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aiilr'\-'/CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY) <br />1/6/2021 <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 />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTTTUTE A CONTRACT BETWEEN THE tSSUtNG TNSURER(S), AUTHORTZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have nOOtftOruel truS URED provisions or be endorsed. <br />lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Eastside Insurance Group, LLC DBA Path Insurance S <br />17530 Northeast Union Hill Road <br />Suite 160 <br />Redmond wA 98052 <br />Tyler Kerlee <br />tsHUNE <br />lAlC. No. Extl: <br />iiifiH'ess, tyler@pathins.com <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURER A : SENTINEL INS CO LTD r 1000 <br />INSURED <br />509 Facility Services Inc <br />400 Pebble Beach Dr <br />Cle Elum wA 98922 <br />INSURER B <br />INSURER C <br />INSURER D <br />INSURER E <br />INSURER F : <br />CERTIFICATE NUMBER:REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BE EN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWTHSTANDING 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 SHO\^/N MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />LTR TYPE OF INSURANCE INSD uruD POLICY NUMBER (MM/DD/YYYY)I\iIM/DD/YYYY LIMITS <br />A <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-IVADE l-Eo""r* <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />'ou"" frdi$oi I-l'o" <br />Y 52SBMAC2843 tU28/2020 t1/2812021 <br />EACH OCCURRENCE $1,000,000 <br />UAIVIAgE IUAEI\ItrU <br />PREMISES (Ea occutrence)1,000,000$ <br />MED EXP (Any one person)$10,000 <br />PERSONAL & ADV INJURY $1,000.000 <br />GENERAL AGGREGATE s 2,000,000 <br />PRODUCTS - COIVP/OP AGG $ 2,000,000 <br />$ <br />A <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />OWNED <br />AUTOS ONLY <br />HIRED <br />AUTOS ONLY <br />SCHEDULED <br />AUTOS <br />NON-OWNED <br />AUTOS ONLY <br />Y 52SBMAC2843 tt/28t2020 1112812021 <br />$1,000,000 <br />BODILY INJURY (Per person)$ <br />BODILY INJURY (Per accident)$ <br />$ <br />$ <br />A <br />K UMBRELLA LIAB <br />EXCESS LIAB <br />K OCCUR <br />CLAIMS-MADE Y TBD ll/28/2020 11t28t2021 <br />EACH OCCURRENCE $2,000,000 <br />AGGREGATE $2,000,000 <br />DED RETENTION $$ <br />A <br />WUI(KhI{S COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRI ETOR/PARTNER/EXECUTIVE <br />CFFICER/MEI/IBER EXCLUDED? <br />(Mandatory in NH) <br />f yes, describe under <br />)ESCRIPTION OF OPERATIONS below <br />Y/N <br />N/A 52SBMAC2843 1t/28/2020 rt/28/2021 <br />x tsEX <br />STATUTE <br />utn- <br />ER <br />E.L, EACH ACCIDENT $1,000,000 <br />E.L. DISEASE. EA EIVIPLOYEE $1,000,000 <br />E.L. DISEASE - POLICY LIMIT $1,000,000 <br />DESCRIPTIONOFOPERATIONS/LOCATIONS/VEHICLES (ACORDl0l,AdditionalRemarksschedule,maybeattachedifmorespaceisrequired) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS.Kittitas County <br />205 West 5th Ave Ste 108 <br />1 Ellensburg WA 98926 <br />ttyAfi"".*AUTHORIZED REPRESENTATIVE <br />O 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORDACORD 25 (2016t031