WORK PLANS - Laserfiche WebLink

Home Browse Search

AC�® r ATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE1110 3/2 01 6 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 CONTACT tV NAME: Aan Risk Services Southwest, Inc. 101 PHONE (866) 283-7122 FAX (800) 363-0105 `y Houston TX Office (A/C.No.Ext): A/C.No.): 5555 San Felipe E-MAIL 75 Suite 1500 ADDRESS: 2 Houston TX 77056 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: ACE American Insurance Company 22667 cascade Drillinq, L.P. INSURERB: ACE Fire Underwriters Insurance Co. 20702 PO BOX 1184 17270 Woodinville-Redmond Road INSURER C: Aspen Specialty Insurance Company 10717 Building "A", #777 INSURER D: Woodinville wA 98072 USA INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570064379525 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE DDL WVD UBI POLICY NUMBER MMIDD POLICY qMMIDD 1'VYY LIMITS C X COMMERCIAL GENERAL LIABILITY ERAFXLW EACH OCCURRENCE $1,000,000 CLAIMS-MADE ❑X OCCUR DAMAGE TO PREMISES H occurrence $300,000 MED EXP(Any one person) $25,000 PERSONAL 8 ADV INJURY $1,000,000 N GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 X POLICY ❑PRO- JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 V OTHER: Professional Liability $1,000,000 0 A ISA H09052094 11/01/2016 11/01/2017 COMBINED SINGLE LIMIT N AUTOMOBILE LIABILITY $2,000,000 Ea accident -, X ANYAUTO BODILY INJURY(Per person) C Z OWNED SCHEDULED BODILY INJURY(Per accident) N AUTOS ONLY AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE U ONLY AUTOS ONLY (Per accdent N C UMBRELLA LIAB X OCCUR EXAFXLY16 11/01/20161110112017 EACH OCCURRENCE $15,000,000 L) X EXCESS LIAB CLAIMS-MADE AGGREGATE $15,000,000 DED RETENTION A WORKERS COMPENSATION AND WLRc49106075 11/01/2016 11 Ol 2017 X PER STATUTE OTH- B EMPLOYERS'LIABILITY YIN SCFc49106087 11/01/2016 11/01/2017 ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000-_ C Env Contr POII 7 1 6 11/01/2016 11/01/2017 Each Pollution Incif $1,000,000= . T DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence of Insurance VJ 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 Drillingg L.P. AUTHORIZED REPRESENTATIVE 17270 woodinville-Redmond Road Building "A" PO Box 1184 cXJNo/n L�lO/G/� Woodinville WA 98072 USA �� >•za ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD