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HomeMy WebLinkAbout5564 - Cascade Natural GasA�� ® DATE (MM/DDYYYY) CERTIFICATE OF LIABILITY INSURANCE 12/07/2021 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 Marsh USA Inc. 333 South 7th Street, Suite 1400 Minneapolis, MN 55402-2400 C N 102299309-CASCA-GAWX-22- INSURED Cascade Natural Gas Corporation 8113 West Grandridge Blvd Kennewick, WA 99336-7166 COVERAGES t EC 15 2021 City of Bremerton City Attorney's Officc CERTIFICATE NUMBER: Marsh � U.S. Operations 866-966-4664 MDU.CertRequest@marsh.com INSURER B INSURER C : Liberty In: INSURER D : INSURER E : INSURER F : CHI-008512856-19 AFFORDING COVERAGE REVISION NUMBER: 212-948-5382 3190004 Ci'ZI�L! 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, INSR LTR TYPE OF INSURANCE ADDL SWVD UER POLICY NUMBER POLICY EFF MMIDDYYYY POLICY EXP MM/DD/YYYY LIMITS A COMMERCIAL GENERAL LIABILITY XL5063411P 01/01/2022 01/01/2023 EACH OCCURRENCE $ 10000,000 CLAIMS -MADE OCCUR Excess General Liability DAMAGE TO RENTED PREMISES Ea occurrence) $ "$500,000 Self -Insured Retention" MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ JECT PRO- ❑ LOC PRODUCTS - COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY XL5063411P 01/0112022 01/01/2023 COMBINED SINGLE LIMIT Ea accident $ 11000,000 BODILY INJURY (Per person) $ X ANY AUTO Excess Auto Liability OWNED SCHEDULED AUTOS ONLY AUTOS "$500,000 Self -Insured Retenton" BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR XL5063411P 01/01/2022 01/01/2023 EACH OCCURRENCE $ 71000,000 X AGGREGATE $ 710002000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPRO1,000,000 OFFICERPMEMBEREXC UDED?ECUTIVE (Mandatory in NH) N/A WA7-64D-005097-022(Regulated) WA7-64D-005097-012 (ADS) "INCLUDES "STOP GAP"" 01/0112022 01/0112023 01/0112023 j( PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ 11000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) City of Bremerton is/are included as Additional Insured per coverage form 8100 attached with regard to General Liability. Excess liability applies to employers liability. CFRTIFIGATF HOI rIFR CANCELLATION City of Bremerton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Risk Management THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 345 6th St, Suite 600 ACCORDANCE WITH THE POLICY PROVISIONS. Bremerton, WA 98337 AUTHORIZED REPRESENTATIVE VWC use ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 0001575 SP 0545-CO1-P01575-I City of Bremerton Attn: Risk Management 345 6th St, Suite 600 Bremerton, WA 98337 0545.01.00-0001575-0001-0008776 �El a ASSC)CIATED EL.ECTRI� &GAS INSURANCE SERVICES LIMITED Endorsement Na. 24 Effective date of Endorsement January 1, 2p22 Attached to and farming part of POLICY Na. XL�p63411P NAMED tNSUf��D: MDU Resources Group, ina. It is understood and agreed that this POLICY is hereby amended as indicated. Alt ether terms and conditions of this PQLICY remain unchanged. CQN©ITION {Qj CAt�CELLATt©N EN[:bRSEMENT (Blanket Basta} With respect to Chase perspns ar c�rganizatiarts entitled by aantraat or written agreement with the NAMr:D INSURED to receive a natice of cancellation, Condition {Q} Cance!/atian is repiaaed by the following: (Q} Car�cai/afipt7 This I�OLiGY may be cancelled: (1) at any time by the NAMED INSURED by mailing written notice to the COMF�ANY stating when thereafter canaeliatian will be effective; ar {2} at any time by the COMI�ARIY by mailing written. natice to: a. the .NAMED INSURED stating when, net less than ninety (9p} days from the date natice was mailed, canaeliatian will be effective; except, in the event of cancellation far nan-payment of premiums, when canaeliatian wiii became effective ten. {1 p}days after the natice was mailed, ar b. any person ar arganizatian entitled by aantraat ar written agreement with the NAMED lNStJR�D to receive a natice. of cancellation stating when, net less than thirty (3p} days from the date natice was mailed, aancellatian wiii be effeative with respect to such person ar arganizatian; except, in the. event afi aanaeliatian for nan-payment of premiums, when aancellatian will became effiective ten {1p} days after the natice was mailed. The N/�MED INSURED shall provide to the CC7MPANY, an a quarterly basis or at any time requested by the CQMI'ANY; a list of the names and addresses of each such person ar argani�atian entitled to receive a natice of canaeliatian. Notwithstanding the above, the COMf�ANY`S failure to provide natice to any person ar arganizatian other than the NAMED INSURED wi0 not impale any obligation ar liability upon the C©MPANY nor will it extend the effective date and hour of aancellatian of this POLICY ar otherwise negate such aancellatian. Such natice is a matter of infa>"matian and aaurtesy only. Praaf of mailing of natiae to the respective addresses in Items 7 and � of the Declarations wiii be sufficient proof of natice and the I�OLICY PERIOD will end on the effective date and hour of canaeliatian stated in the natice. Delivery afi suah notice .either by the NAMED INSURED ar the COMPANY will be equivalent to mailing. 100-EgASi (08i1gZ1) 0545.01-00-0001575-0002.0008777 Pale 1 of " ��!;�: NOTICE OI= CANCEWLLA I ION TO THIRD PARTIES A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. ihis advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. Name a# Other Persons) ! Organizatlon(s). Per Schedule on file with the Company Schedule Email Address ar malEing address; Per Schedule on file with the Company A�II other terms and conditions of this policy remain unchanged. Issued by Liberty Insurance Corporation 21g14 for attachment to Policy No. WA7-84D-0©5fl97-012 Etlective Date Issued to Centennial Energy hinldings, Inc. Number Days Notice: Premium $ Cndcarsement Na. WC 99 2p 75 O �016 Liberty Mutual Insurance Page 1 of 1 Ed. 12/A1/201� NATIGE CiF GANCELLATIC}N Tp THIRD PARTIES A. If we cancel this palicy far any reason other than nonpayment of premium, we wi(1 notify the persons ar organizations shown in the Schedule below. We will send native to the email oe mailing address listed below at least 10 days, ar the number of days listed below, if any, before cancellation becomes effective. In na event does the notice to the third party exceed the notice to the first named insured. B. ibis advance notification of a pending cancellation of coverage is intended as a courtesy only. Qur failure to provide such advance. notification wilt not extend the palicy cancetlatipn date nor negate cancellation afi the policy. Name of {ether Psrsan(s) prganizatian(s): Per schedule an file with the Company Schedule Email Address or mailing address: Per schedule an file with the Company All other terms and conditions of this policy remain unchanged. Issued by Liberty Insurance Corporation 2t814 Fpr at#echment to Paliay Na. WA7-f4D-OQSt)97-022 Effective ©ate Issued to MDt► Resources Group, Inc. Number Days Native: Premium $ Endorsement Na. we �s as 75 Ed. ��roti��ats 0545-Ot•00-0001575-0003-0008778 Q 2016 Liberty Mutuai insurance Page 1 of