CERTIFICATE OF LIABILITY INSURANCE (1081)CERTIFICATE OF LIABILITY INSURANCE
ATE
D0910102DDrYYYY,
0910,1202,
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 INSURERjS), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(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 requlre 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.
1717 Arch Street
Philadelphia, PA 19103.2797
CONTACT
NAME!
FAX
PHONE LAIC, No
E-MAIL
ADDRESS:
INSURERS AFFORDING COVERAGE NAIL#
09!0112021
INSURER A: Zurich American Insurance Comparfy 16535
CN102071519-ALL-GAWU-21-22
INSURED Chesapeake Utilities Corporation
INSURER B: American Zurich Insurance CoR] 40142
INSURER C : Associated Electric S Gas Ins Svcs Lid 3190004
including Martin Gas Services
909 Sliver Lake Blvd
Dover, DE 19904.2408
INSURER D :
PRQDUCTS - CDMPIOP AGG $ 4,000,000
$
INSURER E:
INSURER F :
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
L
COVERAGES CERTIFICATE NUMBER: CLE -006780289.63 REVISION NUMBER: 0
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
I TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
POLICY EFF
MWDDIYYYY
POLICY EXP
µMID IYYYY
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MAGE FxOCCUR
GLO180884200
09!0112021
0910112022
EACH OCCURRENCE $ 2,60,000
PREMISES Ea occLrrsnce $ 1,O(10,IX)tl
MED EXP (Any or* person) $ 10,000
PERSONAL & ADV INJURY $ ZOXx OW
GEN1 AGGREGATE LIMIT APPLIES PER
x POLICY ❑PRO- ❑
JECT LOC
OTHER:
GENERAL AGGREGATE $ 4,400,000
PRQDUCTS - CDMPIOP AGG $ 4,000,000
$
A
AUTOMOBILE
r
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
L
I
BAP1808MO
I
09/01/2021
09/01/2022
Ea aid DnISINGLE LIMIT $ 2,000,000
BODILY INJURY (Per person) $
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
Per accident
X
UMBRELLA LIAR
EXCESS LIAO
_ OCCUR
x CLAIMS MADE
XL5817803P
ON112021
—
on"2022
EACH OCCURRENCE $ 5,000,000
AGGREGATE $ 5,000,000
DED I I RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETORIPARTNERIEA—UTIVE Y1 N
OFFICERIMEMBEREXCLUDED? ❑N
IMandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
WCi8O884106
ON112021
6 '}12027
X AER OTH-
STATUTE ER
€.L EACH ACCIDENT $ 2,000,000
E.L. DISEASE - €A EMPLOYEE $ 2,006,000
E. L. DISEASE - POLICY LIMIT $ 2,006,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101, Additional Remarks Schedule, may be attached IF more space Is required)
Clearwater Gas Syslem Is Included as Addilional Insured (Excepl Workers' Com pensalion) where required by written contract.
Clearwater Gas System SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
400 N. Myrtle Ave THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Clearwater. FL 33755 SEP
_ 4 202 j ACCORDANCE WITH THE POLICY PROVISIONS.
�7 CT Ll L U I AUTHORIZED REPRESENTATIVE
GAS ADMIN
01988-2016 ACORD CORPORATION. All rights reserved.
ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD