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GREGDRI-03 SANDFRSON2
<br />p T
<br />ACOA aD"
<br />,,,,. CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDD/YYYY)
<br />3/(MMIDD
<br />5
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER License # OC36861
<br />Seattle-Alliant Insurance Services, Inc.
<br />401 Union Street, 31st Floor
<br />Seattle, WA 98101
<br />CONTACT
<br />a�N , Ext : (206) 204-9140 � No :(206) 204-9205
<br />E-MAIL
<br />INSUREPAS) AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: Markel Insurance Company
<br />38970
<br />INSURED
<br />Gregory Drilling, Inc.
<br />14112 452nd Ave. SE
<br />North Bend, WA 98045
<br />INSURER B: Mt. Hawley Insurance Company
<br />37974
<br />INSURERC:
<br />INSURER D :
<br />INSURER E
<br />INSURER F :
<br />CAVFRAnPA CFRTIRICeTF hil IMRPR- RFVISION NLIMBER-
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />TYPE OF INSURANCE
<br />AND
<br />SUER WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXPLTR
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />X
<br />AWWP000146-4
<br />10/11/2024
<br />10/11/2025
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTED
<br />1,000,000
<br />MED EXP (Any oneperson)
<br />$ 10,000
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY �X J$Q LOC
<br />OTHER: t�I
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />PRODUCTS
<br />$ 2,000,000
<br />$
<br />A
<br />AUTOMOBILE LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AURRTEEO��S ONLY AUUTNO{SWNEpBODILY
<br />A✓JTOS ONLY Ix AUTOS ONLY
<br />Ix
<br />AWWA000146
<br />10/11/2024
<br />10/11/2025
<br />C a aBd SINGLE LIMIT
<br />$ 1,000,000
<br />BODILY INJURY Per rson
<br />$
<br />INJURY Per accident
<br />$
<br />P O G ent AMAGE
<br />Pe
<br />$
<br />$
<br />A
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />AWWE000146
<br />10/11/2024
<br />10/11/2025
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />DED I X I RETENTION $ 10,060
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE —]
<br />0FFICER/MEMgWEXCLUDED?
<br />(Mandatory In NH)
<br />It yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />AW W P000146-4
<br />10/11 /2024
<br />10111 /2025
<br />PER OTH-
<br />TA ITE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />1 OOOOOO
<br />$
<br />I E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />B
<br />Pollution Liability
<br />EGL0012314
<br />10M1/2024
<br />10/11/2025
<br />Aggregate
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Kittitas County is Additional Insured With respect to the General Liability perform attached.
<br />Kittitas County
<br />205 West Sth Avenue, Suite 108
<br />Ellensburg, WA 98926
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />'/ ^t
<br />ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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