The URL can be used to link to this page

ENP2022-0009+Certificate_of_Liability_Insurance+3.10.2022_1.26.27_PM+273036772/28/2022 (MM/DD/YYYY) A`oRo° CERTIFICATE OF LIABILITY INSURANCE 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 NAME: Tiffany Krueger Downers Grove, IL -Hub International Midwest West PHONE FAX 1411 Opus Place A/c No Ext : 630-468-5600 A/c No): Suite 450 ADDRIESS: Downers Grove IL 60515 License#: 100290819 INSURER A: Everest Indemnity Insurance Company Named Insured and Address CAVENTU-01 INSURERB: Markel CA Senior Edmonds WA Property Owner, LLC INSURERC: 130 East Randolph Street, Suite 2100 INSURERD: Chicago, IL 60601 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER:353005731 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 LTR TYPE OF INSURANCE DDL AINSD SUBR AVID NUMBER PICPOLICY MM DDY/YYYY EXP MM/ DY/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y TBD 3/1/2022 9/1/2024 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR DAMAGES( RENTED PREMISES Ea occurrence) $Excluded MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JE LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Deductible $ 25,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY r AUTOS ONLY $ A UMBRELLA LIAB OCCUR Y TBD 3/1/2022 9/1/2024 EACH OCCURRENCE $5,000,000 X N AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DIED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBFREXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Excess Liability Y TBD 3/1/2022 9/1/2024 5,000,000 Each OCC 5,000,000 Agg DESCRIPTION OF OPERATIONS 21200 72nd Ave W. Edmonds, WA City of Edmonds is included as Additional Insured as their interest may appear. CERTIFICATE HOLDER CANCELLATION Name and Address SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Edmonds ACCORDANCE WITH THE POLICY PROVISIONS. Engineering Division 121 Fifth Avenue North AUTHORIZED REPRESENTATIVE Edmonds, WA 98020 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD