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A(�'/�] ® • • DATE(MMIDDIYYYY)
<br /> O CERTIFICATE OF LIABILITY INSURANCE 12/11/2012
<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 BY THE POLICIES
<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: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to
<br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> NAME:
<br /> Packer,Smith&Feek,Inc. vxoNE 425-709-3600 FAX 425-709-7480
<br /> 2233 112th Avenue NE , A/C xo
<br /> EMAIL
<br /> Bellevue,WA 98004 ADDRESS,
<br /> INSUREPAS)AFFORDING COVERAGE NAIC#
<br /> INSURER A: Zurich American Insurance Co.
<br /> INSURED National EWP,Inc. INSURER B: Steadfast Insurance Company
<br /> 500 Main Street INSURER C:
<br /> Woodland,CA 95695 INSURER D:
<br /> INSURER E,
<br /> INSURER F;
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> IN PETY OF INSURANCE AINABI DOL SUER POLICY NUMBER MOLIC YYYY MM/DP� LIMITS
<br /> A GENERAL LIABILITY GL0931933101 12/15/2012 12/15/2013EACH OCCURRENCE $ 1,000,000
<br /> X COMMERCIAL GENERAL LIABILITY MA ET RENTED 100,000
<br /> REMISES(Ea occumence $
<br /> CLAIMS-MADE OCCUR MED EXP(Any one person) $ 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GENERALAGGREGATE $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> POLICY X PRO X LOC $
<br /> AUTOMOBILE LIABILITY BAP931933001 COMBINED 5INULE LIMIT 2,000,000
<br /> A 12115/2012 12/15/2013 Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED
<br /> AUTOS AUTOS BODILY INJURY(Per acdtlen) $
<br /> NON OWNED PROPERTY DAMAGE $
<br /> HIREDAUTOS AUTOS Peracdtlent
<br /> $
<br /> A UMBRELLA LIAS X OCCUR AUC931933301 EACH OCCURRENCE $ 5,000,000
<br /> EXCESS LIAR 12115/2012 12/15/2013 5,000,000
<br /> X CLAIMS-MADE AGGREGATE $
<br /> DED X RETENTION$ 10,000 $
<br /> A WORKERS COMPENSATION WC931933202 X WCSTATLI OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N 12/15/2012 12/15/2013 TQPVIMITq ER
<br /> ANY PROPRIETORIPARTNERIEXECUTIVE❑ N/A E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICERIMEMBER EXCLUDED?
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000
<br /> II yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> B Pollution Liability CPL557162600 802012 8/2/2013 6,000,000 Each Claim/6,000,000 Aggregate
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(AHach ACORD 101,AtlGlaonal Remarks Schedule,N more space Is required)
<br /> EXHIBIT OF INSURANCE.
<br /> CERTIFICATE HOLDER CANCELLATION
<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 /> FOR BID/PREQUALIFICATION PURPOSES ONLY
<br /> AUTHORIZED REPRESENTATIVE
<br /> T�tAo -P�
<br /> ©1988-2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
<br /> 2 of 2 NAT IEWPI(TDFOO)
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