SH25-008 - Professional Service Agreement 2025-26

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.4co ry'° CERTIFICATE OF LIABILITY INSURANCE D 02/13/2025 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 SUBROGATIONIS 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 CONTACT NUTMEG INS AGENCY INC/PHS PHONE (888)925-3137 lac, No, Ext): FAX (ac, No): 76210781 The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio, TX 78251 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURER A: Hartford Underwriters Insurance Company 30104 LEPS-PSS PLLC DBA Public Safety Psychological 20818 44TH AVE W STE 150 INSURER B: INSURER C : LYNNWOOD WA 98036-7734 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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. IL S TYPE OF INSURANCE ADDL SUBDR POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 CLAIMS -MADE F�]OCCUR DAMAGE TO RENTED $1,000,000 PREMISFSa occurrence) General Liability ty MED EXP (Any one person) $10,000 A X 76SBU BB2KAT 05/21/2024 05/21/2025 PERSONAL & ADV INJURY $2.000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $4,000,000 X POLICY ❑ PRO - POLICY LOC PRODUCTS - COMP/OP AGG $4,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $2,000,000 d nt BODILY INJURY (Per person) ANY AUTO A ALL OWNED SCHEDULED AUTOS AUTOS 76 SBU BB2KAT 05/21/2024 05/21/2025 BODILY INJURY (Per accident) X HIRED NON -OWNED AUTOS X AUTOS PROPERTY DAMAGE (Per accident) UMBRELLA LIAR X OCCUR EACH OCCURRENCE $1,000,000 A Excess LIAB DES 76 SBU BB2KAT 05/21/2024 05/21/2025 AGGREGATE $1,000,000 ED I RETENTION $ 10,000 WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY STATUTE I E E.L. EACH ACCIDENT ANY YIN PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE -EA EMPLOYEE (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below A Employment Practices Liability Insurance 76 SBU BB2KAT 05/21/2024 05/21/2025 Each Claim Limit Annual Aggregate Limit $25,000 $25,000 DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) Those usual to the Insured's Operations. Notice of Cancellation Will be provided in accordance with Form SL 90 13, attached to this policy. Coverage is primary and noncontributory per the Business Liability Coverage Form SL 30 32, attached to this policy. Certificate holder is an additional insured per the Business Liability Coverage Form SL 30 32, attached to this policy. CFRTIFICATF HOLDER CANCFI 1 ATION Kittitas County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 205 W 5TH AVE STE 108 BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED ELLENSBURG WA 98926-2887 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD