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052-14 - Cascade Natural Gas Corporation - Insurance Exp 1-1-2015A� V CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/01/2014 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 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 CONTACT NAME: IFAX AIC. o Ext : A/C No): E-MAIL ADDRESS: Minneapolis, MN 55402-2400 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Associated Electric & Gas Ins Services Ltd 3190004 J43750-CASCA-GAWX-14-15 INSURED CASCADE NATURAL GAS CORPORATION INSURER B : Liberty Mutual Insurance Company 23043 INSURER C : 8113 WEST GRANDRIDGE BLVD INSURER D : KENNEWICK, WA 99336-7166 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: CHI-004958047-01 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 W MMIDD/YY LIMITS A GENERAL LIABILITY XL5063403P 01/01/2014 01/01/2015 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY '$500,000 Self -Insured Retention' DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 $ POLICY PRO- LOC A AUTOMOBILE LIABILITY XL5063403P 01/01/2014 01/01/2015 (CEO a NdeeD SINGLE LIMITml $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO '$500,000 Self -Insured Retention' BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Peraccident $ X X NON -OWNED HIREDAUTOS AUTOS UMBRELLA LIAB OCCUR XL5063403P 01I01/2014 01/01/2015 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 X EXCESS LIAB CLAIMS -MADE DDIEDRETENTION $ —0TAND $ FBB WORKERS COMPENSATION EMPLOYERS'LIABILITYANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A WC7-641-005097-024 (Guar. Cost) WA7-64D-005097-014(AOS) 'INCLUDES "STOP GAP"' 01/01/2014 01/01/2014 01/01/2015 01/01/2015 X RY LMIT ER T E.L. EACH ACCIDENT $1,000,000 0 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ If yes, describe under DESCRIPTION OF OPERATIONS below -El I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Excess liability applies to general liability, products and completed operations, automobile liability, and employers liability. lha:illll;ILht\Ia:Lai III •J=1 A' • City of Port Orchard Attn: City Clerk's Office 216 Prospect St. Port Orchard, WA 98366 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee 1�Lauao►� ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD