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ACORD® CERTIFICATE OF LIABILITY INSURANCE (MM/DD/YYYY) 711/28/2023 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 have ADDITIONAL INSURED provisions or 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 Hub International Northwest LLC 110 Unity Street Bellingham WA 98225 NAME CT AiCON o Ext • 360-647-9000 FAArc No:360-734-8496 AIL ADDRESS: now.bellinghaminfo@hubintemational.com INSURERS AFFORDING COVERAGE NAIC # INSURERA: Western National Mutual Insurance Company 15377 INSURED TENELCO-01 Hartridge LLC dba Tenelco INSURER B : 2824 Old Hartford Rd INSURER C : INSURER D : Lake Stevens WA 98258-9760 INSURER E . INSURER F . COVERAGES CERTIFICATE NUMBER: 1843038449 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. ILTR TYPE OF INSURANCE ADDL SUER POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FTIOCCUR Y Y CPP 122713504 12/1/2023 12/1/2024 EACH OCCURRENCE $ 1.000,000 PREMISES Ea occu ence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ PRO- JECT ❑ LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OPAGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED X SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED ONLY AUTOS ONLY Y Y CPP 122490104 12/1/2023 12/1/2024 COMEaacciBINED SINGLE LIMITdent $1,000,000 BODILY INJURY (Per person) $ IAUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ $ A X UMBRELLALIAB EXCESS LIAB X OCCUR CLAIMS -MADE UMB103845004 12/1/2023 12/1/2024 EACH OCCURRENCE $1,000,000 AGGREGATE $ 1,000,000 DED I X I RETENTION $ $ q WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA CPP 122713504 12/1/2023 12/1/2024 SPER TATUTE X OERH St0 Gap E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Per policy forms and conditions: Commercial General Liability Enhancement Endorsement form CIS MU 0009 06 22; Additional Insured - Contractors - Operations and Completed Operations - With Additional insured Requirement in Construction Contract form WN GL 139 06 18; and Business Auto Enhancement Endorsement form WN CA 80 06 19. Umbrella Liability follows form to terms and conditions of underlying policies. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Kittitas County 205 W 5th Ave Ste 108 AUTHORIZED REPRESENTATIVE Ellensburg WA 98926 -7 n ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD