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ENG2021-0391 NW Arborcare insurance 09.23.2021OP ID: BW CERTIFICATE OF LIABILITY INSURANCE D0823/202YY) 08123/2021 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 endorsements . PRODUCER CONTACT Gunning &Associates, Inc. PHONE FAX 14030 NE 24th St. (A/C No Ext: _.TNC No):_ —� Bellevue, WA 98007 E-MAIL Becky L Witty PaooucER - -- - — - INSURED NW Arbor Care LLC P. O. Box 6184 Edmonds, WA98026 ENG2021-0391 -LN3W12iVd3O S3OI/�2i3S 1N3 Wd013/�3O R(lN0 WO3 �(� A 110 I ZOZ CZ daS rFRTIPWATP NI IMRPP- c STOMER to r: NWARB-1 INSURER(S) AFFORDING COVERAGE _ _ NAIC N INSURER A: Western World Ins. Co. A IX_ _ 13196 INSURER Et: Ohio Security Insurance Co 24082 INSURER c : American Contractors Indemnity _ INSURER D : OCvtc In Al •11IaADOD. EN WMVJPOLICIES 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 IICY EFF POLICY EXP L R TYPE OF INSURANCE iINSIRAD-6U$11�R1 POLICY NUMBER MMlOD/YYYY MM OD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 _ I A COMMERCIAL GENERAL LIABILITY 01/02/2021 01/02/2022 '�. PREMISES (Ea occurrence i 100,000 _ CLAIMS -MADE ; X OCCUR ! MED EXP (Any one person) i5,000 S 2,000,000 S 3,000,00 PPEERS_ONAL & ADV INJURY _ AGGREGATE LIMIT APPLIES PER I I GENERAL AGGREGATE I PRODUCTS - COMPIOP AGG S 2,000,000 _GEN'L Poucv I X I PRO- i Loc Prof aLi b _ s included AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 I I ANY AUTO (Ea acadelH) t--- — -- -- — -- _ B X� ALL OWNED AUTOS BODILY INJURY (Per person) $ BAS55388366 01/02/2021 01/02/2022 '• -!-- - - �— BODILY INJURY (Per accident) I $ SCHEDULED AUTOS — ---- - I PROPERTY DAMAGE $ X I HIRED AUTOS i (PER ACCIDENT) I X NON OWNED AUTOS I �----------- -- S_ --_— -------------5-- ---- I UMBRELLA LIAR - OCCUR I EACH OCCURRENCE S EXCESS LIAR CLAIMS MADE __— AGGREGATE S DEDUCTIBLE S -- RETENTION S S WORKERS COMPENSATION WCSTATU- I X OTH- '--'IORYJ.IMl7il AND EMPLOYERS' LIABILITY YIN A ANY PROPRIETORIPARTNER/EXECUTIVE NPP8489289 01/02/2021 01/02/2022 $ 1,000,000 EL EACHACCIDENT --- OFFICER/MEMBER EXCLUDED? (Mandatory In NH) I NIA EMPL LIAB/STOP GAP E.L. DISEASE - E_A EMPLOYEE$ -- — 1,000,000 If yes. describe under E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below I S 1,000,000 C Contractors Bond ! 100449800 I 07101/2021 07/01/2022 Limit 6,000 _ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Evidence of Insurance 1. c:m I If II.HI C 1-1 ULL)rf% GANUtLLAI IUN TOWHOMI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN To Whom It May Concern ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Becky L Witty 1 e;i". lJ 19t5t5-ZUU9 AGUNU CUKPUKAI IUN. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD L&I regional offices are closed to public visits until further notice. Offices can still help you by phone from 8 a.m. to 5 p.m. weekdays (except state holidays). Use the phone number for your closest regional office fhtlos:onima.aov/agency/conlact/aofrice-locations) or you can call the Office of Information and Assistance at 360-902-5800. Aft li i ,i.:I I.,!' r,d aa: NW ARBOR CARE LLC Owner or tradesperson Principals GRIFFITHS, MARK PHILLIP, PARTNER/MEMBER Doing business as NW ARBOR CARE LLC WA UBI No 604 442 778 License PO BOX 6184 EDMONDS. WA 98026 425-745-1889 SNOHOMISH County Business type Limited Liability Company Verify the contractors active registration / license / certification (depending on trade) and any past violations Construction Contractor Active Meets current requirements. License specialties Tree Removal Service License no NWARBAC814L1 Effective — expiration 07/01/2019— 07/01/2021 Bond American Contractors Indem CO 56.000 00 Bond account no 100449800 Received by L&I Effective date 06121/2019 07101/2019 Expiration date Until Canceled Insurance Western World Ins Co $1,000,000.00 Policy no NPP8489289 Received by L&I Effective date 12/3012019 01/02/2020 Expiration date 01/02/2021