COMPLIANCE INFO - Laserfiche WebLink

Home Browse Search

— 7 8 ACCORD CERTIFICATE OF LIABILITY INSURANCE 4......---- DATE (MM/DD/YYYY) 10/30/2017 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 Crystal & Company Crystal IBC LLC 32 Old Slip New York NY 10005 CONTACT NAME: PHONE 800-221-5830 FAX 800-383-1852 (A/C_N Fon. (A/C Nol" E-MAIL ADDRESS' INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :ACE American Insurance Co 22667 INSURED CASCDR Cascade Drilling, LP 17270 Woodinville Redmond Rd NE Suite 777 Bldg A Woodinville WA 98072 INSURER B :ACE Fire Underwriters Insurance Company 20702 INSURER C :Underwriters at Lloyd's London 15792 INSURER D :Allied World Assurance Company (U.S.) I 19489 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER. 1741929087 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. NOTVVITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VVITH 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 INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DINYYYY) POLICY EXP (MM/DDNYYY) LIMITS C x COMMERCIAL GENERAL LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) GENERAL LIABILITY: Additional Insured status when required by written contract (GAP10286/1/2016, GAP10046/1/2016); Primary/Non-Contributory when required by written contract (GAP10056/1/2016); Waiver of Subrogation when required by written contract (GAP10306/1/2016). AUTOMOBILE: Additional Insured status when required by written contract (DA9U74c0316); Primary/Non-Contributory when required by written contract (DA21886b0614); Waiver of Subrogation when required by written contract (CA04441013) See Attached... CERTIFICATE HOLDER CANCELLATION 1 Cascade Drilling, L.P. 17270 Woodinville-Redmond Road Building "A" PO Box 1184 Woodinville, WA 98072 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 eAlaat- ii- et0,'Yieraft,"".....1r.„ © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD