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ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/yyyy) ~ 1/26/2016 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 endorsement(s). PRODUCER ~~~~~CT Vicki Boser InsuranceTek, Inc. r~gN~o.Extl: (888)505-1555 I FAX (AiC No): (800) 521-1528 CA #OE32789 ~DMD~~SS: Info@Insurance-tek . com PO Box 70 INSURER(S) AFFORDING COVERAGE NAIC # Snohomish WA 98291-0070 INSURER A :Wes tern Heritaqe Ins CO INSURED Richard A. Schuknecht INSURER B : Schuknecht's P .O.F. Polygraph Service INSURER c: 413 N 2nd St INSURER 0: INSURER E: Yakima WA 98901 INSURER F: COVERAGES CERTIFICATE NUMBER-CL1612 652615 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 TYPE OF INSURANCE ADDl SUBR (~~hl5TvW() 1(~gT6%~1 lTR IINSR I wvD POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 -~~~~~~~?E~~~~U~~nce \ ~ pMMERCIAL GENERAL LIABILITY $ 100,000 A CLAIMS-MADE ~ OCCUR SCP0988600-371 2/4/2016 12/4/2017 MED EXP (Anyone person) $ 5,000 - ~ PROFESSIONAL E&O PERSONAL & ADV INJURY $ 1,000,000 ~ BLANKET ADDL INSURED GENE RAL AGGREGATE $ 2,000,000 ~'L AGGREAE LIMIT APnS PER: PRODUCTS -COMPIOP AGG $ INCLUDED X POLICY ~~R,: LOC PROFESSIONAL E&O $ 1,000,000 AUTOMOBILE LIABILITY fE~~~b~~~tFINGLE LIMIT $ r-- ANY AUTO BODILY INJURY (Per person ) $ r--ALL OWNED -SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident ) $ r---NON·OWN ED ip~?~~C~d~~t~AMAGE HIRED AUTOS AUTOS $ r--- $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ r-- EXCESS LlAB CLAIMS-MADE AGGREGATE $ DEDi I RETENTION $ $ WORKERS COMPENSATION I TV:;~$T~JI¥S I IOJ~' AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE D N/A E.l. EACH ACCIDENT $ OFFICER/M EMBER EXCLUDED? (Mandatory in NH) E.l. DISEASE -EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.l. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101 , Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Verification of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Vicki Boser/DAWSON ~~ ~ --zjj$~ ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. INS025 l?n1nn<;\ n1 Tho. 6.r.n~n n~rnA !:Inri Innn !:IrA rAnic.tAr~:u" nH.rfcc: nf .4rnRn