfo®hubintemational.com <br /> INSURERS)AFFORDING COVERAGE NAIC t/ <br /> INSURER A:General Insurance Company of America 24732 <br /> INSURED WORKF-1 <br /> INSURER B: <br /> Work Force Development Center <br /> "A Resource For Our Future" INSURERC: <br /> 11400 Airport Road Suite 100 INSURER D: <br /> Everett WA 98204 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:2043757245 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 /> INSR TYPE OF INSURANCE ADDL SUBR POUCY EFF POUCY EXP LIMITS <br /> LTRIVSD WVD POLICY NUMBER IMM/DD/YYYY) (MM/DD/YYYY) <br /> A X COMMERCIAL GENERAL LIABILITY Y Y 24CC3040807 9/1/2018 9/1/2019 EACH OCCURRENCE $1,000,000 <br /> DAMAGE TO <br /> CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $1,000,000 <br /> MED EXP(Any one person) $10,000 _ <br /> PERSONAL&ADV INJURY $1,000,000 _ <br /> GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE $3,000,000 <br /> POLICY JET X LOC PRODUCTS-COMP/OP AGG $3,000,000 <br /> OTHER: $ <br /> A AUTOMOBILELIABIUTY 24CC3040807 9/1/2018 9/1/2019 COMBINEDSINGLEaccident)_ LIMIT $1,000,000 <br /> (Ea <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY (Per accident) <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> q WORKERS COMPENSATION 24CC3040807 9/1/2018 9/1/2019 PER X ORH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER WA Stop Gap <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 <br /> OFFICER/MEMBER EXCLUDED? N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $3,000,000 <br /> A Property 24CC3040807 9/1/2018 9/1/2019 Max Limit 3,308,465 <br /> Deductible 5,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) <br /> Per policy forms and conditions:Liability Plus Endorsement form CG 76 35 02 07. <br /> City of Everett,its officers,employees and agents are included. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> City of Everett <br /> 2930 Wetmore Ave Ste 8-A AUTHORIZED REPRESENTATIVE <br /> Everett WA 98201-4067 <br /> 9144k444 <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />