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052-14 - Cascade Natural Gas Corporation - Insurance Exp 1-1-2020
AC"Rf> ® CERTIFICATE OF LIABILITY INSURANCE FDATE(MM(DD/YYYY) 12/14/2018 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 ICONTACT Marsh USA Inc. E_ _NAM _ PHONE 333 South 7th Street, Suite 1400 c No. Ext): _ PnAiC, Minneapolis, MN 55402-2400 1 E-MAIL -- - -- INSURERS) AFFORDING COVERAGE # CN102299309-CASCA-GAWX-19 1.) _NAIC _ _ INSURER A: Associated Electric & Gas Ins Services Ltd 3190004 INSURED --' Cascade Natural Gas Corporation �^ r1 9 INSURER B : ES'' D2 4 2� I$ 8113 West Grandridge Blvd INSURER c : Liberty Insurance Corporation 42404 Kennewick, WA 99336-7166 CITY OF PORT ORCHARD INSURERD: CITY CLERKS OFFICE INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: CHI-008512862-18 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. INSR LTR TYPE OF INSURANCE ADDL sum POLICY EFF POLICY EXP - iNqn POLICY NUMBER IMM'DD1YYYY11 lMMt1DDtYYYyiLIMITS A COMMERCIAL GENERAL LIABILITY XL5063408P 01/01/2019 01101/2020 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR Excess General Liability DAMA E T RENTED EJ PREMISES Ea Occurrence $ "$500,000 Self -Insured Retention" MED EXP (Any one person) $ PERSONAL S ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER : GENERAL AGGREGATE $ POLICY ❑JECT PRO- ❑ LOC PRODUCTS - COMP/OP AGG $ OTHER A AUTOMOBILE LIABILITY XL5063408P 01/01i2019 01101/2020 COMBINED sINGr-E LIMIT $ 1,000,000 X ANY AUTO Ea accident Excess Auto Liability BODILY INJURY (Per person) $ OWNED SCHEDULED "$500,000 Self -Insured Retention" AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PRDPERTYDAfVIgGE Per accident $ UMBRELLA LIAB OCCUR XL5063408P 01/01/2019 0110112020 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB X CLAIMS -MADE AGGREGATE $ 5,000,000 DED RETENTION $ $ C WORKERS COMPENSATION WA7-64D-005097-029(Regulated) 01/01/20 00 X I PER OTH- C AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE STATUTE ER WA7-64D-005097-019 (AOS) 01/01/2019 01/01/2020 1,000,000 E.L. OFFICER/MEMBEREXCLUDED7 NIA EACH ACCIDENT $ (Mandatory in NH) "INCLUDES "STOP GAP"" EL DISEASE - EA EMPLOYEE $ 1,000,000 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) Excess liability applies to general liability, products and completed operations, automobile liability, and employers liability CERTIFICATE HOLDER CANCELLATION City of Port Orchard Attn: City Clerk's Office SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 216 Prospect St. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Port Orchard, WA 98366 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee _M t1rv� aess `� e i ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 0751-01-00-0000428-0002-0002943 NOTICE OF CANCELLATION 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. This 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. Schedule Name of Other Person(s) I Email Address or mailing address: Organization(s): Per schedule of certificate Per schedule of certificate holders on file with the holders on file with the company company All other terms and conditions of this policy remain unchanged. Issued by Liberty Mutual Fire Insurance Company 16586 For attachment to Policy No. WA7-64D-005097-029 Effective Date Issued to MDU Resources Group, Inc. Number Days Notice: 90 Premium $ WC 99 20 75 iO 2016 Liberty Mutual insurance Page 1 of 1 Ed. 12/01/2016 0751-01-00-0000428-0005-0002946 NOTICE OF CANCELLATION 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. This 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. Schedule Name of Other Person(s) / Email Address or mailing address: Number Days Notice - Organ izati on (s): Per schedule of certificate Per schedule of certificate 90 holders on file with the holders on file with the company company All other terms and conditions of this policy remain unchanged. Issued by Liberty Insurance Corporation 21814 For attachment to Policy No. WA7-64D-05097-019 Effective Date Premium $ Issued to Centennial Energy Holdings, Inc. WC 99 20 75 O 2016 Liberty Mutual Insurance Page 1 of 1 Ed. 12/01/2016 0751-01-00-0000428-0004-0002945 5� (0) Cadency All amounts stated herein are expressed in United States Dollars and all amounts payable hereunder are payable in United States Dollars, (P) Sole Agent The NAMED INSURED first named in Item I of the Declarations shall be deemed the Sole agent of each INSURED hereunder for the purpose of issuing instructions for any alteration of this POLICY, making premium payments and adjustments, receipting payments of indemnity of receiving notices, including notice of cancellation from the COMPANY, (Q) Cancellation This POLICY way be cancelled-, (1) at any time by the NAMED INSURED by mailing written notice to the COMPANY stating when thereafter cancellation shall be effective, or (2) at any time by the COMPANY by mailing willen notice to the NAMED INSURED stating when, not less than ninety (90) days from the date notice was mailed, cancellation shall be effective-, except, in the event of cancellation for non-payment of premiums, such cancellation shall become effective ten (10) days after the notice was mailed. Proof of mailing of notice to the respective addresses in Items 7 and 8 of the Declarations shall be sufficient proof of notice and the POLICY PERIOD shall end on the effective date and hour of cancellation stated in the notice. Delivery of such notice either by the NAMED INSURED or the COMPANY shall be equivalent to mailing. In the event of cancellation by the INSURED, the premium retained by the COMPANY shall be calculated in accordance with the COMPANY'S short rate table which shall be made available to the INSURED upon reciti". In the event of cancellation by the COMPANY, the premium retained by the COMPANY shall be calculated an a pro -rats basis. The offer by the COMPANY of renewal on terms or premiums different from those in of during the POLICY PERIOD shall not constitute cancellation or refusal to renew this POLICY, (R) Dispute Resolution and Service of Suit Any controversy or dispute arising out of or retaling to this POLICY, or the breach. termination or validity thereof, shall be resolved in accordance with the procedures specified in this Section IV.(R). which shall be the sole and exclusive procedures for the resolution of any such controversy or dispute, (11) Negotiation. The INSURED and the COMPANY shall attempt in good faith to promptly resolve any controversy of dispute arising out of or relating to this POLICY by negotiations between executives who have authority to settle the controvemy. Any party may give the other party written notice of any dispute not resolved in the normal course of business. Within fifteen (15) days the receiving party shall submit to the other a written response. The notice and the response shall include-, (a) a statement of each party's position and a summary of arguments supporting that position, and (b) the name and title of the executive who will represent that party and of any other person who will accompany the executive. Within thirty (30) days after delivery of the disputing party's notice. the executives of both parties shall meet at a mutually acceptable time and place, and thereafter as often as they reasonably deem necessary, to attempt to resolve the dispute-. All reasonable requests for information made by one party to the other will be honored. It the matter has not been resolved within sixty (60) days of the disputing party's notice, or if the parties fail to meet within thirty (30) days, either party may initials mediation of the controversy or claim as provided hereinafter, 8100 (1112017) (17 of 19) 0751-01-00-0000428-0003-0002944