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CERTIFICATE.OF.LIABILITY.INSURANCE <br />FJW DATE (MM/DD/YYYY) <br />R001 1/23/2018 <br />THIS CERTIFICATEIS 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(ies) 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 this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT <br />NAME: <br />MICHELETTI INSURANCE SERVICES/PHS PHONE <br />(A/C, No, Ext):(866) 467-8730 FAX <br />(A/C, No):(888) 443-6112 <br />556314 P:(866) 467-8730 F:(888) 443-6112 E-MAIL <br />ADDRESS: <br />PO BOX 33015 INSURER(S) AFFORDING COVERAGE NAIC# <br />SAN ANTONIO TX 78265 INSURER A :Sentinel Ins Co LTD 11000 <br />INSURED INSURER B : <br />LAW ENFORCEMENT PSYCHOLOGICAL INSURER C : <br />SERVICES, INC.INSURER D : <br />15251 NATIONAL AVE STE 201 INSURER E : <br />LOS GATOS CA 95032 INSURER F : <br />COVERAGES CERTIFICATE NUMBER: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 <br />TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE ADDL <br />INSR <br />SUBR <br />WVD <br />POLICY NUMBER POLICY EFF <br />(MM/DD/YYYY) <br />POLICY EXP <br />(MM/DD/YYYY) <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 <br />CLAIMS-MADE X OCCUR <br />57 SBA BZ5288 <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence)$1,000,000 <br />A X General Liab 04/01/2017 04/01/2018 MED EXP (Any one person)$10,000 <br />PERSONAL & ADV INJURY $2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $4,000,000 <br />POLICY PRO- <br />JECT X LOC PRODUCTS - COMP/OP AGG $4,000,000 <br />OTHER:$ <br />AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br />(Ea accident)$2,000,000 <br />ANY AUTO <br />57 SBA BZ5288 <br />BODILY INJURY (Per person)$ <br />A OWNED <br />AUTOS ONLY <br />SCHEDULED <br />AUTOS 04/01/2017 04/01/2018 BODILY INJURY (Per accident)$ <br />X HIRED <br />AUTOS ONLY X NON-OWNED <br />AUTOS ONLY <br />PROPERTY DAMAGE <br />(Per accident)$ <br />$ <br />X UMBRELLA LIAB X OCCUR <br />57 SBA BZ5288 <br />EACH OCCURRENCE $1,000,000 <br />A EXCESS LIAB CLAIMS-MADE 04/01/2017 04/01/2018 AGGREGATE $1,000,000 <br />DED X RETENTION $10,000 $ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />N/ A <br />PER <br />STATUTE <br />OTH- <br />ER <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />Y/N E.L. EACH ACCIDENT $ <br />E.L. DISEASE- EA EMPLOYEE $ <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Those usual to the Insured's Operations. Certificate holder is an additional <br />insured per the Business Liability Coverage Form SS0008 attached to this <br />policy. <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE <br />DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />Kittitas County <br />205 W 5TH AVE STE 108 <br />ELLENSBURG, WA 98926 <br />AUTHORIZED REPRESENTATIVE <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD