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052-14 - Cascade Natural Gas Corporation - Insurance Exp 1-1-2018ACOR" CERTIFICATE OF LIABILITY INSURANCE ATE D12/27/2016DnyyY) 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 be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may rQ.quire: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. r 333 South 7th Street, Suite 1400 !" rnn2. Minneapolis, MN 55402-2400 ) ``'A � <i tlI � •:''• CONTACT NAME: PHONE I FAX A/C, No. Ext : A/C No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # �y�-r ORCHARD J43750-CASCA-GAWX-17-18 CIiYCQC r -11CI t - , _ _ INSURER A: Associated Electric & Gas Ins Services Ltd 3190004 INSURED ' Cascade Natural Gas Corporation 8113 West Grandridge Blvd INSURER B : Liberty Mutual Fire Insurance Company 23035 INSURER C : Liberty Insurance Corporation 42404 INSURER D : Kennewick, WA 99336-7166 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: CHI-005573776-13 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 SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A COMMERCIAL GENERAL LIABILITY XL5063406P 01/01/2017 01/01/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE E OCCUR Excess General Liability DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ "$500,000 Self -Insured Retention" PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT ❑ LOC PRODUCTS - COMP/OP AGG $ $ OTHER: A AUTOMOBILE LIABILITY XL5063406P 01/01/2017 OV0112018 COEaMaBIideNED sINGLE LIMIT cc $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO Excess Auto Liability ALL OWNED SCHEDULED AUTOS AUTOS "$500,000 Self -Insured Retention" BODILY INJURY (Per accident) $ X _ PROPERTY DAMAGE Per accident $ X NON -OWNED HIRED AUTOS AUTOS $ A UMBRELLA LIAB OCCUR XL5063406P 01/01/2017 01/01/2018 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ B C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY CER/M PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A WC2-641-005097-027 (Guar. Cost) WA7 64D 005097 017 AOS ( ) "INCLUDES "STOP GAP'"' 01/01/2017 01/0112017 01/01/2018 01/0112018 X STATUTE E.L. EACH ACCIDENT $ 1,000,000 E.L. 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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: City Clerk's Office THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 216 Prospect St. ACCORDANCE WITH THE POLICY PROVISIONS. Port Orchard, WA 98366 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee I+�tc�uvs' ,tj�4,� tc..►�c�,ac ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 0823-01-00-0000146-0002-0000973 {} Currency AN amounts stated herein are expressers In United States Dollars and all amounts payable hereunder are payable In United States Doll r& g ant The NAMED t lirg named ydeemed hereunderINSURED px..F r Declarationsw of this POLICY, making notice,premium payments and adjustments, recelpting payments of indamn�t or receiving noficas, Including y .. from 11he COMPANY. (Q) Canceflation wo (0112013) Fiat Data: 12JOWMIS 15 ;14 03 0823-01-00-0000148-0003-0000974 NOTICE OF CANCELLATIONTO THIRDPARTIES A. if we cancel this policy fur any reasOri Ott€t'r "'Aft o0nPOY ftnt Of Pfe,Iduni, WS Will notify the per on,:i Or organizations sllowra in the Schedule br--low. We will send notice I l items emaii per €r€atl nq address s Pstes below at bast 10 days, or the number of days listed below, If any, before cancellation t)ecoerres effef tivo, In no evert does tt€e notice Ida the thirst party exceed the noft to the first ne( led insured, B. This avivance rroetifieati0n at s pending cancefsation otcnverage is intended as a courtesyz orty. Our faiir,rc to provide sucfr advance n€atificMira:°) Witi € ut oxtend the palicY ca€ e€�srallrr mate nor n> gate c..r Ike@=a €fare s�f tt�e peti'ry. Name of Other erson s) f Or nl tion(s): Per rctredule of cerr, fleate holders c4i% file wl.Iwtr �IIa Email Address or mailing address, ss Per sc r;xlu1e.>. of cerrifi .are holders on Ile w1th t1he, /'Ul Other terms area oone9itiarrs cr this policy renjalr� vnchan ea. Ioil far atta�rr€wrrt t� Sul€�y I�l€s,�':=_� < <._'rl.: t€�.�(��� �em.� t ; �fft;w:•atbJc= fsat�:? rt. '.';i i lasuod tra < rr.,rr3 frtdar Days Notics. 90 WC 99 20 7 �Kj 2016 t_iR crr Mvluai jnjsurara e Page i tit 1 Eu, 'I� ult,2€r1# 0823-01-00-0000148-0004-0000975 NOTICE OP CANCELLATION TO THIRD PARTIES A. if we cancel uif's policy y t(, r any o1lhvr tt Af i f tonpayi9 ent of 3iv thin: Lve vvili notify the per t;� :i<'. 3r €eiz rtcr= tit t tra lr € c € .� ticlr i€ . `; €Ii S("r€C} r gi,€c.€" is x% e sirs<E t{ ear r i iI€rrtQ eddies listed below pit tau r. 10 dcz c or Mer rtiar bar of mays € CI below, if eid3}°, before caei3ctella-liom beck rnw € ffaai:v °(-:. :r€ no avtat goes thy: notice W Uw thie'd party exceed the notice to Vlw fast dared i#z,ured. < Ttri� act wxe reatiYi€.mbn of a pending cmrtA, tiaMrr of co% raci€s is intended a,�; a -,c-ul ec y cz€€<+�. ()arr fai£ijtr, t Provide su,.h advance r'€�f;iir�� �a€ wifl of emend the policy cancebati on of r1or negate: �<�zilG�itrsr� cyf the, poky. Name of Wier person(s) Per schedule of certificaLc holders or file with the c om €.}a%. into Schedule Email Address or rnafflnp address, Per schedule of a'ert f cacti Wdeers on f i lt' with th the company All r:: her let.ri s ii nrj c.)nc€iti ;r,s €`?f ':.c`: � r'ci'ic f 'fr3ai c sf :taF�rt sec? 'Ssu;jo Tt3k:.:!.P.y Mutual .'.":i..£,, .€ns..r.._n .,t;<r:e .flit'' 16 n EFinakiic"M t..€sit. .L`_...Di&i. r. :',s is-." t. € ) < ..,.. E& 1M 1 2016 Number r Not € 0823-01-00-0000148-0005-0000976