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052-14 - Cascade Natural Gas Corporation - Insurance Exp 1-1-2017DATE (MM/DD/YYYY) AtCf.:7RL7® CERTIFICATE OF LIABILITY INSURANCE 12/14/2015 l i 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 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 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 J43750-CASCA-GAWX-16.17 INSURED CASCADE NATURAL GAS CORPORATION 8113 WEST GRANDRIDGE BLVD KENNEWICK, WA 99336-7166 oog-ILI Cascad INSURER A: Associated Electric & Gas Ins Services Ltd Liberty Mutual Insurance Company COVERAGES CERTIFICATE NUMBER: CHI-005573776-10 REVISION NUMBER: 90004 THIS IS TO CERTIFY THAT T"HE 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 MM/DD/YYYV LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR XL5063405P Excess General Liability "$500,000 Self -Insured Retention" 01/01/2016 01/01/2017 EACH OCCURRENCE $ 1,000,000 DMAGE TO RENTED A PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO ❑ LOC JECT OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS UTOSNON-OWNED HIRED AUTOS X AUTOS XL5063405P Excess Auto Liability "$500,000 Self -Insured Retention" 01/01/2016 01/0112017 COMBINED SINGLE LIMIT Ea accident _ $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A UMBRELLA LIAB EXCESS LIAB CLAIMS -MADE XL5063405P 01/01/2016 01/01/2017 EACH OCCURRENCE $ 5,000,000 X HOCCUR AGGREGATE $ 5,000,000 DED RETENTION $ $ B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC2-641-005097-026 (Guar. Cost) WA7-64D-005097-016 () AOS "INCLUDES "STOP GAP"" 01/01/2016 01/01/2016 01/01/2017 01/01/2017 X STATUTE ORH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 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 Mukherjeei taw ao►-=4,uc»ic.. cat ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD "AEGIS (3) The DISCOVERY PERIOD shall not reinstate extend the POLICY PERIOD and shall apply COVERAGE PERIOD. :)r increase the COMPANY'S Limits of Liability or only with respect to OCCURRENCES during the (4) The DISCOVERY PERIOD shall not be cancellable by the COMPANY except for non-payment of premium where applicable or for fraud or material misrepresentation. (5) The DISCOVERY PERIOD shall not apply to any claim or any part of any claim which is covered by a subsequent insurance policy issued by the COMPANY or by any other insurer or would be covered but for the exhaustion of the applicable limit of liability of such subsequent insurance policy; except, however, that the DISCOVERY PERIOD shall apply to any claim which is covered by a subsequent insurance policy issued by the COMPANY where such DISCOVERY PERIOD arises under section (1) (b) of this Condition (N) because of the imposition of a lower limit of liability under such subsequent insurance policy; provided, however, that the maximum amount payable by the COMPANY under this POLICY for ULTIMATE NET LOSS with respect to any claim covered under such DISCOVERY PERIOD shall be the amount of the difference between the Limit of Liability under this POLICY and the lower limit of liability under the subsequent insurance policy issued by the COMPANY and shall apply excess of the applicable limit of liability of such subsequent insurance policy. (0) Currency 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 1 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 or receiving notices, including notice of cancellation from the COMPANY. (Q) Cancellation This POLICY may 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 written 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 request. In the event of cancellation by the COMPANY, the premium retained. by the COMPANY shall be calculated on a pro-rata basis. The offer by the COMPANY of renewal on terms or premiums different from those in effect 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 relating 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. (1) Negotiation. The INSURED and the COMPANY shall attempt in good faith to promptly resolve any controversy or dispute arising out of or relating to this POLICY by negotiations between executives who have authority to settle the controversy. 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 8100 (01/2013) [15 of 171 A, if we cancel this policy for any reason other than noInPayrrient of prerniurn, we will notify the persons or Organizations shown in the Strhed€.#le taelt vy, We will send notice e to the email or rnaiiing address listed hearw at least 10 days, or this number of day: listed belos v, €f any, before cancellation bec€ pies of erlive. In no event does the notice to the thirst party exceed the notice ttt the first narrred insured. B. This advance notification of pending cancellation of coverage is intended as a courtesy only, Our failure to provide such advance notification will not �,xteno the policy cancellation riate nor negate cancellation of the policy. Schedule Namur of Other Person() Ernai! Address ofmailing address Organization (s)= PCIr schedule, of cerl:ificait holders on fide iffi the Company All other lerms and conditions of this P,Db ; reniain unchanged, €ssr<t°d try Liberty Insurance Carl oration ZIO-14 90 � t cr attaci rrtc r;t lc� lac Sic - f�t�. T A s - 64D--0050 3 t_rJ [ 6 Effective Date 0:1 / 1 ; 2 01, 6 lss€ e-, to Centennial Energy Holdings, Inc, WM 0 18 06 11 0 2011. Liberiy Mutual Group, All Rights Resewed. page 1 of 1 d. 061,010011 A. if we cancel this policy for any reason other than nonpayment of premium, we will nolify the persons or organizations shown in the Schedule below. We will send notice to the entail or mailing address listed bolo", at least 10 days. or the nLIM-,)Gr of days listed below, if any, before cancellation becomes affective, In no event does the notice to the third party exceed the notice to the fiat natraed ins Bred. B, Thisqdvance 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 raer Bate cancellation of the policy, Schedule Name of OtherPerson(s) Email Address or mailing address: Or ani tion sj: Per schedule of certific.ato holders on file with the company All other terms and conditions of this poiicy remain unchaar€ged. Issued t: I_herty Mutual Fire insuranc„ Curr€lmyly &586� Number Days Notice: 101 For attact mart tc Prllny l%io.` v'C2--6 4 l —00. 09 s -»E: 26 Move Date 0 1 / 01 f 20 i. 6 p erraium IsWe t to MDU R srie€ ces Gmup, Inc. WM 90 18 06 11 C: 2011, Liberty Mutual Group. Ali Rights Reserved. Ed. 6/01,12011 Page 1 of 1 0003468 SP 0638-001-P03469-1 City of Port Orchard Attn: City Clerk's Office 216 Prospect St. Port Orchard, WA 98366