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HomeMy WebLinkAbout20260309_PJA26-0128_COI ACORD DATE(MMIDD'YYYY) CERTIFICATE OF LIABILITY INSURANCE 1 03/09/2026 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 Alma Wang Insurance Agency, Inc. CONTACTNAME Lily Wang 23020 Edmonds Way Ste.112 PHONE .425-218-3432 FAx Edmonds WA 98020 A/C No): MAIL ADDRESS: g � g Iwan 1 farmersa ent.com A INSURER(S)AFFORDING COVERAGE NAIC t INSURER A:Northfield Insurance Company 27987 INSURED TACOS EL PACIFICO LLC INSURER B: 3617 150TH PL NE APT A Marysville WA 98271 INSURERC: 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. LIMITS SHOWN ARE INCLUSIVE OF AMOUNTS REQUESTED BY THE CERTIFICATE HOLDER AND MAY NOT REFLECT POLICY LIMIT AMOUNTS IN EXCESS OF THOSE REQUESTED 'Not Applicable in WY INSR ADWDTYPE OF INSURANCE Lj POLICY EFF POLICY EXP LTR �WVQ GIQ POLICYNUMBER MMIDOfYYYV MM DD VYYY LIMITS +I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE ✓❑OCCUR PREMISES(Ea occurrence) $300+000 _ MED EXP(Any one person) $5+000 A WS565072 1/29/2026 01/29/2027 -PERSONAL 8ADVINJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2+000+000 ✓ POLICY1:1 JPRO- LOC PRODUCTS-COMP/OP AGG $2,000+000 OTHER: $ AUTOMOBILE LIABILITYLi COMBINED SINGLE LIMIT $ (Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accJdettt UMBRELLA LIAB OCCUR + EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DLU 171 RLfENTION$ $ WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ ElOFFICER/MEMBEREXCLUDEC NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Arlington THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN 17202 51 st Ave NE ACCORDANCE WITH THE POLICY PROVISIONS, Arlington, WA 98223 AUTHORIZED REPRESENTATIVE ACORD 25(2025/12) ©1988-2025 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD