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--ACORD" <br />GtBS&SO-02 <br />CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <br />41712026 <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 BYTHEPOLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed <br />lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies <br />this certificate does not confer riqhts to the certificate holder in lieu of such endorsement(s). <br />may require an endorsement. A statement on <br />PRODUCER <br />Terril, Lewis & Wilke lnsurance, lnc. <br />P.O. Box 1789 <br />Yakima, WA 98907 <br />CONTACT <br />NAMF' <br />ljlS)r1, .,u, (soe) 248-3s1 5 248-3673 <br />ns.com <br />INSURERISI AFFORDING COVERAGE NAIC { <br />TNsURFR a , Admiral lnsurance co 24A56 <br />INSURED <br />Gibson & Son Road Building, lnc <br />1221 Thorp Highway South <br />Ellensburg, WA 98926 <br />rNsuRFR B, Navioators Soecialtv lnsurance Go, <br />INSI'RER C : <br />INSIIRER D : <br />INSTJRER E : <br />INSURER F : <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTMCTOROTHERDOCUMENTWITHRESPECTTOWHICHTHIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN ISSUBJECTTOALLTHETERIVIS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br />INSRtio ryPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br />A X COMMERCIAL GENERAL LIABILITY <br />CLAIMS.i/ADE OCCUR <br />x Contractor's <br />LIMIT APPLIES PER: <br />PRO.JECT | | LUUx <br />cAo00047581 44 12t26t2025 12t26t2026 <br />EACH OCCURRENCE $1,000,000 <br />RENTED <br />$300,000 <br />MED EXP fAnv one oerson)$5,000 <br />PFRSONAI & AN\/ IN-IIIRY g 1,000,000 <br />GFNtrRAI AGGRFGATF $2,000,000 <br />ppnnt tcTs COMP/OP AGG $2,000,000 <br />WA STOP GAP s 1,000,000 <br />B AUTOMOBILE LIABILITY <br />ANYAUTO <br />OWNED <br />AUTOS ONLY <br />HIRED <br />AUTOS ONLY <br />X SCHEOULED <br />AUTOS <br />NON-OWNED <br />AUTOS ONLY <br />=424MOT02321201 <br />'t212612025 1212612026 <br />Q 1'000'000 <br />Rnnll Y lN.lllRY lPpr nersnn\$ <br />Ronll Y lN.lllRY lPer ecci.lcntl s <br />PROPERry DAMAGE <br />$ <br />s <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS-IVIADE <br />FACH OCCI JRRFNCF s <br />AGGRFGATF $ <br />DED RETENTION $$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNEFVEXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />lf yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />PERqTATI ITtr OTH-trR <br />tr I FACH ACCIDFNT $ <br />F I DISFASF - FA FMPI OYEE $ <br />F r ntsFAsF - Pot lcY I lMlT $ <br />DESCRTPTIONOFOPERATTONS/LOCATIONS/VEHICLES (ACORDl0l,AdditionalRemarksSchedule,maybeattacheditmorespaceisrequired) <br />Project: Cle Elum Transfer Station Driveway lmprovements and Tank Replacement <br />Kittitas County Solid Waste, county and its officials, employees and agents per written contract is additional insured per form CG2010 0413. Waiver of <br />subrogationandprimarynon-contiibutorycoverageappliesperAD6S930225. AutoadditionalinsuredperformCA2O4E l0l3,waiverofsubrogationapplies <br />per ANF7040215 <br />Kittitas Gounty Solid Waste <br />205 W. sth Ave Suite 199 <br />Ellensburg, WA 98926 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />t=- nt llt'q <br />@ 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />ACORD 25 (2016t03)