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RECEIVED AUG t6 2022 NORTFUE-01 ZFRIEZ CERTIFICATE OF LIABILITY INMRGNIOENTAL HEA TWTE (MMIDDIYYYY) 1111 /2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RId^5rL*i@5W1TdffY1fttTIFICATE 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(les) 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 C91 ACT Butte OfficePHONE PayneWest Insurance, a Marsh McLennan Agency LLC Company Are, No, Ext): (406) 494-8000 ac He : (406) 494-7641 PO Box 3089 Butte, MT 59702 E- INSURER AFFORDING COVERAGE NAIC # INSUR A : Westchester Surplus Lines Insurance Co 10172 INSURED INSURERS : Liberty Mutual Insurance Company 23043 Nwestco LLC dba Northwest Fuel Systems, INSURER C i Ohio Casualty Insurance Company 24074 ANC Vehicle Wash, Petrol Services 115 Industrial Court INSURER 0 : Evanston Insurance Company 36378 Kalispell, MT 59901 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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, ILTRNSR I TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP POLICY NUMBER LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 210009000 CLAIMS-MADE a OCCUR628147545 003 9/30/2020 9/30/2022 DAMAGE TO RENTED PR B fEe occurrence) S 250,000 MED EXP (Any oneperson) S 50000 PERSONAL & ADVINJURY S 21000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GEN RA AGGREGATE 2,000,000 POLICY IA j LOC PRODUCTS • CO P OP A 2,000, 000 OTHER: Bggident, S AUTOMOBILE LIABILITY CO eBiNED SINGLE LIMIT S 11000,000 ANY AUTO BAW57384241 10/3012021 10/30/2022 BODILY INJURY Perperson) S AUTOS ONLY X SCHEDULED A�RREE �� yy�Ep BODILY INJURY Per accident S AUTODSONLY AUTO ONLY VO®E�RdY t AMAGE S S A UMBRELLA LIARX OCCUR EACH OCCURRENCE $ 41000,000 X EXCESS LIAe El CLAIMS.MADE G28147557 005 9/30/2021 9/30/2022 AGGREGATE S DED I I RETENTION $ Aggregate S 4,000,000 C WORKERS COMPENSATIONPER OTH- AND EMPLOYERS' LIABIL TY / NIA UTE I ER ANY OoPROWRPMRIIETgOERRIPARTNER/EXECUTIVE XWS57384241 10/30/2021 10/30/2022 EL EACH ACCIDENT s 110000000 [ A m atoryin NH) EXCLUDED? N / A E.L. DISEASE - EA EMPLOYE S 11000,000 It yyes dascribe under 10000,000 DESG�RIPTION OF OPERATIONS be E.L. DISEASE - POLICY LIMIT $ D Commercial Excess LI MKLV2EFX100575 9/3012021 9130/2022 Excess Liability 2,0001000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE To Whom It May Concern THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) © 1968-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD