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KLUMP-2 OP ID: EA
<br />CERTIFICATE OF L LABILITY INSURANCE
<br />DATDNYYY)
<br />1 121222/22!15
<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 />'.OW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />'RESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does notconfer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER 360-748-0051
<br />Virgil R. Lee & Son
<br />HUB International NW, LLC 360-748-3941
<br />P.O. Box 1226
<br />CONTACT
<br />NAME: Emily E. Buss
<br />PHONE
<br />AIC No E,:360-748-0051 a/c N,: 360-748-3941
<br />ADDRESS: ebuss@lovstedworthington.com
<br />Chehalis, WA 98532
<br />John O Thurston
<br />INSURERS AFFORDING COVERAGE NAIC#
<br />INSURER A: Mutual of Enumclaw 14761
<br />INSURED Dynamic Collectors, Inc.
<br />INSURER B :
<br />INSURERC:
<br />790 S. Market Blvd
<br />Chehalis, WA 98532
<br />'
<br />INSURERD:
<br />INSURER E:
<br />PRODUCTS -COMP/OP AGG $ 2,000,000
<br />INSURER F:
<br />t1V V lzMAUCJ v". I u 1_r . - ,..+,., — -
<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
<br />LTR
<br />TYPE OF INSURANCE
<br />IN
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DDfY"YYY
<br />POLICY XP
<br />MM/DDIMY
<br />LIMITS
<br />A
<br />GENERALLIABILITY
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE I—XI OCCUR
<br />X WA Stop Gap below
<br />X
<br />X
<br />CPP001272703
<br />12/27/15
<br />12/27/16
<br />EACHOCCURRENCE $ 1,000,000
<br />TiI-NII-U
<br />MA 300,000
<br />PREMISES Ea occurrence $ �
<br />MED EXP (Any one person) $ 10,000
<br />PERSONAL & ADV INJURY $ 1,000,00
<br />GENERAL AGGREGATE $ 2,000,000
<br />PRODUCTS -COMP/OP AGG $ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />$
<br />COMBINED
<br />cccSINGLE LIMIT $ 1,000,000
<br />a accident)
<br />X POLICY PRO
<br />LOC
<br />AUTOMOBILE LIABILITY
<br />BODILY INJURY (Per person) $
<br />A
<br />X ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />X HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />CPP001272703
<br />12/27/15
<br />12/27/16
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE
<br />Per accident)$
<br />$
<br />UMBRELLA LIABOCCUR
<br />EACH OCCURRENCE $
<br />AGGREGATE $
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />WORKERS COMPENSATION
<br />STAT
<br />Y LIMIUT- X OTERH-
<br />TWOCRS
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />A
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />N / A
<br />CPP001272703
<br />WA STOP GAP
<br />12/27/15
<br />12/27/16
<br />1 000,000
<br />E.L. DISEASE - EA EMPLOYEE $ ,
<br />E.L. DISEASE -POLICY LIMB 1 $ 2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additlonal Remarks Schedule, if more space is required)
<br />Kittitas County is named as Additional Insured as required by written
<br />contract, as per CG 20 26 04/13. Waiver of Subrogation applies, as per CG 24
<br />04 05/09. Coverage is Primary and Non -Contributory, as per CG 20 01 04/13.
<br />CERTIFI
<br />KITTITA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Kittitas County ACCORDANCE WITH THE POLICY PROVISIONS.
<br />205 W. 5th Avenue
<br />Ellensburg, WA 98926 AUTHORIZED REPRESENTATIVE
<br />U IU?JS-Lu-I U A IL'umu LVRt"vr% a,v,v. Mu rryuw
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
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