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• 1 ® DATE(MMIDDIYYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 11/19/2019 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 endorsements). PRODUCER NNW'Jane Orr Crystal &Company IPA HONE E , 713-624-6315 INC,FAXNo: Alliant Insurance Services e+nal 2000 West Loop South, Suite 2150 ADDRESS' Jane.Orc alliant.com Houston TX 77027 INSURERS AFFORDING COVERAGE NAICE INSURERA:ACE American Insurance Cc 22667 INSURED CASCOR INSURER IS:ACE Fire Underwriters Insurance Company 20702 Cascade Drilling, LP INSURERC: Lloyd's of London.. 22722 29th Drive SE, Suite 228 Bothell, WA 98021 INSURERD: Lloyd's of London.. 10200 INSURER E: NSURERF: COVERAGES CERTIFICATE NUMBER:119791420 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 TYPE OF INSURANCE ADOL SUER POLICY NUMBER MMIDUPOLICY EFF POOLICCY EXP LIMITS LTRWv, D X COMMERCIAL GENERALLIABILITY ENVP000016019 ll/l/2019 11/1/2020 EACH OCCURRENCE $1,000,000 DAMAGE TO I E CLAIMS-MADE lxl OCCUR PREMISES EaEoaumance $300,000 MED EXP(Anyone person) $25,000 PERSONAL BADV INJURY S1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000.000 POLICY PRO- LOC PRODUCTS-COMPIOP AGG $2,000,000 X JECT OTHER: Proressional Uabili a'1,000,000 A AUTO MOBILELIABILITY ISAH25288993 11/1/2019 11/1/2020 COMBINED SINGLE LIMIT $5,000,000 Ea.trident X ANY AUTO BODILY INJURY(Per pe,san) S OWNED SCHEDULED BODILY INJURY(Pm.mmdent) $ AUTOS ONLY AUTOS HIRED NON IWNED PROPERTY DAMAGE It ONLY AUTOSONLV Per aodtlent $ C UMBRELLALIAS X OCCUR ENVX000011719 11/112019 11/112020 EACHOCCURRENCE 315,000.00D. X EXCESS LIAR CLAIMS-MADE AGGREGATE $15.000,000 DED I I RETENTION$ _ $ A WORKERS COMPENSATION WLRC65890252 11/112019 -111112020 X STATUTE ER B AND EMPLOYERS'LIABILITY YIN SCFC6589029A 11/112019 11I1I2020 ANYPROPRIETORIPARTNERIE%ECUTIVE rq NIA E.L.EACH ACCIDENT $1,000,000 OFFICERIMEMBEREXCLUDED4 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,desmlo under E.L.DISEASE-POLICY LIMIT $1.000.000 DESCRIPTION OF OPERATIONS below C Pollution UeNliry ENVP000015019 111112019 111112020 Emit Poll lnddent 1,000.000 rri DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be allachad If more space Is required) GENERAL LIABILITY: Additional Insured status when required by written Contract(GAP1028 611/2016, GAP1 0 04 611/201 6);Additional Insured Primary/Non-Contributory Amendatory when required by written Contract(GAP1005 6/1/2016);Waiver of Subrogation when required by written contract (GAP1030 6/1/2016). AUTOMOBILE: Additional Insured status when required by written Contract(DA91.174c 0316); Primary/Non-Contributory when required by written contract (DA21886b 0614);Waiver Of Subrogation when required by written contract(CA0444 1013) WORKERS'COMPENSATION: Waiver of Subrogation when required by written contract-Other States(WCOOD3131105);Waiver of Subrogation when See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Cascade Drilling, LP 22722 29th Drive, SE, Suite 228 AUTHORIZEDREPRESENTATIVE Bothell WA 98021 �y, ©1988-201�2.01��5 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD