Loading...
Chesapeake Bay/COIPage 1 of 1 R. ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 08/31/2019 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 endorsement(s). PRODUCER Willis of Pennsylvania, Inc. c/o 26 Century Blvd P.O. Box 305191 CONTACT NAME_ PHONE 1-877-945-7378 FAX 1-888-467-2378 A1C No certificates@willis.com -ADDRESS: INSURERS)_AFFORDINQ COVERAGE NAIC # Nashville, TN 372305191 USA INSURERA: Liberty Mutual Fire Insurance Company 23035 INSURED Chesapeake Utilities Corporation 909 Silver Lake Boulevard INSURERS: Associated Electric & Gas Insurance Servic 81164 - -- INSURERC: Liberty Insurance Corporation 42404 INSURER D INSURER E Dover, DE 19904 Y INSURER F: COVERAGES CERTIFICATE NUMBER: W12460626 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. - POLICY EFF I POLICY EXP /CTR' TYPE OF INSURANCE IA 1SD U D POLICY NUMBER MM/DD/YYYY MM/DDIYYYY LIMITS X j COMMERCIAL GENERAL LIABILITY' EACH OCCURRENCE_ III 1,000,000 $ 100,000 CLAIMSDAMAGE -MADE I X OCCUR TO RENTE15 PREMISES (Ea occurrence $ 10, 000 AMED Y TB2-641-444639-039 09/01/2019109/01/2020 EXP (An one person) PERSONAL &ADV INJURY $ 1,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: $ 2,000,000 GENERAL AGGREGATE i �J PRO- I X 'POLICY JEC7 LOC i PRODUCTS • COMPIOP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY _ _, COMBINED SINGLE LIMIT Ea accident $ 1,000,000 $ X j ANY AUTO BODILY INJURY (Per person) A OWNED SCHEDULED ,AUTOS ONLY AUTOS AS2-641-444639-019 09/01/2019109/01/2020 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE {Florida PIP Coverage $ 10000 B IUMBRELLAIIAB X OCCUR X EXCESS LIAB CLAIMS -MADE XL5827801P 09/01/2019 EACH OCCURRENCE 09/01120201 AGGREGATE $ 4,000,000 $ 4,000,000 DED j RETENTION$ I 1 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? No (Mandatory in NH) II yes, describe undernnn NIA WC2-641-444639-059 109/01/2019 I X PER OTH- STATUTE ER E L EACH ACCIDENT 09/01/20201 E.L. DISEASE - EA EMPLOYEE $ 1, 000, 000 _ $ 1,000,000 — -_ nnn DESCRIPTION P T O be i I DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached it more space is required) City of Okeechobee is included as an Additional insured as respects to General Liability. Terms and conditions provide that the City of Okeechobee is an Additional Insured as to the Company's construction or operation of a natural gas distribution system within the corporate limits of the City of Okeechobee as they currently exist or may exist in the future. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Okeechobee AUTHORIZED REPRESENTATIVE 55 BE 3rd Avenue Okeechobee, FL 34974 �41t'm r�'laaxc� ©1988-2016 ACORD CORPORATION. All rlgnts reserves. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD sa ID: 18459554 BATCH: 1350507 3 of 3 9183 A °® CERTIFICATE OF LIABILITY INSURANCE Page 1 of 1 08/28/20U15 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 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 Willis of Pennsylvania, Inc. c/o 26 Century Blvd. P. O. Box 305191 Nashville, TN 37230-5191 CONTACT NAME PHONE FAX (A/C No FXT) 877- 945 -7378 (A/c No) 888- 467 -2378 E -MAIL ADDRESS. certificates @willis.com INSURER(S)AFFORDING COVERAGE NAIC # INSURERA:Liberty Mutual Fire Insurance Company 23035 -001 INSURED Chesapeake Utilities Corporation 909 Silver Lake Boulevard Dover, DE 19904 I INSURERB:Starr Surplus Lines Insurance Company 13604 -001 INSURERC:Liberty Insurance Corporation 42404 -001 INSURER D: $ 1,000,000 INSURER E: $ 1,000,000 INSURER F: COVERAGES CERTIFICATE NUMBER: 23503493 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 ITR TYPE ADDL INSn SUBP. WVD POLICY NUMBER POLICYEFF (MM/nn/WW) POLICYEXP (MM /nn/YYW) LIMITS A A X COMMERCIAL GENERAL LIABILITY Y Y TB2- 641 - 444639 -045 TB2- 641 - 444639 -035 9/1/2015 9/1/2015 9/1/2016 9/1/2016 EACH OCCURRENCE $ 1,000,000 PREMISEIQEMcurence) $ 1,000,000 CLAIMS -MADE X OCCUR MEDEXP(Anyoneperson) $ 5,000 $ 1,000,000 X Railroad Protective PERSONAL &ADVINJURY X GEN'LAGGREGATELIMITAPPLIESPER: X Liability POLICY OTHER: PRO- JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS- COMP /OPAGG $ 1,000,000 $ A A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS AS2- 641- 444639 -025 AS2- 641 - 444639 -015 9/1/2015 9/1/2015 9/1/2016 9/1/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILYINJURY(Perperson) $ BODILY INJURY(Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 1000095022151 9/1/2015 9/1/2016 EACHOCCURRENCE $ 4, 000, 000 AGGREGATE $ 4,000,000 $ DED RETENTION $ (+ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY /N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) if yes, describe under DESCRIPTION OF OPERATIONS below N/A WC7- 641 - 444639 -055 9/1/2015 9/1/2016 X PER OTH STATIITF FR E . EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E . DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additonal Remarks Schedule, may be attached if more space is required) City of Okeechobee is included as an Additional Insured as respects to General Liability. Terms and conditions provide that the City of Okeechobee is an Additional Insured as to the Company's construction or operation of a natural gas distribution system within the corporate limits of the City of Okeechobee as they currently exist or may exist in the future. CERTIFICATE HOLDER CANCELLATION City of Okeechobee 55 SE 3rd Avenue Okeechobee, FL 34974 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 ACORD 25 (2014/01) Co11:4756631 Tp1:1987150 Cert:23503493 © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A ? °® CERTIFICATE OF LIABILITY INSURANCE Page 1 of 1 08/2 /2014 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 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 Willis of Pennsylvania, Inc. c/o 26 Century Blvd. P. O. Box 305191 Nashville, TN 37230 -5191 CONTACT NAME: PHONE FAX (A/C, NO. EXT): 877 - 945 -7378 (NC,N0): 888 - 467 -2378 ADDRIESS: certificates@willis.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Zurich American Insurance Company 16535 -006 INSURED Chesapeake Utilities Corporation 909 Silver Lake Boulevard Dover, DE 19904 I INSURER B: Starr Surplus Lines Insurance Company 13604 -001 INSURER C: American Zurich Insurance Company 40142 -001 INSURER D: $ 1,000,000 INSURER E: $ 1,000,000 INSURER F: COVERAGES CERTIFICATE NUMBER: 21973769 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 LTR TYPE OF INSURANCE ADD'L INSRD SUB F WVD POLICY NUMBER POLICY EFF (MWDD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY Y Y GL06724433 -04 GL06724434 -04 9/1/2014 9/1/2014 9/1/2015 9/1/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO PREMSES(EaoccuErence) $ 1,000,000 CLAIMS -MADE X OCCUR MEDEXP(Anyoneperson) $ 5 000 X X GEN'L X Railroad Protective PERSONAL &ADV INJURY $ 1,000,000 Liability AGGREGATE POLICY LIMIT APPLIES PECOT- PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 $ A A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _AUTOS _AUTOS SCHEDULED NON -OWNED BAP6724435 -04 BAP6724432 -04 9/1/2014 9/1/2014 9/1/2015 9/1/2015 COa MaccidenBINED t) SINGLE LIMIT (E $ 1,000,000 BODILYINJURY(Perperson) $ BODILYINJURY(Peraccident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 1000095022141 9/1/2014 9/1/2015 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 $ DED RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory,inNH) f yes, describe under DESCRIPTION OF OPERATIONS below Y/N N/A WC6724436 -04 9/1/2014 9/1/2015 X WCSTAT- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach Acord 101, Additional Remarks Schedule, 'd more space is required) City of Okeechobee is included as an Additional Insured as respects to General Liability. Terms and conditions provide that the City of Okeechobee is an Additional Insured as to the Company's construction or operation of a natural gas distribution system within the corporate limits of the City of Okeechobee as they currently exist or may exist in the future. CERTIFICATE HOLDER CANCELLATION City of Okeechobee 55 SE 3rd Avenue Okeechobee, FL 34974 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 cry 40. =x- ACORD 25 (2010/05) Co11:4501035 Tp1:1855647 Cert:21973769 © 1988- 2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AR ° CERTIFICATE OF LIABILITY INSURANCE Page 1 of 1 10/24/2013) 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 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 Willis of Pennsylvania, Inc. c/o 26 Century Blvd. P. O. Box 305191 Nashville, TN 37230 -5191 CONTACT NAMF• PHONE FAX (A/CNIZFxT) 877- 945 -7378 jp./cNO). 888- 467 -2378 E -MAIL AnOREss. certificates@willis.com INSURER(S)AFFORDING COVERAGE NAIC # INSURER A: Zurich American Insurance Company 16535 -006 INSURED Chesapeake Utilities Corporation 909 Silver Lake Boulevard Dover, DE 19904 I INSURER B: Starr Surplus Lines Insurance Company 13604 -001 INSURER C: American Zurich Insurance Company 40142 -001 INSURER D: 19REMISES(EaEoac7urence) INSURER E: INSURER F: X COVERAGES CERTIFICATE 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. jNTR TYPE OF INSURANCE ADD'Lf SUER INS ma_ POLICY NUMBER POLICY EFF (MM/nn/YYYY) POLICY EXP ()JIM/nOYYYY) LIMITS A A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY Y Y GL06724433 -03 GL06724434 -03 9/1/2013 9/1/2013 9/1/2014 9/1/2014 EACH OCCURRENCE $ 1,000,000 $ 1,000,000 19REMISES(EaEoac7urence) CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 $ 1,000,000 $ 2,000,000 $ 1,000,000 $ X Railroad Protective PERSONAL BADVINJURY X Liability GENERAL AGGREGATE GEN'LAGGREGATELIMITAPPLIESPER: POLICY n PR°- LOC PRODUCTS - COMP/OP AGG A A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS ^AUTOS SCHEDULED AUTOS NON -OWNED BAP6724435 -03 BAP6724432 -03 9/1/2013 9/1/2013 9/1/2014 9/1/2014 COMBINE t)S LELIMIT (Ea accident) $ 1,000,000 BODILYINJURY(Perperson) $ BODILY ( ) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE SLSLXNR03021013 9/1/2013 9/1/2014 EACHOCCURRENCE $ 4,000,000 $ 4,000,000 $ AGGREGATE DED (RETENTION$ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVEI I OFFICER/MEMBER EXCLUDED? (Mandatory.inNH) RRyes, describe under DESCRIPTION OF OPERATIONS below NIA WC6724436 -03 9/1/2013 9/1/2014 X ITCIRYIIMTS OTH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1, 000, 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required) City of Okeechobee is included as an Additional Insured as respects to General Liability. Terms and conditions provide that the City of Okeechobee is an Additional Insured as to the Company's construction or operation of a natural gas distribution system within the corporate limits of the City of Okeechobee as they currently exist or may exist in the future. CERTIFICATE HOLDER CAN LL City of Okeechobee 55 SR 3rd Avenue Okeechobee, FL 34974 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 ACORD 25 (2010/05) Coll:4248192 Tp1:1722838 Cert:20618176 © 1988- 2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD kR'/ zi s) AR L CERTIFICATE OF LIABILITY INSURANCE page 1 of 1 04/(19/2013 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 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 Willis of Pennsylvania, Inc. c/o 26 Century Blvd. P. 0. Box 305191 Nashville, TN 37230 -5191 CONTACT NAME: PHONE FAX (A/C, NO, EXT): 877 - 945 -7378 (A/C NO): 888 - 467 -2378 ADDRIL ADDRESS: certificates@willis.com INSURER(S)AFFORDING COVERAGE NAIC k INSURER A: Zurich American Insurance Company 16535 -006 INSURED Chesapeake Utilities Corporation 909 Silver Lake Boulevard I y- Dover, DE 19904 ., n , �-,, ,�/ {� /�'�` /'/�<' {/ 1 1 /i�I.P rYit rr a.. Aie?t DC 1�+! L'1 O INSURER B: Starr Surplus Lines Insurance Company 13604 -001 INSURER C: American Zurich Insurance Company 40142 -001 INSURER D: $ 1,000,000 $ 1,000,000 DAMAGE TO RENTE PREMISES (Ea occurence) MEDEXP(Anyoneperson) SURER F: BER: 19751 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 LTR TYPE ADD'L INSRD SURF' WVD POLICY NUMBER POLICYEFF (MM /DD/YYYY) POLICYEXP (MM /DD/YYYY) LIMITS A A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY Y Y GL06724434 -02 GL06724433 -02 9/1/2012 9/1/2012 9/1/2013 9/1/2013 EACH OCCURRENCE $ 1,000,000 $ 1,000,000 DAMAGE TO RENTE PREMISES (Ea occurence) MEDEXP(Anyoneperson) $ 5,000 $ 1,000,000 CLAIMS -MADE X OCCUR PERSONAL &ADV INJURY X Railroad Protective $ 2,000,000 GENERAL AGGREGATE X Liability $ 1,000,000 $ PRODUCTS - COMP/OP AGG GEN'L AGGREGATE POLICY LIMIT APPLIES PRO- JECT PER: LOC A A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS BAP6724435 -02 BAP6724432 -02 9/1/2012 9/1/2012 9/1/2013 9/1/2013 COMBINED t) SINGLE LIMIT (Ea acciden $ 1,000,000 BODILYINJURY(Perperson) $ BODILY INJURY(Per accident) $ PROPERTY $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE SLSLXNR0302102 9/1/2012 9/1/2013 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVEY /NI OFFICER /MEMBER EXCLUDED? I Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC6724436 -02 9/1/2012 9/1/2013 X WR YLIMI - TORY LIMITS OTH- ER ER E.L. EACH ACCIDENT $ 1,000,000 E. L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required) City of Okeechobee is included as an Additional Insured as respects to General Liability. Gt11 I It-It.,H I t n'Lucrt City of Okeechobee 55 SE 3rd Avenue Okeechobee, FL 34974 -• ----- - - - --- 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 ACORD 25 (2010/05) Co11: 4072500 Tp1 :1630010 Cert :19751871 ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD *H 2 O16 ACORN A "I °I;CATE OF LIABILITY INSURANCE. Pag el of'. DATE (MM /00/YYYY) 08,24,zo16 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPQNTHE CERTIFICATE MOLDER; THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFF iRDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THEFSSUING INSURER(S,), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. = !/ IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATIOV IS WAIVED, 9ubfect to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not conferrighfs to the certificate holder in lieu of such endorsement(s). PRODUCER Willis of Pennsylvania, Inc. c/o 26 Century Blvd. P. O . Box 305191 P. 0. Box, TN 37230-5191 CONTACT PHONE FAX (A/C NO EXT) 877- 945 -7378 (AJC,.ND1 888 - 467 -2378 E -MAIL ADORFSSW certificates @willis.com INSURER(S)AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Fire Insurance Company 23035 -001 INSURED Chesapeake Utilities Corporation 909 Silver Lake Boulevard Dover, DE 19904 INSURER B: Starr Surplus Lines Insurance Company 13604 -001 INSURER C:Liberty Insurance Corporation 42404 -001 INSURER D: INSURER E_ CLAIMS -MADE INSURER F: OCCUR COVERAGES CERTIFICATE NUMBER: 24628010 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 I TR TYPE OF INSURANCE ADDL INSD SUBP. WVD POLICY NUMBER POLICY EFF (MM /DD /YYYY) POLICY EXP (MM /DD /YYYYI LIMITS A A X COMMERCIAL GENERAL LIABILITY Y y TB2- 641- 444639 -036 TB2- 641 - 444639 -046 9/1/2016 9/1/2016 9/1/2017 9/1/2017 EACH OCCURRENCE $ 11000,000 CLAIMS -MADE X OCCUR E TO PRES(Eaoccure EMIS nce) $ 1,000,000 X Railroad Protective MED EXP (Any one person) $ 5,000 $ 1,000_, 000 $ 2 .,000,000 X GEN'L X Liability AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER J LOC PERSONAL &ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP /OP AGG $ 1,000,000 $ j A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS AS2- 641- 444639 -016 AS2- 641 - 444639 -026 9/1/2016 9/1/2016 9/1/2017 9/1/2017 COMBINE DSINGLELIMIT (Ea accident) $ 1,000,000 BODILYINJURY(Per person) $ BODILYINJURYPer accident ( ) $ PROPERTY DAMAGE (Per accident) $ $ X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 1000095022161 9/1/2016 9/1/2017 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y/N ANY PROPRIETOR/PARTNER/EXECUTIVE N OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A PER OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E . DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additonal Remarks Schedule, may be attached if more space is required) City of Okeechobee is included as an Additional Insured as respects to General Liability. Terms and conditions provide that the City of Okeechobee is an Additional Insured as to the Company's construction or operation of a natural gas distribution system within the corporate limits of the City of Okeechobee as they currently exist or may exist in the future. CERTIFICATE HOLDER CANCELLATION City of Okeechobee 55 SE 3rd Avenue Okeechobee, FL 34974 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 /' /,- _._ i ._ ACORD 25 (2014/01) Co11:4951092 Tp1:2079386 Cert:24628010 © 1988- 2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD