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INSURED <br />JOHNSTON FUNERAL PARLORS, LLC <br />301 E 3RD AVE <br />ELLENSBURG, WA 98926-3348 <br />PRODUCER <br />FEDERATED MUTUAL INSURANCE COMPANY <br />HOME OFFICE: P.O. BOX 328 <br />O\A/ATONNA, MN 55060 <br />iXrEl i., .*,r' s88-3334949 <br />INSURER Fr <br />INSURER E: <br />II.ISURER D: <br />INSURER C: <br />INSURER B: <br />IilSURER A:FEDERATED RESERVE INSURANCE COMPANY <br />INSURERS AFFORDING COVERAGE <br />T}IIS CERTIFrcATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOT.DER. THIS CERTIFICATE <br />DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. THIS CERTIFICATE OF <br />INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUTNG INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE <br />CERTIFICATE HOI..DER. <br />DATE {MM/DD/YYYY) <br />0411612025 <br />16024 <br />NAIC # <br />i-JRLLss, CLI ENTcoNTACTCENTER@FEDI Ns.coM <br />[fA, .n.r, so744l.lriel <br />fiXilt'f'' cLIENT coNTAcr cENTER <br />IMPORTANT: ll the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. lf <br />SUBROGATION lS WAIVED, subiect to the tenns and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not conter rights to the certificate holder in lieu of $ch endorsement(s). <br />CERTIFICATE OF LIABIUTY INSURANCE <br />0COVERAGESCERTIFICATE NUMBER:9 <br />DESCRIPTION OF OPERATIONS , LOCATIONS , VEHICLES (ACORD 101, Additional Remarks Schedule, may be aladred il more space is required) <br />SEE ATTACHED PAGE <br />A <br />A <br />A <br />A <br />INSRttF <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE <br />ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />AT*E-EMPLOYERS' LIABI LITY <br />ANY PROPRIETOR'PARTNER' EXECUTIVE <br />CFFICER'MEMBER EXCLUDED? <br />(Mandatory in NH) <br />ll yes, describe uder <br />DESCRIPTION OF OPERATIONS below <br />Y/Nf <br />x <br />AUTOMOBILE UABILIW <br />X AUTO <br />OWNED AUTGS ONLY <br />HIREO AUTOS ONLY <br />x COMMERCIAL GENERAL LIABILITY <br />CLAIMS.MAD€OCCUR <br />x <br />OTHER: <br />x <br />TYPE OF INSURA{CE <br />)ED <br />UMBRELLA LIAB <br />EXCESS LIAB <br />x CCCUR <br />}LAIIVS-IVIADE <br />N/A N <br />N <br />N <br />N <br />9841128 <br />9841'129 <br />98/.1128 <br />9841 128 <br />POLICY NUMBER <br />06/08/2025 <br />o6to8t2025 <br />06/08/2025 <br />06/08/2025 <br />POLICY EFF <br />06to8t2026 <br />o6to8t2026 <br />06to8t2026 <br />06/08/2026 <br />POLICY EXF <br />PRODUCTS & COMPTOP ACC <br />GENERAL AGGREGATE <br />PERSONAL & ADV INJURY <br />MED EXP (Any one persn) <br />EACH OCCURRENCE <br />LIMITS <br />E.L DISEASE .POLICY LIMIT <br />E.L DISEASE €A EMPLOYEE <br />E.L EACH ACCIDENT <br />AGGREGATE <br />EACH OCCURRENCE <br />BODILY INJURY (PeT Acciden0 <br />BOOILY INJURY (Per PeFon) <br />COMBINED SINGLE <br />(Ea acciden0 <br />LIMIT <br />)AMAGE TO RENTED PREMISES <br />Ea ocdrence) <br />PER STATUTE )THER <br />$1,000,000 <br />$1,000,000 <br />$1,000,000 <br />$2,000,000 <br />$2,000,000 <br />$1,000,000 <br />$2,000,000 <br />$2_000_000 <br />s1.000.000 <br />EXCLUDED <br />$100,000 <br />$1,000,000 <br />CERTIFICATE HOLDER CANCELLATION <br />KITTITAS COUNTY CORONERS OFFICE <br />205 W sTH AVE STE 108 <br />ELLENSBURG, WA 98926-2887 <br />90 <br />AUTHORIZED REPRESENTATIVE <br />,,&* (.2.* <br />SHOU1D ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELTED <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN <br />ACCORDAI.ICE WTH THE POUCY PROVISIONS. <br />@ 1988-2015 ACORD CORPORATION. All rights reseryed. <br />The ACORD name and logo are registered marks ol ACORDACORD 25 (2016103)