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CERTIFIGATE OF LIABILITY INSURANCE oArE{ilu/DD/YYYn <br />@ 198&201 5 ACORD CORPORATION. All rights reserved. <br />I <br />o <br />oooo <br />THIS CERNRCATE IS ISSUED AS A MATTER OF INFORffANON ONLY AND CONFERS NO RIGHTS UPON THE CERNRCATE I{OLDER <br />THIS CERTIFICATE DOES NOT AFFIR*IATTVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COIIERAGE AFFORDED BY THE <br />POLICIES BELOW. THIS CERNFrcATE OF INSURANCE OOES <br />'IIOT <br />CONSNTUTE A CONTRACT BETWEEN THE ISSUING INSURER{S), <br />AUTHORIZED REPRESENTATTVE OR PRODUCER, AND THE CERNFICATE HOLDER <br />holder is an AIlDlTtOllAL INSURED, the policy{ies) must be endorsed. lf SUBROGAIIONIS WAIVED, <br />subjoct to the torms and conditione of the poliry, ertaln policies may requiro an endorsement A etatemont on this c6rtifi'ca0s doos not <br />NUTMEG INS AGENCY INCiPHS <br />76210781 <br />The Hartford Businegs Service Genter <br />3600 Wiseman Blvd <br />San Anhnio, TX 78251 <br />(888) 9213 <br />lr{suRER{S) aFFoRDtNc covERAGE <br />No); <br />AODRESS: <br />t{Atcc <br />IMPORTAI{T: U tfte certftcate <br />confer rights to ths cerlificats holdor in lieu of eqch <br />PHOI{E <br />(ArC, No, Exrl: <br />INgURERA:Company of theHartford lnsurance <br />Southeast <br />38261 <br />IflSUR€R B <br />INgURERC <br />IIISURER O : <br />INgURER E: <br />lllsuRED <br />LEPS-PSS PLLC DBA Public Sabty Psychologicat <br />20818 44TH AVE W STE 150 <br />LYNNWOOD WA 98035-7734 <br />II{gURER F <br />CONDITION OF AT.IY CONTRACT OR OTHER OOCUMENT WIIH RESPECT TO WHICH THIS <br />INSURANCE AFFORDEO BY THE POLICIES OESCRIEED HEREIN IS SUEJECT TO ALL THE <br />THIS IS TO CERTIFY TTIAT THE POLICES OF INSURANCE LISTED BEI.OW T{AVE BEEN ISSUED TO THE NSUREO MMED ABOVE FOR THE POLICYPERIODINDICATED.NOTWITHSTAIIOING AIf/ REOUIREMENI, TERM OR <br />CERTIFICATE MAY BE ISSUED OR IUAY PERTAIN, THE <br />D(CLUSIONS AiID CONDITIONS OF SUCH POLICIES. LIM]TS SHOWN MAY HAVE EEEN REDUCED BY PAID CLAIMS. <br />lrra9FIE TYPE OF I'{SI'RAI{CE APDL <br />NqD <br />SUARw6 PC'UCYNUUEER FOUCYEFT <br />lMta/tiltrYYvYt <br />FgUCY EXFlilrnntrm IJMITS <br />EACH OCCURRENCE <br />UAMA(iE IO RENIED <br />DiIFMISFS Gr a',a-rar <br />COMMERCIAL GET{ERAL UABILITY <br />]cr.n'rur*oorf o""r* <br />MEO E(P (Any me porson) <br />PERSOML & ADV INJURY <br />GENERAL ACGREGATE <br />PROOUCTS . COMP/OP AGG <br />OTHEFI <br />GENL AGGREGATE UMIT APPUES PERI:# [.* <br />COMBINED SINGLE UMIT <br />lEa acddentl <br />BOOILY INJURY (Pcr p6rson) <br />EOOILY INJURY (Per aeldont) <br />PROPERTY DAMAGE <br />(Per acctdonl) <br />AUTOXOSTLE uAttury <br />AIIY AUTO <br />ALLOwl.IEO <br />AUTOS <br />HIRED <br />AUTqS <br />SCHEOULEO <br />AUTOS <br />NONOI,VT{ED <br />AUTOS <br />EACH OCCURRENCEUiISRELIA UA8 <br />EXCESS UAS <br />()(.;(;uR <br />ct-ArMs- <br />r]lADE AGGRECATE <br />REIENNON $ <br />x l:;l** I <br />(JtFt- <br />FR <br />EL. EACH ACCIOENT $100,@0 <br />E.L. DISEASE €A EMPLOYEE $100,000 <br />A <br />IY(JRXIR:' COXPEfl SATION <br />A'{D EuH.oYERS TIABIUTY <br />Arsr <br />PROPRIETOR/PARTNERIEGCUNVE <br />OFFICERAIEMSER E (CLUDED? <br />(Undaoryh ilH) <br />lf y€a, dsllo undor <br />DESCRjPTION OF OPERATIOilS bdd <br />Y.lXf t{rA 76 WEG AKOLBB 01n2no24 01t12r2025 <br />E.L DIS€ASE . POUCY LIMIT $500,000 <br />/tooanotts Addltlonaltol,Reinettr 9chedulq be Etnched moF lirotrPsE rcqulrsd) <br />usralThose he lnsuredsb holderCerti6cate tsOperalions.an insuredadditional he Businessper Form attachedssm@ thistoUabilityCoverage <br />rs andCoverage the Businesspolicy.Pflmary nonconEibutcry per FormUability attached thistttCoveragess0008,Notica Cancellationof willpolicy. <br />tnprovidod accordance Formwith ss1 toattached223,Bris <br />SHOULI' AilY OF THE AAOVE OESCRIAEO POUCIE9 8E CAHCELLED <br />BEFORE THE EXPIRANON DATE THEREOF, i{OTTCE IVILL BE DELIVEREO <br />IN ACCORDANCE WTH THE POLICY PROVISIONS. <br />Kittitas County <br />205 West 5ttr Avenue Suite 108 <br />Ellensburg WA 98926 <br /><ftaaa.f taafr-r-a-^t <br />AI'THORUED RTRESEI{TATM <br />ACORD 25 (2016103)The ACORD name and logo are reglstered marks of ACORD