Commonwealth Of Before The Public Service Commission

Transcription

COMMONWEALTH OF ICENTT JCICYBEFORE THE PUBLIC SERVICE COMMISSIONIn the Matter 0-T:ALTERNATIVE RATE FILING OFCOOL,BROOK UTILITIES, LLC.COOLBROOK UTILITIES, LLC’S NOTICE OF FILING OF CERTIFICATE OFLIABILITY INSURANCEComes Coolbrook Utilities, LLC (“Coolbrook”), by counsel, and hereby files itsCertificate of Liability Insurance reflecting that the insurance policy issued by Nautilus InsuranceCompany to Coolbrook became effective on May 4, 201 1. A copy of the Commercial GeneralL,iability Quote reflecting total premium and fees in the amount of 5,778.24 for said policy is alsoattached.Respectfully submitted,,lRobert C. MooreHazelrigg & Cox, LLP41.5 West Main StreetP.O. Box 676Frankfort, ICentucky 40602-0676CERTIFICATE OF SERVICEI hereby certify that a true and correct copy of tlie foregoing was served by first class mail,postage prepaid, on Jeff Derouen, Executive Director, Public Service Commission, 2 1 1 Sower Blvd. ,P.O. Box 6 1.5, Fraiddoi-t, Kentucky 40602 and David Edward Spenard, Assistant Attorney General,1024 Capital Center Drive, Suite 200, Fraidcfort, Kentucky 40601-8204, on this the 5“’day of May,201 IRobert C. Moore1

CONTACTNAME:PRODUCERVOIT-LEE INSURANCE INC370 1 TAYLORSVJLLE ROAD-#5AL 0UI SVIL LE, w x 0 2 20z g , N t o Frt)'E-MAILADDRESS:INSURER(S) AFFORDING COVERAGEINSURERA:COOLBROOK lJTlLlTlESP.O. BOX 91588LO(JISVILLE, KY 40291IN55REDFAX(NC. No):(502)459-4272NAlC 11NAUTILUS INSURANCE COMPANYINSURER B :INSURER C :INSURER D :INSURER E :CERTIFICATE NUMBER:COVEWGESREVISION NUMBER:THIS IS T O CERTIFY THAT THE POLICIES OF INStJRANCE LISTED BELOW HAVE BEEN ISSUED TO TINDICATED NOTWITHSTANDING ANY RfQUlRfh.1ENT. T E R M OR CONDITION OF ANY CONTRACT 01CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, T H E INSURANCE AFFORDED BY THE POLICIES IFXCLlJSlONS A N D CONDITIONS OF SUCH POLICIES LIMITS S H O W N MAY HAVE BEEN REDUCED BY PPADD1POLICY EFFINSRTYPEOFINSURANCEPOLICY NUMBERIMMIDDNYYY)LTRIWGENERAL LIABILITYAE INSURED NAMED ABOVE FOR THE POLICY PERIODO T H E R DOCl!MENT W ! T H RESPECT TO WHICH THIS:SCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,1CLAIMSPOLICY EXPLIMITSJMMIDDNWY)-xTO BE ASSIGNEDCOMMERCIAL GENERAL LIABILITY1CLAIMS-MADEE]05/04/201 1OCCURni-1 PERSONAL & ADV INJURY GENERAL AGGREGATE 5000100000010000001000000 LOCCOMBINED SINGLE LIMIT(Ea accident)BODILY INJURY (Per c'erson)ALJTOMOBILE LIABILITYHIRED AUTOSMED EXP (Any one person) mALL OWNEDAUTOSEACHOCCURRENCEDAMAGE TO RENTEDPRODUCTS COMPlOP AGGGENL AGGREGATE LIMIT APPLIES PER1--INSURER F :SCHEDULEDBODILY INJURY (Per accident)PROPERT( DAMAGE(Per accident)AUTOSNON-OWNEDAUTOS -UMBRELLA LlABOCCUREACHOCCURRENCEEXCESS LlABCLAIMS-MADEAGGREGATE . WORKERS COMPENSATIONAND EMPLOYERS CERlMEMBER EXCLUDED?(Mandatory In NH)If yes, describe underDESCRIPTION OF OPERATIONS belowWC STATUT WI M T SE.L. EACH ACCIDENTIAE.L. DISEASE - POLICY LIMITICANCELLATIONThe ACORD name and logo E.L. DISEASE - EA EMPLOYEE JESCRIPTION OF OPERATIONS I LOCATIONSI VEHiCLES (AttachACORD 25 (2010105)OTHFRistered marks of ACORD -

Arlington/Rrm of Kentacky IncLouisville KYTo :Attention:Agency Number:Date: 03/23/2018AngierPhone Number:Extension:Direct Fax:From :Email:Insured Name:DE%:Renewal Of:COOLBROO1(s UTIUnESExpiration Date:'ny (A.M. Best rating A i - IX), w e are pleased to offer theThank you for the submission. On behalf of Nautilus InsurancePlease review cardully as coverage may not be exactJy asfdlowing Terms and tandltions based on Informatian received.in prior Company approval and provide an assigned policyrequested on the application. When binding coverage, you munumber and affective date. Terms are valld for 30 days.IF TERMS &RE SUEKIECTvPoilcy and/or endorsement must be received by the Company within 21 days of inception.aIF an inspaction Is required, It must be brwardetd to the Company within 45 days of Inception.Any policy changes, including rancellatton, can only be authorized by the Commny. 93.11 356.814t 5,778.24subject tu furttter adfurtrnsnt Refer ta form E O 1 for further exptanotlon.N/APERCLAIMAdditional Fees: Other is Municipal TaxUNDERWRITING REQUIREaInspeaion: required within 45 daysNumber of Locatlons to be Inspected:Signed Application : Acordcopy of Contracts: as neededEJ o s s u n s :Auditable: Yes- Annual0CONRDEMlAUTY NOTICE: The transmitted documents contain private, privileged and confidential information belonging to thesender. The information therein is solely for the use of tbe addressee. If your receipt of this tmnsmlssion has occurred as the resultof an error, please irnmedlately notirj. us so we can a r r a n p for the return of the original dmuments. I n such circumstances, you areadvised that you may not dlscloSe, copy, dlstrlbute or take any otherreliance on the InformaltJon transmitted.REPER to M E L TP'LXIED 0QoOlGA (09/09)

Date:RegardingI n s u r e d Name:03/23/2011COOLBROOKS lJTILITXESDEN:QENERAL P O U N CONDITIONS AND MANDATORY FORMS@ EO013 Policy Jacket8i EO01 Common DeclarationsEl BOL Servim of SuitILD017 Policy ConditionsS150 CGL Coverage Part DecCGOOOl Comml GL Coverage Form (12/04 Edition)@ CGOOL7 Excl - Violatlon of Statutes That Govern E-Malls[i4 CG2147 Excl Employment Related PracticesCG2196 S111 or Slllca-Related Dust Excluslonl l o D 2 l Nuclear Energy Exclusion-a@ L217 Exclusion - Punitive or Exemplav Damages@ U 2 3 Exclusion - Total Polkition-EL241 Exclusion MicroorganismsLLO1 Amendment Of Conditions - Premium Audit@LB50I Deductible Uablllty Insurance@ L21L Amendment of Definitions - Insured ContractSO13Min Earn Prem 25% orlio[i4 SO30 Amendment of Llquor@ 5261 Exclusion Asbestos@ S902 Schedule of Forms & Endts[XI-[i4 State-specific amendatory f o r m a s requiredADDITIONAL FORMSCl CG2104 EXCI - ProductsB CG213L Excl . New Entitiesc] CG2138 Excl - Personal and Advertising InjuryCG2145 Excl- L h m g e tu Premises Rented0 CG214L Abuse or Molestation Exclusionc] Ll02 Animai-Related BI or PD Umited Liab CoverageU O O Excl - Media and Internet LlabilityU 0 4 Excl -Aircraft, Auto or Watercraft(E3 L205 Excl Injury to Employees0 L209 Excl Medical PaymenhU10 Excl - A l l Assault or Battery(E3 U 1 3 Excl Computer Related Loss0 U 1 9 Excl Prof Svcs - Contractors17 L226 Excl Contagious, Infectious or Transmissible Diseasec] U 2 8 Excl Communicable DiseaseL234 Cond Excl -Tanning OperationsL236 Total Exclusion Subsidence o r MovementLZ38 Excl -Toxic MetalsE 0 4 0 Umitation of Coverage to Designated OperationsLZ82 Excl -Contractors and SubcontractorsU 8 4 Excl Pressure Treated Wood---flCl0001-301E X C - WeaponsU 1 7 Additional Excl - Scheduled Events0 UBI Exci Events0 L320 Excluslon - Tslnted Drywall MaterialsL402 Cov Ext Alarm or Security System - Prof Liabfl L602 Amendment of Conditions - When We Do Not RenewSO16Cov Extension - Designated Professional Services0c] SO28 Excl - Participants0 SO40 Excl - Cancer0 SOLO Cond Excl Llfesaving Equipment0 SO61 Cond Excl Lifeguard / S i g n Posting Req0 SOL3 Cond Excl - Water-Related Hazard Sign Posting Req0 SO64 Swimming P w l Fencing Conditions1 Excl0 SO71 Excl . Directors and Offlcers Liability0 SO77 Security Guards Mditlonal ExclSO70 Excl Water Damage0 SO95 Excl Water-Related Recreatlonal Equlpmentc] SO97 Cov Ext .security / Patrol Professional Liability(E3 S222 Excl - Intellectual Property Hszardc] 5239 Excl Electromagnetic Radiation[iil 5261 EXcl Asbetit -------L283 Excl - All Hazards Ongoing Operations and Your WorkAdditional InsuredSO32 Umitation of CoverageCl013c]c]00CONFIDENTIAUTY NOTICE: The transmitted documents contain private, privllwed snd confidential Information belonging to thesender. The information therein Is solely for the use of the addressee. I f your receipt of thls mnsmlsslon has occurred as tbe m u l tof an error, please l m m d l a t e l y notify us so we can armnge for the return of the original documents. I n such circumstances, you areadvlsed that you m y not dlwlose, copy, distribute or take any other action In rellance on the l n f o r m t l o n transmitted.REFER TO THE ATTACHED FOR ADDXTIOWAL TERMS ARD COWDITIOMSQOOlGA (09/09)

Date:RegardingImured Name:03/23/2011C001SROOKS l J T K l l I E SDEN:I Opeknsl H l n d Auto and Non-olvnrd Auto Liability m y bc avallable subjact to dlglbllity:'a U M H l d Auto and Noo-Owned Auto Uabllity (SprdW U r n b d Imumnce)-IF rx) entry No covo(IgP pmvldsd Any One AcddentOccurrence Limit. Any amount pald under this coverage wlll s r v a to reduca tba Pqgrepate UrnltsH l r d Auto and Non-Owned Auto Usblity Urnlt of Insurance * Unit is not in addition to Policyof InsuranceGENERAL UABIUTY PrnmOPSIProd/co0PsIS U Mtn 3,500 mlnlrnum rJrarnlumC Q N F I D E M M L I R NOTICE: The transmltted documsots contain privata, privihed and confldentlal lnformatlon belonging to thesander. The lnformtlon thenin is solely for the use of the addnssca. If your racsCpt of this bansrnlsslon has acurred as tha msultof an trror, p h m immadlataly notlfy us so we can arrange for ttWr faturn d the orlglnsl documenh. In such clrcumshlnuts, you aresdvlp.sd that you m y not dtplose, copy, dlshlbuts fx hko any cthsr sctlon In rsllmm on the inrwmylon transn-dtfod.aoorGA ( W / WID c o p o D

POLICYHOLDER DISCLOSURENOTICE OF TERRORISM I SURWNCE COVERAGE1You are hereby notified that under the Terrorism Risk Insurance Act, as amended, (the "Act"), that p u have a right to purchase insurance1coverage for bssss restilting from acts of terrorism, es defined in Section 102(f) of the Act The term 'act of terrorism" means any act that iscertified by the Secretary of the Treasury-in concumne with the Secretary of State, and the Attorney General of the United States-to bean xi of temrism; ta be a vioknt8c1 oran act that is dangerous to human life, property,or infrastructure, to have resulted in damage withinthe United States, cx outside the United States in the case of certain air carriers or vessels or the premises of a United States mission, and tohave been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to i n f b n c ethe poky or affect the conduct of the United States Government by coercionCoverage under your 0NEW orRENEWAL policy may be affected as folbws.YOlJ SHOULD KNOW THAT WHERE COVERAGE IS PROVIDED BY THIS POLICY FOR LOSSES RESULTING FROM CERTIFIED ACTSOF TERRORISM, SUCH LOSSES MAY BE PARTIALLY REIMBURSED BY THE UNITED STATES GOVERNMENT UNDER A FORMULAESTABLISHED BY FEDERAL LAW. HOWEVER, YOUR POLICY MAY CONTAIN OTHER EXCLUSIONS WHICH MIGHT AFFECT YOURCOVERAGE, SUCH AS AN EXCLUSION FOR NUCLEAR EVENTS. UNDER THE FORMULA, THE UNITED STATES GOVERNMENTGENERALLY REIMBURSES 85% OF COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY ESTABLISHED DEDUCT1BL.EPAID BY THE INSURANCE COMPANY PROVIDtNG THE COVERAGE. THE PREMIUM CHARGED FOR THIS COVERAGE IS PROVIDEDBELOW AND DOES NOT INCLUDE ANY CHARGES FOR THE PORTION OF LOSS THAT MAY BE COVERED BY THE FEDERALGOVERNMENT llNDER THE ACT.YOU SHOULD ALSO KNOW THAT 'THE ACT, CONTAINS A 100 BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENTAS WELL AS INSURERS' LIABILITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OFSUCW LOSSES IN ANY ONE CALENDAR YEAR EXCEEDS 100 BILLION IF THE AGGREGATE INSURED LOSSES FOR ALLINSURERS EXCEED 100 BILLION, YOUR COVERAGE MAY BE REDUCED.4cceptance I Rejection of Terrorism Insurance CoverageCI-I hereby elect to purchase terrorism cxverage, subject to the imitations of the Act, for acts of tem'sm as defined inplus the folbwing taxes and fees,Ihe Act, for a prospxtive premium of -,Surplis Lines Tax ofLSurpbs Lines Stamping Fee ofofL-LL.LL99ofofofOfofofLofLTotal of Premium, taxes and fees ishereby decine to purchase terrurism coverage for certified ects of terrorism I understand that I will have noaverage for bsses my king from certified acts of temrism.In------Pnnt NameE903 (02/08)NAUTILUS INSURANCE COMPANYInsurance CompanyPolcv NumberIncludes copyrighted material of National Association of lmurance Commissioners, with its permission.

sdvlp.sd that you my not dtplose, copy, dlshlbuts fx hko any cthsr sctlon In rsllmm on the inrwmylon transn-dtfod. aoorGA (W/W DcopoD POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM I SURWNCE COVERAGE 1 You are hereby notified that under the Terrorism Risk Insurance Act, as amended, (the "Act"), that pu have a right to purchase insurance 1 .