List of Known Insurance Providers for Underground Storage Tank Owners and Operators

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List Of Known Insurance Providers For Underground Storage Tank Owners And Operators

CONTENTS

Using This Booklet To Help Meet Financial Responsibility Requirements ...... 1

How Can You Get The Most Current List? ...... 2

Need More General Information About USTs Or Financial Responsibility? ...... 2

List Of Insurance Companies ...... 3

List Of Insurance Agents And Brokers ...... 5

Model Of “Endorsement” Criteria ...... 18

Model Of “Certificate Of Insurance” Criteria ...... 19

Please note:

• The following list is not an endorsement by EPA of the products or services provided by these companies, agents, and brokers. • You are free to contact anyone you believe can meet your insurance needs. • The following list is not necessarily comprehensive because it captures only those who have contacted us as of the date of this publication.

USING THIS BOOKLET TO HELP MEET FINANCIAL RESPONSIBILITY REQUIREMENTS

The U.S. Environmental Protection Agency (EPA) developed financial responsibility regulations to ensure that underground storage tank (UST) owners and operators can pay the costs of cleaning up leaks from USTs and compensate third parties for bodily injury or property damage resulting from leaks.

The financial responsibility regulations (40 CFR Part 280, Subpart H) allow UST owners and operators to choose from Who’s Who? a variety of financial mechanisms to comply with the regulations. One of these financial mechanisms is the use of Insurance Company Or insurance. Insurer A corporation or association In order to facilitate access to UST insurance, EPA engaged primarily in the developed this booklet based on information it received from business of furnishing the listed companies, agents, and brokers. The companies, insurance to the public. agents, and brokers listed may help you – as an UST owner The party to the insurance or operator – find the UST insurance that can fulfill your contract who promises to pay financial responsibility obligation. See the text box on the losses or benefits. right for a description of the roles of companies, agents, and brokers. Insurance Agent An insurance company IMPORTANT: It is your responsibility to make sure representative who solicits, the coverage you are offered meets federal negotiates or effects contracts requirements and any state or local requirements of insurance, and provides that may apply to your USTs. service to the policyholder for the insurer. Under federal requirements, in order to fully demonstrate financial responsibility using an insurance Insurance Broker policy, your insurance policy must provide coverage for A marketing specialist who taking corrective action and for compensating third represents buyers of property parties for bodily injury and property damage caused by and liability insurance and both nonsudden and sudden accidental releases arising who deals with either agents from the operation of an UST. You should contact your or companies in arranging for state environmental agency to be sure that your the coverage required by the insurance policy meets state requirements. customer.

Some insurance companies sell insurance policies that provide only partial coverage (e.g., only provides coverage for third-party liability). If you decide to purchase such a policy, you will need to demonstrate financial responsibility for the remaining coverage in order to fully comply with the federal requirements (e.g., through the use of another financial mechanism). It is your responsibility to understand what type of coverage is provided by your insurance policy.

If you choose to use insurance to demonstrate financial responsibility, you should contact your state insurance regulatory agency to be sure that your insurer and broker or agent is authorized to provide that type of insurance. To get contact information for your state insurance regulatory agency, call the National Association of Insurance Commissioners at 816-842-3600 or visit its website at the following Internet address: www.naic.org/state_web_map.htm.

List Of Known Insurance Providers For UST Owners And Operators Page 1 November 2020

If your insurer adds your UST coverage to an existing policy, your insurer should provide you with an endorsement that conforms to the “Endorsement” criteria described in §280.97 of the financial responsibility rule (40 CFR Part 280, Subpart H). If your insurer provides you with a new policy, it should conform to the “Certificate Of Insurance” standard also described in §280.97 of the financial responsibility rule. See pages 18 and 19 of this document for these criteria or you can read the rule at the following Internet address: www.epa.gov/ust/underground-storage-tanks- usts-laws-regulations

HOW CAN YOU GET THE MOST CURRENT LIST?

The companies, agents, and brokers listed on the following pages have identified themselves as willing to deal with UST insurance. The following is not a comprehensive list because there are doubtless other companies, agents, and brokers who have not yet identified themselves to EPA.

EPA will periodically update this list. You can find the most current version on EPA’s UST website at: www.epa.gov/ust/publications-related-underground-storage-tanks.

Printed copies of this list will not be available. It is not practical to update and reprint them as often as EPA can update the version available on the website.

NEED MORE GENERAL INFORMATION ABOUT USTs OR FINANCIAL RESPONSIBILITY?

You can go to EPA’s website at www.epa.gov/ust/publications-related-underground-storage-tanks to read or download a copy of Dollars And Sense: Financial Responsibility Requirements For Underground Storage Tanks (EPA 510-K-18-01), a booklet that briefly and clearly summarizes the financial responsibility requirements.

List Of Known Insurance Providers For UST Owners And Operators Page 2 November 2020

LIST OF INSURANCE COMPANIES

AIG TankGuard Insurance Program Chubb Formerly Chamber Insurance Agency Services c/o Chubb Environmental Risk 100 Executive Drive 436 Walnut Street West Orange, NJ 07052 Philadelphia, PA 19106 Phone: 800-336-2007 Phone: 215-640-1451 Fax: 973-731-2288 Contact: Robert Winterburn Internet: www.aig.com Email: [email protected] Area of Coverage: United States Internet: www.chubb.com/us/tanksafe Area of Coverage: United States Allied World Assurance Company 311 S. Wacker Drive, Suite 1100 Crum & Forster, Environmental Division Chicago, IL 60606 305 Madison Avenue Phone: 312-646-7742 Morristown, NJ 07962 Contact: David Lau Phone: 678-504-6789 Email: [email protected] Fax: 877-622-6603 Internet: www.sti-bind.com Contact: Scott Kreuzer Area of Coverage: United States Internet: www.cfins.com Area of Coverage: United States Argo Environmental 7272 E. Indian School Road, Suite 500 Freberg Environmental, Inc. Scottsdale, AZ 85251 2000 S. Colorado Blvd, Tower II, Suite 800 Phone: 480-751-2673 Denver, CO 80222 Fax: 804-327-3175 Phone: 720-931-2135 Contact: Scott Trueba Fax: 303-623-8101 Internet: argolimited.com Contact: Kelly Schanzenbach Area of Coverage: United States Internet: www.feiinsurance.com Area of Coverage: United States Berkley Environmental Two Ravinia Drive, Suite 1100 Garage Service Equipment Dealers Liability Atlanta, GA 30346 Association of America Phone: 404-443-2008 8722 South Harrison Fax: 888-201-8109 Sandy, UT 84070 Contact: Greg Travis Phone: 801-304-3788 Email: [email protected] Fax: 877-452-6910 Internet: https://berkleyenvironmental.com Contact: Mike Fennell Area of Coverage: United States Internet: www.smallcompanyinsurance.com Area of Coverage: United States except CA, CT, NH, Century Surety Insurance NJ, NY, RI 550 Polaris Parkway Westerville, OH 43082 Liberty International Underwriters Phone: 614-823-6264 55 Water Street Contact: Brian Ritchie 18th Floor Email: [email protected] New York, NY 10041 Internet: home.centurysurety.com/Environmental.html Phone: 212-208-4100 Area of Coverage: United States Internet: www.liu-usa.com Area of Coverage: United States

NOTE: It is your responsibility to make sure the coverage you are offered meets federal requirements and any state or local requirements that may apply to your USTs. Under federal requirements, in order to fully demonstrate financial responsibility using an insurance policy, your insurance policy must provide coverage for taking corrective action and for compensating third parties for bodily injury and property damage caused by both nonsudden and sudden accidental releases arising from the operation of an UST. You should contact your state environmental agency to be sure that your insurance policy meets state requirements.

List Of Known Insurance Providers For UST Owners And Operators Page 3 November 2020

Mid-Continent Group 1437 S. Boulder Ave Ste 200 Tulsa, OK 74119 Phone: 918-588-1218 Fax: 918-588-1295 Contact: Lynn Marchbank Internet: www.mcg-ins.com Area of Coverage: AR, AZ, CA, CO, CT, DE, IA, ME, MD, MI, MN, MO, NE, NJ, NM, NY, NC, OH, OK, OR, PA, SC, TX, UT, VA, WA, WV, WI, WY

Petroleum Marketers Management Insurance Company (PMMIC) Box 7628 Urbandale, IA 50323 Phone: 515-334-3001 Fax: 515-334-3013 Contact: Patrick Rounds Internet: www.pmmicinsurance.com Area of Coverage: AZ, CT, IA, KS, NM, OR, WI

Prime Insurance Company 8722 S. Harrison St. Sandy, UT 84070 Phone: 801-304-5804 Contact: Emanuelle Mercado Area of Coverage: United States except CA and NJ

U.S. Risk Underwriters, Inc. 10210 North Central Expressway, Suite 500 Dallas, TX 75231 Phone: 800-232-5830 Fax: 214-265-4958 Contact: Terry Hazelton Internet: www.usrisk.com Area of Coverage: LA, NM, TN, TX

List Of Known Insurance Providers For UST Owners And Operators Page 4 November 2020

WANT TO ADD AN INSURER, AGENT, OR BROKER TO THE LIST?

NEED TO REMOVE A PROVIDER FROM THE LIST?

EPA will periodically update the list of insurers, agents, and brokers in this booklet. If you are an insurer, agent, or broker who can provide the insurance described in 40 CFR §280.97, please contact Sharon Fredericks, EPA’s Office of Underground Storage Tanks, at (202) 564-0675 or [email protected]. You will need to provide your name, address, phone and fax numbers, Internet address, area of coverage, and the name of a single point of contact within your company. Please be sure to review the requirements in 40 CFR Part 280, Subpart H, specifically §280.97, to ensure your company can provide insurance that meets those specific requirements. If your company is currently listed, but no longer provides this insurance, please contact Sharon Fredericks (as noted above) to have your company removed from the list.

LIST OF INSURANCE AGENTS AND BROKERS

AAU: Allied American Underwriters All Risks, Ltd. (Wholesaler) 1000 Town Center Way, Suite 300 1920 Greenspring Drive, Suite 200 Canonsburg, PA 15317 Timonium, MD 21093 Phone: 800-886-3897 Phone: 800-366-5810 Fax: 724-265-5751 Fax: 410-828-8179 Contact: Jennifer Kessel Contact: Erik Halvorsen Internet: www.aauins.com Internet: www.allrisks.com Area of Coverage: United States Area of Coverage: United States

Accusure Insurance Agency Allied Insurance Managers, Inc. 6 East Black Well Street 811 South Blvd East, Suite 110 Dover, NJ 07801 Rochester Hills, MI 48307 Phone: 973-366-7850 Phone: 248-853-0930 Fax: 973-366-7852 Fax: 248-853-1512 Contact: Bob Werner Contact: Dennis Cieplak Internet: www.accusure.com Internet: www.alliedinsmgr.com Area of Coverage: NJ Area of Coverage: MI

Allan Twitty Insurance Agency, LLC American Heritage Insurance Agency, Inc. P.O. Box 419 975 Elm Street Patterson, NY 12563 West Springfield, MA 01089 Phone: 845-278-6160 Phone: 413-736-1400 Fax: 845-278-6537 Fax: 413-736-0306 Contact: Allan Twitty Contact: Ray Belden Internet: www.atwittyinsurance.com Internet: www.aainsurance.com Area of Coverage: CT, GA, MA, NH, NJ, NY, OH, PA, Area of Coverage: MA RI

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Americana Insurance Agency Applied Risk Management Solutions P.O. Box 428 409-A Alamance Road Danube, MN 56230 Burlington, NC 27215 Phone: 320-826-2553 Phone: 336-229-0429 Fax: 320-826-2630 Fax: 336-214-1411 Contact: Dallas Schneider Contact: Heather Baldwin Internet: NA Area of Coverage: GA, NC, SC, TN, VA Area of Coverage: MN Arlington/Roe & Co. American Risk Management Resources 8900 Keystone Crossing Network, LLC P.O. Box 80803 7507 Hubbard Ave, Suite 200 Indianapolis, IN 46280 Middleton, WI 53562 Phone: 800-878-9891 Phone: 608-836-9590 Fax: 317-554-8551 Fax: 608-836-9565 Contact: Allen J. Grau; Ruth Kelly Contact: Angela Oroian Internet: www.arlingtonroe.com Internet: www.armr.net Area of Coverage: IL, IN, KY, MI, OH Area of Coverage: United States Arroyo/Caldwell & Moreland Insurance Services AmWINS Program Underwriters, Inc. P.O. Box 6185 214 Senate Avenue San Bernadino, CA 92412 Camp Hill, PA 17001-0718 Phone: 909-889-0295 Phone: 717-214-2800 Fax: 909-888-3422 Fax: 717-214-2801 Contact: John Terry Contact: James Titus Internet: NA Internet: www.amwins.com/apu Area of Coverage: CA and limited coverage in some Area of Coverage: United States, GU, PR states

Anco Insurance Services of Bryan/College Station Associated Insurance Agencies, Inc. Inc. 63 Commerce Park Drive 1111 Briarcrest Drive Westerville, OH 43082 Bryan, TX 77802 Phone: 614-882-2335 Phone: 800-749-1733 Fax: 614-882-2340 Fax: 979-774-6513 Contact: Tim Bowers Contact: Duane Arbuckle Internet: www.associated-ins.com Internet: www.anco.com/business- Area of Coverage: OH insurance/underground-tank-pollution Area of Coverage: TX Associated Petroleum Insurers First Casualty Insurance Group, Inc., (DBA) Anderson Insurance Services, Inc. 190-A Turner Street 933 Webster Street Southern Pines, NC 28387 Marshfield, MA 02050 Phone: 800-352-3416 Phone: 800-878-6578 Fax: 910-692-9752 Fax: 781-837-3756 Contact: Gary C. Kunce Contact: Peter Anderson Internet: www.associatedpetroleuminsurers.com Internet: www.insuremass.com Area of Coverage: NC, SC, VA Area of Coverage: MA

Aon Risk Services Southwest, Inc. 5555 San Felipe, Suite 1500 Houston, TX 77056 Phone: 832-476-6526 Fax: 800-953-4542 Contact: Herbert Mora Are of Coverage: United States, GU, PR, USVI

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Axia Insurance Group Bill Taylor & Associates 209 West Central Street, Suite 102 P.O. Drawer 2229 Natick, MA 01760 San Marcos, TX 78667-2229 Phone: 508) 651-2100 Phone: 800-606-6221 Fax: 508) 651-2101 Fax: 512-392-5443 Contact: Michael Hackett Contact: Bill Taylor E-mail: [email protected] Internet: www.btainsurance.com Internet: www.axiagroup.net Area of Coverage: TX Area of Coverage: CT, MA, NE, NH, RI, VT Brady & Company Bain Insurance Agency P.O. Box 107502 P.O. Box 659 Anchorage, AK 99510 Bandon, OR 97411 Phone: 907-276-5627 Phone: 541-347-3435 Fax: 907-276-6292 Fax: 541-347-9232 Contact: Judy Chadwick Contact: Joseph Bain Internet: www.bradycompany.com Internet: www.baininsurance.com Area of Coverage: United States Area of Coverage: TX Braley & Wellington Insurance Agency Corp. Bayrisk Insurance Brokers, Inc P.O. Box 15127 P.O. Box 567 Worcester, MA 01615-0127 Alameda, CA 94501 Phone: 508-754-7255 Phone: 510-523-3435 Fax: 508-797-3507 Fax: 510-523-7449 Contact: Parker Wellington, Jr. Contact: Kevin Milroy Internet: www.braleywellingtongroup.com Internet: www.bayrisk.com Area of Coverage: CT, MA, NH, RI, VT Areas of Coverage: CA, NV, OR Brian Spears Agency, Inc. Beacon Hill Associates 684 A Fairview Road P.O. Box 1532 P.O. Box 80280 Charlottesville, VA 22902 Simpsonville, SC 29680 Phone: 800-596-2156 Phone: 864-228-0754 Fax: 434-979-8964 Fax: 864-228-0853 Contact: William Pritchard Contact: Brian Spears Internet: www.b-h-a.com Internet: [email protected] Area of Coverage: United States Area of Coverage: SC

Berger Briggs Real Estate & Insurance, Inc. Brier Insurance Agency 215 3rd Street, SW 30 Maple Drive P.O. Drawer K Wexford, PA 15090 Albuquerque, NM 87103 Phone: 724-935-5924 Phone: 505-247-0444 Fax: 724-935-1730 Fax: 505-243-1505 Contact: Dana Brier Contact: Berger Briggs Internet: www.brieragency.com Internet: www.bergerbriggs.com Area of Coverage: PA Area of Coverage: Southwest United States Brown Agency BHL Insurance 110 S. Willow St., Suite 106 5232 Witz Drive Kenai, AK 99611 North Syracuse, NY 13212 Phone: 907-283-7834 Phone: 315-558-6790 Fax: 907-283-6179 Fax: 315-457-7902 Contact: Doug Brown Contact: James F. Blasting Internet: www.brownak.net Internet: www.bhlinsurance.com Area of Coverage: AK Area of Coverage: United States

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Brown & Brown Lone Star Insurance Services, Inc. Centralia General Agencies, Inc. 1717 N. Sam Houston Parkway, Suite 115 P.O. Box 698 Houston, TX 77038 209 ½ W. Main Street Phone: 281-260-2007 Centralia, WA 98531 Contact: Elizabeth Alvarado Phone: 360-736-8281; 800-700-8281 Internet: www.bbtexas.com Fax: 360-736-4740 Area of Coverage: United States Contact: Terry Mosier or Janine Hislop Internet: www.centraliageneralins.com Brown & Brown Public Entity Services Area of Coverage: WA One International Centre 100 N.E. Loop 410, Suite 965 Chamber Insurance Agency Services LLC San Antonio, TX 78216 1700 Market Street, Suite 2000 Phone: 210-340-8985 Philadelphia, PA 19103 Fax: 210-340-8986 Phone: 215-255-6471 Contact: Robert Hughes Fax: 877-594-6502 Internet: www.bbpes.com Contact: Susan DiDomenico Area of Coverage: United States Internet: www.chamberagent.com Area of Coverage: United States (except FL) Burns & Wilcox Ltd. 2301 E. Lamar Boulevard Chamberlin Insurance Arlington, TX 76006 764 Campbell Avenue Phone: 800-442-1496 West Haven, CT 06516 Fax: 817-652-9090 Phone: 203-932-5877 Contact: Sheila Hailey Fax: 203-932-9328 Internet: www.burnsandwilcox.com Contact: Roger Chamberlin Area of Coverage: TX Internet: www.chamberlininsurance.com Area of Coverage: CT Cambridge General Agency 100 Pine Street, Suite 250 Commonwealth Underwriters, Ltd. San Francisco, CA 94111 P.O. Box 5441 Phone: 415-955-8555 ext. 57 Richmond, VA 23220 Fax: 415-394-6305 Phone: 804-359-4568 Contact: Julie Sylim-Uang Fax: 804-359-6994 Internet: www.cambridgega.com Contact : Ben Kusterer Area of Coverage: CA Internet: www.commund.com Area of Coverage: MD, NC, PA, VA Capacity Group of NY, LLC 900 Merchants Concourse, Suite 414 Connelly-Campion-Wright Westbury, NY 11590 704 Belmar Plaza Phone: 516-280-7676 Belmar, NJ 07719 Fax: 516-280-7677 Phone: 800-924-2809 Contact: Vincent Franco Fax: 732-681-4951 Area of Coverage: United States Contact: Tara Maolini Internet: www.ccwinsurance.com Central Insurance Agency, Inc. Area of Coverage: NJ 6000 North Lamar Boulevard, Suite 100 Austin, TX 78761 Continental Agency of CT, Inc. Phone: 512-451-6551 P.O. Box 187109 Fax: 512-454-0183 Hamden, CT 06518-0109 Contact: Scott Raper Phone: 800-922-2563 Internet: www.centralins.com Fax: 203-288-2312 Area of Coverage: TX Contact: Brendan Mullally Internet: www.ca-group.com Area of Coverage: CT, MA, ME, NH, RI, VT

List Of Known Insurance Providers For UST Owners And Operators Page 8 November 2020

Continental/Marmorstein & Malone Insurance Dana Insurance and Risk Management 305 Route 17 South 9-B W. Ridgely Road, Suite 100 Paramus, NJ 07652 Timonium, MD 21093 Phone: 800-932-0849 Phone: 800-821-1990 Fax: 201-261-8922 Fax: 410-821-1997 Contact: Michael Kane Contact: Eric Dana Internet: www.ca-group.com Internet: www.dana-ins.com Area of Coverage: CT, NJ, NY Area of Coverage: United States

Cooney, Rikard & Curtin, Inc. (CRCINS) Danskin Insurance Agency, Inc. P.O. Box 59689 1937 State Highway #35, Suite 1 Birmingham, AL 35259-9689 Wall Township, NJ 07719 Phone: 205-870-7790; 800-824-1709 Phone: 732-449-3800 Fax: 205-879-3739 Fax: 732-974-2065 Contact: Charles Wood Contact: John C. Casagrande Internet: www.crcins.com Internet: www.danskin-agency.com Area of Coverage: United States Area of Coverage: NJ

Cortland Management LLC Dean Insurance Agency, Inc. CEI Environmental Insurance P.O. Box 669 P.O. Box 3161 Bel Air, MD 21014-0669 Richmond, VA 23228 Phone: 410-838-3700 Phone: 844-234-2341 Fax: 410-893-3647 Fax: 844-234-2342 Contact: Norman Dean Contact: Kristen Cannon Internet: www.deaninsurance.com Internet: www.ceienvins.com Area of Coverage: MA Area of Coverage: United States Delaware Valley Underwriting Agency, Inc. Crawley Warren Insurance Services, Inc. 420 S. York Road 100 California, Suite 650 Hatboro, PA 19040 San Francisco, CA 94111 Phone: 215-443-3500; 800-388-0215 Phone: 415-544-0969 ext. 304 Fax: 215-672-7983 Fax: 415-544-0974 Contact: Rita Hanebury Contact: Cass Alimonti Internet: www.dvua.com Internet: www.crawleywarrenins.com Area of Coverage: DE, MD, NJ, NY, OH, PA, VA, WV Area of Coverage: CA, HI Dennis Insurance Agency Crump Insurance Services NW 822 Market Street, Suite 3 21540 30th Drive SE, Suite 100 Zanesville, OH 43701 Bothell, WA 98021 Phone: 800-450-7117 Phone: 800-221-9628 Fax: 740-450-0203 Fax: 425-398-1133 Contact: Jeff Dennis Contact: Leslie Myer or Terry Brown Internet: www.dennisinsuranceagency.com Internet: www.crumpins.com Area of Coverage: OH Area of Coverage: OR, WA Don-Rick Insurance Custom Environmental Insurance 313 Oak Street P.O. Box 29664 Baraboo, WI 53913 Richmond, VA 23242 Phone: 800-924-6536 ext. 129 Phone: 804-876-4120, 877-826-5268 Fax: 608-356-9022 Fax: 866-383-9917 Contact: Ed Kothbauer Contact: Chris Montgomery Internet: www.don-rick.com Internet: www.tankcov.com Area of Coverage: WI Area of Coverage: United States

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Elliott, Powell, Baden & Baker Inc. Forsyth Insurance Group, Inc. 1521 SW Salmon Street 201 S. Fourth Portland, OR 97205 Springfield, IL 62705 Phone: 503-227-1771 Phone: 217-525-9500 Fax: 503-274-7644 Fax: 217-528-1526 Contact: Pam Wimmer Contact: Bob Ford Internet : www.epbb.com Internet: NA Area of Coverage: OR, WA, ID, MT, UT, AZ, AK Area of Coverage: IL, IN, MI, MN, OH

Environmental Insurance Agency Four Star Insurance Agency, Inc. P.O. Box 23605 5835 Pearl Road Portland, OR 97281 Parma, OH 44130 Phone: 503-977-3333 Phone : 440-888-4525 Fax: 503-977-3334 Fax: 440-888-0320 Contact: Jenn Hickey Contact: Joe Germana Internet: www.eiains.com Internet: www.fourstarinsurance.com Area of Coverage: United States Area of Coverage: OH

Environmental Insurance Agency, Inc. Fox and Fox Insurance Agency, Inc. 138 Chatsworth Avenue, Suite 2 101 East 38th Street Larchmont, NY 10538 Indianapolis, IN 46205 Phone: 914-833-5100 Phone: 317-925-1456 Fax: 914-833-5102 Fax: 317-927-5178 Contact: Susan Neuman Contact: Jim Fox Internet: www.enviroinsurance.com Internet: NA Area of Coverage: United States Area of Coverage: United States

Farm Bureau Financial Services Gallen Insurance 1166 E Warner Rd Ste. 204A 2237 Lancaster Pike Gilbert, AZ 85296 Shillington, PA 19607 Phone: 480-339-7148 Phone: 610-777-4123 Fax: 480-393-1949 Fax: 610-777-9957 Contact: Brian M. Smith Contact: Allen Convey Internet: https://www.fbfs.com/ Internet: NA Area of Coverage: AZ. IA, KS, MN, NE, NM, SD, UT Area of Coverage: PA

First American Insurance Agency, Inc. Garrett Insurance Company 625 Front Street P.O. Box 291425 Chicopee, MA 01013 Kerrville, TX 78029-1425 Phone: 413-592-0995 Phone: 830-896-6600 Contact: Remmy Nartens Fax: 839-896-1822 Internet: www.faiagency.com Contact: Bob Shmerbeck Area of Coverage: United States Internet: www.garrettinsurance.com Area of Coverage: TX First National Insurance 1205 Westlakes Drive, Suite 260 GBP Risk Solutions Berwyn, PA 19312 P.O. Box 13598 Phone: 610-996-1216 Tucson, AZ 85732-3598 Contact: James T. Carl Phone: 520-571-7737; 800-933-9646 Internet: [email protected] Fax: 520-571-9115 Area of Coverage: United States Contact: Rick Gregson Internet: www.gbprs.com Area of Coverage: AZ

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Green Insurance Services Highland Insurance, Inc. 1500 Sixth Street, NW P.O. Box 2487 Winter Haven, FL 33881 Huntington, WV 25725-2487 Phone: 800-476-1106 Phone: 304 529-3381 Fax: 863-294-4243 Fax: 304-529-6623 Contact: Jim Green Contact: Robert Cline Internet: www.greeninsurance.com Internet: NA Area of Coverage : FL Area of Coverage: KY, OH, VA, WV

Griffin Underwriting Services Hill & Kehne, LLC 1980 112th Avenue NE, Suite 210 2300 Wisconsin Avenue NW, Suite 300 Bellevue, WA 98004 Washington, DC 20007 Phone: 800-562-8095 Phone: 202-558-2100 Fax: 425-453-8696 Fax; 202-558-2127 Contact: Lillian Nixon Contact: Tiffany Germain Internet: gogus.com Internet: www.hillkehne.com Area of Coverage: OR, WA Area of Coverage: United States

GST Group, Inc. Hillcrest Agency, LLC 2291 Bristol Pike 30 Main Street Bensalem, PA 19020 Centerbroo, CT 06409 Phone: 800-220-2088 Phone: 860-767-9190 Fax: 215-245-0422 Fax; 860-767-9196 Contact: Mike Smith Contact: Diane M. Vizzo Internet: www.gstgroup.com Internet: www.hillcrestagency.com Area of Coverage: DC, DE, MD, NJ, NY, PA, VA Area of Coverage: CT, MA, NH, NY, RI

Harrison, Fincher & Associates Hometown Insurance of Smithtown 2712 Middleburg Drive, Suite 203 1461 Lakeland Avenue, Suite 3 Columbia, SC 29204 Bohemia, NY 11716 Phone: 803-254-0330 Phone: 631-589-0100 Contact: Becky Fincher Fax: 516-589-0164 Internet: NA Contact: Eric Keiffert Area of Coverage: GA, NC, SC Internet: NA Area of Coverage: NY Hays Companies of Texas 10333 Richmond Avenue, Suite 720 Hudson & Muma, Inc Houston, TX 77042 4600 Coolidge Highway, Suite 100 Phone: 832-209-4900 Royal Oak, MI 48073 Fax: 832-209-4865 Phone: 248-549-3519 Contact: John Watkins Fax: 248-549-6452 Internet: www.hayscompanies.com Contact: Jim Thurman Area of Coverage: United States Internet: www.hudsonmuma.com Area of Coverage: United States Hempkins Insurance 431 W. Crawford Hull & Company, Inc Denison, TX 75020 8400 E Prentice Ave, Suite 535 Phone: 903-463-6251 Greenwood Village, CO 80111 Fax: 903-463-6265 Phone: 303-218-3087 Contact: Robert W. Hempkins Fax: 877-731-3073 Internet: www.hempkins.com Contact: Erik Peterson Area of Coverage: OK, TX Internet: hullcodenver.com Area of Coverage: United States

List Of Known Insurance Providers For UST Owners And Operators Page 11 November 2020

Hutcherson Insurance Agency John Hackney Agency, Inc. P. O. Box 430 P.O. Box 998 Gainesville, TX 76241 3700 Nash Street North Phone: 940-665-4711 Wilson, North Carolina 27894 Fax: 940-665-7363 Phone: 252-291-3111 ext. 209 Contact: Shelia Colwell Fax: 252-291-6306 Internet: hutchersoninsurance.com Direct Phone: (252) 265-8070 Area of Coverage: OK, TX Contact: Mark A. Rosell Internet: [email protected] Independent Insurance Wholesalers, Inc. Area of Coverage: GA, NC, SC, TN, VA 808 Southwest 3rd Avenue Portland, OR 97204 Kennedy Professional Insurance Agency Phone: 503-224-1956; 800-886-9235 P.O. Box 847 Fax: 503-224-3010 Apple Valley, CA 92307 Contact: Tom Sawyer Phone: 760-242-2345 Internet: www.iiw.com Fax: 760-242-2211 Area of Coverage: AK, CA, ID, OR, WA Contact: Kevin Kennedy Internet: www.kpia.com Insurance Consultants Group Area of Coverage : CA 20180 Center Ridge Road Rocky River, Ohio 44116 Klinger Associates, Inc. Phone: 440-356-2055 P.O. Box 503526 Fax: 440-331-1482 Indianapolis, IN 46256 Contact: Brian Singleton Phone: 317-542-9890 Email: [email protected] Fax: 317-542-0685 Area of Coverage: OH Contact: Bob Klinger Internet: NA Insurance Market: A Yaworsky Company Area of Coverage: IN 3453 Pelham Road Greenville, SC 29615 Laginess Insurance Agency, Inc. Phone: 864-438-0557, 877-679-0008 199 North Main Street, Suite B7 Fax: 864-751-6333 Plymouth, MI 48170 Contact: Nick Yaworsky Phone: 734-455-5088 Internet: www.theinsurancemarketonline.com Fax: 734-455-2750 Area of Coverage: CT, FL, GA, NC, PA, SC, TX Contact: Terry Laginess Internet: www.laginess.com Intercorp, Inc. Area of Coverage: MI 138-F Main Street Ephrata, PA 17522 Lenix US, LLC Phone: 717-721-3500 1110 Brickell Avenue, Suite 300 Fax: 717-721-3515 Miami, FL 33131 Contact: Mark Waltman Phone: 305-424-7742 Internet: www.intercorpinc.net Contact: Mandy Corrieri Area of Coverage: United States Internet: http://lenix.us/ Area of Coverage: FL ISU BC Environmental Insurance Brokers, Inc. 1037 Suncast Lane, Suite 103 Lockton Companies, LLC El Dorado Hills, CA 95762 444 West 47th Street, Suite 900 Phone: 916-939-1080, 800-257-1639 Kansas City, MO 64112 Fax: 916-939-1085 Phone: 816-960-9465 Contact: Kevin Woodwick / Marci Teschner Fax: 816-783-9465 Internet: www.environmentalinsurance.com Contact: Matthew J. Pateidl Area of Coverage: United States Internet: www.lockton.com Area of Coverage: United States

List Of Known Insurance Providers For UST Owners And Operators Page 12 November 2020

M3 Insurance Solutions, Inc. Michigan Insurance Group 3113 W. Beltline Highway 1373 E. Laketon Ave, Suite A B.O. Box 8950 Muskegon, MI 49442 Madison, WI 53708-8950 Phone: 616-755-3000; 231-755-3000 Phone: 608-228-2703 Fax: 231-755-3002 Fax: 608-273-1725 Contact: Donald Shampine, CIC, CRM Contact: Heidi M. Lobraco Internet: www.michiganrisk.com Internet: www.m3ins.com Area of Coverage: MI, WI, OH Area of Coverage: United States Midwest General Agency M.J. Kelly 3300 Birch Street P.O. Box 231 Eau Claire, WI 54702 Turners, MO 65765 Phone: 715-832-4000 Phone: 800-725-7211 Fax: 715-834-7117 Fax: 417-883-7103 Contact: Tim Proue Contact: Lori Drake Internet: www.mgarws.com Internet: www.mjkelly.com Area of Coverage: MN, WI Area of Coverage: AR, FL, IA, IL, KS, MO, OK Moiz Ali Group, Insurance Services MarketPlus Insurance Agency 10121 SE Sunnyside Suite 206 26255 American Drive Clackamas, OR 97086 Southfield, MI 48034 Phone: 503-353-9500 Phone: 248-204-8202 Fax: 503-353-9200 Fax: 248-281-5370 Contact: Tiffany Macomber Contact: Drew Delaney, JD, CLCS Internet: www.moizaligroup.com Internet: www.marketplusagency.com Area of Coverage: OR, WA Area of Coverage: United States, except AK and HI Morgan-Marrow Environmental Insurance Marsh USA Inc. 484 Viking Drive, Suite 140 3560 Lenox Road, Suite 2400 Virginia Beach, VA 23452 Atlanta, GA 30326 Phone: 757-865-1900; 800-683-8493 Phone: 404-995-2748 Fax: 757-431-8256 Fax: 404-995-2749 Contact: Jason P. Magruder Contact: Chris Smy Internet: www.morganmarrow.com Internet: www.marsh.com/us Area of Coverage: United States Area of Coverage: United States Morrell, Butz, & Junker, Inc. McElveen Insurance Agency, Inc. 100 Park Manor Drive Division of Arthur J. Gallagher and Co. Pittsburgh, PA 15205 700 West Prien Lake Road Phone: 412-571-1010; 888-222-8891 Lake Charles, LA 70601 Fax: 412-446-1022 Phone: 337-478-5485 Contact: Bill Kaiser Fax: 337-478-8660 Internet: www.mbjinsurance.com Contact: Louis Todd Area of Coverage: United States Internet: www.ajg.com Area of Coverage: United States Murray Insurance & Financial 3550 FM 1092 Rd McNamara Company Missouri City, TX 77459 1330 Highway 96 East Phone: 281-499-0377 St. Paul, MN 55110 Fax: 281-208-6780 Phone: 651-426-0607 Contact: Jim Murray Fax: 651-426-2031 Internet: jimmurrayinsurance.com Contact: Kathleen McNamara Area of Coverage: TX Internet: www.mcnamaracompany.com Area of Coverage: United States

List Of Known Insurance Providers For UST Owners And Operators Page 13 November 2020

National Environmental Coverage Corporation O’Dell Insurance Agency 747 Chestnut Ridge Road, Suite 305 136 South Stygler Road Chestnut Ridge, NY 10977 Gahanna, Ohio 43230 Phone: 845-425-2333; 800-552-0230 Phone: 614-475-4786; 800-743-8467 Fax: 845-425-2853 Fax: 614-475-7154 Contact: Todd Turner Contact: Margot O’Dell or Debbie Blue Internet: www.necc.com Internet: www.odell-insurance.com Area of Coverage: United States Area of Coverage: OH

National Program Management, Inc. Ogren Insurance 3457 Lawrenceville Suwanee Road, Suite C 6929 Hohmen Avenue Suwanee, GA 30024 Hammond, IN 46324 Phone: 678-730-0505 ext 226 Phone: 219-933-0076 Fax: 678-730-0509 Fax: 219-933-0080 Contact: Bruce Kersey Contact: Thomas Ogren Internet: www.npminc.com Internet: www.ogreninsurance.com Area of Coverage: United States Area of Coverage: AL, AZ, CO, FL, ID, IL, IN, MI, OH, PA, TX, VA, WI New Office Business Systems of America, Inc 375 Commerce Parkway PartnerOne Environmental Rockledge, FL 32955 P.O. Box 1532 Phone: 321-433-4046 Charlottesville, VA 22902 Fax: 321-433-1093 Phone: 800-596-0172 Contact: Ben Harrison Fax: 434-979-8964 Internet: www.policymanagers.com Contact: Amanda Duncan Area of Coverage: FL Internet: www.p1enviro.com Area of Coverage: United States North Island Facilities, Ltd. (NIF) Services 30 Park Avenue People’s United Insurance Agency, Inc. Manhasset, NY 11030 One Goodwin Square Phone: 516-365-7440; 800-892-8892 Hartford, CT 06103 Fax: 516-365-7392 Phone: 860-524-7658 Contact: Daphney Alvarado Fax: 860-722-7760 Internet: www.nifgroup.com Contact: J. Michael Collier Area of Coverage: United States Internet: www.peoples.com/insurance Area of Coverage: United States Northeastern Underwriters, Ltd. P.O. Box 1310 Petra Insurance Agency Madison, CT 06443 P.O. Box 936 Phone: 203-245-7169 Chehalis, WA 98532 Fax: 203-245-0018 Phone: 360-748-8855; 800-346-2519 Contact: James Davidson or Barbara Bunting Fax: 360-748-7260 Internet: www.marine-ins.com Contact: Kevin Thompson Area of Coverage: CT, MA, NY, RI Internet: www.localaccess.com/jmpetra Area of Coverage: WA NSM, Inc. TankInsure Storage Tank Liability Program Pollution and Property Insurance Specialists LLC 1000 River Road, Suite 200 6 Lakeview Court Conshohochen, PA 19428 North Brunswick, NJ 08902 Phone: 610-941-9877 Phone: 732-348-8571 Fax: 610-941-9889 Fax: 732-348-8572 Contact: Thomas Zapalac Contact: Aldo Salonna Internet: www.tankinsure.com Email: [email protected] Area of Coverage: United States Area of Coverage: DE, NJ, NY, PA

List Of Known Insurance Providers For UST Owners And Operators Page 14 November 2020

Professional Liability Brokers and Consultants RISC 175 E. Hawthorn Parkway, Suite 310 2001 Bryan Street, Suite 2900 Vernon Hills, IL 60061 Dallas, TX 75201 Phone: 847-816-4480 Phone: 214-954-0707 ext.101; 800-725-7472 Fax: 847-816-4484 Fax: 214-954-0999 Contact: Erv Kranberg Contact: Jere Freel Internet: www.plbc.com Internet: www.gorisc.com Area of Coverage: United States Area of Coverage: United States

Public Risk Underwriters Sigel Insurance Group (Division of Brown & Brown Insurance) P.O. Box 488 615 Crescent Executive Court, Suite 600 Schwenksville, PA 19473 Lake Mary, FL 32746 Phone: 610-287-8800; 800-243-5041 Phone: 321-832-1450 Fax: 610-287-5348 Fax: 321-832-1489 Contact: Eric Sigel Contact: Pat Adams Internet: www.sigelinsurance.com Internet: www.publickrisk.com Area of Coverage: DE, MD, NJ, PA Area of Coverage: United States SilverStone Group Quaker Special Risk 11516 Miracle Hills Drive, Suite 100 P.O. Box 415 Omaha, NE 68154 Sea Girt, NJ 08750 Phone: 402-964-5516; 800-288-5501 Phone: 732-223-6666; 800-447-4180 Fax: 402-557-6335 Fax: 732-223-9072 Contact: Andrew Fereday Contact: Mike Walsh Area of Coverage: Midwest United States Internet: www.qsr-insurance.com Area of Coverage: United States Specialty Risk Associates, Inc. 2800 Youree Drive, Suite 462 Rebsamen Insurance Shreveport, LA 71104 P.O. Box 50810 Phone: 318-865-7023 Springfield, MO 65805 Fax: 318-865-7049 Phone: 417-866-7222 Contact: John Wood Fax: 417-866-0712 Internet: www.specialty-risk.com Contact: John West Area of Coverage: United States Internet: www.rebsamen.com Area of Coverage: United States Starfire Insurance 2375 NE 25th Avenue, Suite C ReleaseGuard Ocala, FL 34470-3901 615 N Capital Avenue Phone: 352-789-6683 Lansing, MI 48933 Fax: 352-789-6683 Phone: 866-423-4878 Contact: Mark Sears Fax: 517-342-5016 Email: [email protected] Contact: Josh Brower Area of Coverage: FL Internet: www.releaseguard.com Area of Coverage: United States Tanksurance 110 East King Street Rig Morgan Insurance Lancaster, PA 17602 P.O. Box 202438 Phone and Fax: 888-910-8265 Austin, TX 78720 Contact: Tim Donnellon Phone: 800-291-1061 Internet: www.tanksurance.com Fax: 512-219-5601 Area of Coverage: MD, NJ, NY, OH, PA Contact: Georgette Hardy E-mail: [email protected] Area of Coverage: TX

List Of Known Insurance Providers For UST Owners And Operators Page 15 November 2020

Tejas American General Agency, LLC (TAGA) True Benchmark Insurance Services P.O. Box 3009 1100 Jorie Boulevard, Suite 126 Cedar Park, TX 78630 Oak Brook, IL 60523 Phone: 512-346-0030; 888-999-8242 Phone: 630-645-0500 Fax: 512-342-2803 Fax: 630-645-0501 Contact: Anita Herzog Contact: Michael White Internet: www.taga1.com Area of Coverage: United States Area of Coverage: TX UCPM, Inc. The Abe Peinado Insurance Group 335 E. Germann Rd. #340 801 Myrtle Ave, Suite 105 Gilbert, AZ 85297 El Paso, TX 79901 Phone: 480-682-1574; 480-444-8911 Phone: 915-351-0973 Contact: Casey Springer Fax: 915-351-0975 Internet: www.ucpm.com Contact: Abe Peinado Area of Coverage: United State Internet: www.elpasobusinessinsuranceagent.com Area of Coverage: United States, except AK and HI United Assurance, Inc. 16-00 Pollitt Drive The DJB Group Fair Lawn, NJ 07410 231 Chestnut Street Phone: 800-866-0161 Meadville, PA 16335 Fax: 201-797-4455 Phone: 814-724-1516 Contact: Thomas Perna Fax: 814-337-2793 Internet: www.unitedassurance.com Contact: Daniel J. Severo Area of Coverage: Northeast United States Internet: www.djbgroup.com Areas of Coverage: OH, PA, WV USI Southwest 1445 Ross Avenue, Suite 4200 The McCall Insurance Agency, Inc. Dallas, TX 75202 609 West 15th Street, Suite 200 Phone: 214-443-3103 Plano, TX 75075 Fax: 214-443-3900 Phone: 972-423-3595; 800-423-3595 Contact: Shawn Heiser ([email protected]) Fax: 972-578-9268 Internet: www.usi.biz Contact: Suzanne Van Meter Area of Coverage: United States Internet: www.mccallagency.com Area of Coverage: TX USTI (Underground Storage Tank Insurance of Ohio) The Spofford Group Insurance Brokerage LTD 210 Bell Street 14 Main Street Chagrin Falls, OH 44022 Hingham, MA 02043 Phone: 440-247-3750 Phone: 781-740-8990 Fax: 440-247-3720 Fax: 781-740 8770 Contact: Robert T. Barbero, CPCU Contact: Mark L. Liffers Area of Coverage: OH Internet: www.spoffordgroup.com Area of Coverage: United States Village Insurance Agency, Inc. P.O. Box 579 Tower Special Facilities, Inc. Grove City, Ohio 43123 N14 W23777 Stone Ridge Drive, Suite 140 Phone: 614-875-3010 Waukesha, WI 53188 Toll Free: 888-875-3010 Phone: 262-513-6000 ext. 24; 800-837-1525 Fax: 614-875-3030 Fax: 262-513-6010 Contact: Don Mulchaey Contact: Gary Kubesch Internet: www.viaoh.com Internet: www.towerspecial.com Area of Coverage: OH Area of Coverage: United States

List Of Known Insurance Providers For UST Owners And Operators Page 16 November 2020

Wade S. Dunbar Insurance Agency WISA, Inc. 800 Atkinson Street P.O. Box 7568 Laurinburg, NC 28352 Ewing, NJ 08628 Phone: 910-610-2352 Phone: 609-883-4190 Fax: 910-277-3590 Fax: 609-538-0274 Contact: Cynthia Foland Contact: Neil Wesley Internet: [email protected] Internet: www.wesleyinsurance.com Area of Coverage: NC Area of Coverage: United States

W.A. George Insurance Agency Willis HRH 155 N Michigan Avenue Suite 300 Three Copley Place, Suite 300 Chicago, IL 60601 Boston, MA 02116 Phone: 312-729-5265 Phone: 617-351-7530 Fax: 312-729-5264 Cell phone: 781-500-9244 Contact: John George Contact: Michael Balmer Internet: www.wag-insurance.com Internet: www.willis.com/Client_Solutions/Services/ Areas of Coverage: IL, IN, MI, OH Environmental/ Area of Coverage: United States Wang Insurance Agency, Inc. 2620 Judah Street Worldwide Facilities, Inc. San Francisco, CA 94122 3530 Wilshire Boulevard, Suite 1500 Phone: 415-731-7062 Los Angeles, CA 90010 Fax: 415-731-8168 Phone: 213-380-4670 Contact: Paul Wang Fax: 213-384-5180 Internet: www.wangins.com Contact: Davis Moore Area of Coverage: CA Area of Coverage: United States

Watson Agency Zain Jeewanjee Insurance Agency P.O. Box 249 6155 Almaden Expressway Chesnee, SC 29323 San Jose, CA 95120 Phone: 800-869-2204 Phone: 408-997-7718; 800-257-7718 Fax: 864-461-3980 Fax: 408-997-7890 Contact: Randy Roberts Contact: Zain Jeewanjee Internet: www.watsonagency.net Internet: www.jeewanjee.com Area of Coverage: SC Areas of Coverage: AZ, CA, FL, GA, IL, NJ, NY, TX, VA Westex Insurance Agency 15701 Henderson Pass Zutz Insurance / Professional Liability Insurance San Antonio, TX 78232 P.O. Box 2287 Phone: 201-494-9105, 800-299-2211 Wilmington, DE 19899 Fax: 210-494-0079 Phone: 302-658-8000; 800-441-9385 Contact: John F. Thabet Fax: 302-658-8015 Internet: www.westexia.com Contact: Matthew Doyl Area of Coverage: TX Internet: www.zutzgroup.com Area of Coverage: United States Westfield Specialty Brokerage Services 2000 Polaris Parkway Columbus, OH 43240 Phone: 800-277-2159 Fax: 614-796-7745 Contact: Tricia Curnutte Internet: www.specialtybrokerage.com Area of Coverage: United States

List Of Known Insurance Providers For UST Owners And Operators Page 17 November 2020

Model Of “Endorsement” Criteria

Name: [name of each covered location] b. The [“Insurer” or “Group”] is liable for the payment of Address: [address of each covered location] amounts within any deductible applicable to the policy Policy Number: to the provider of corrective action or a damaged third Period of Coverage: [current policy period] party, with a right of reimbursement by the insured for Name of [Insurer or Risk Retention Group] any such payment made by the [“Insurer” or “Group”]. Address of [Insurer or Risk Retention group] This provision does not apply with respect to that Name of Insured: amount of any deductible for which coverage is Address of Insured: demonstrated under another mechanism or combination of mechanisms as specified in 40 CFR 1. This endorsement certifies that the policy to which 280.95-280.102 and 280.104-280.107. the endorsement is attached provides liability insurance c. Whenever requested by [a Director of an covering the following underground storage tank(s): Implementing Agency], the [“Insurer” or “Group”] [List the number of tanks at each facility and the agrees to furnish to [the Director] a signed duplicate name(s) and address(es) of the facility(ies) where the original of the policy and all endorsements. tanks are located. If more than one instrument is used to assure different tanks at any one facility, for each d. Cancellation or any termination of the insurance by tank covered by this instrument, list the tank the [“Insurer” or “Group”], except for non-payment of identification number provided in the notification premium or misrepresentation by the insured, will be submitted pursuant to 40 CFR §280.22, or the effective only upon written notice and only after the corresponding state requirement, and the name and expiration of 60 days after a copy of such written notice address of the facility.] is received by the insured. Cancellation for non- payment of premium or misrepresentation by the for [insert: “taking corrective action” and/or insured will be effective only upon written notice and “compensating third parties for bodily injury and only after expiration of a minimum of 10 days after a property damage caused by” either “sudden accidental copy of such written notice is received by the insured. releases” or “nonsudden accidental releases” or “accidental release”; in accordance with and subject to [Insert for claims-made policies: the limits of liability, exclusions, conditions, and other terms of the policy; if coverage is different for different e. The insurance covers claims otherwise covered by tanks or locations, indicate the type of coverage the policy that are reported to the [“Insurer” or “Group”] applicable to each tank or location] arising from within six months of the effective date of the operating the underground storage tank[s] identified cancellation on non-renewal of the policy except where above. the new or renewed policy has the same retroactive date or a retroactive date earlier than that of the prior The limits of liability are [insert dollar amount of the “per policy. And which arise out of any covered occurrence occurrence” and “annual aggregate” limits of the that commenced after the policy retroactive date, if Insurer’s or Group’s liability; if the amount of coverable applicable, and prior to such policy renewal or on for different underground storage tanks or locations, termination date. Claims reported during such indicate the amount of coverage for each type of extended reporting period are subject to the terms, coverage and/or for each underground storage tank or conditions, limits, including limits of liability, and location], exclusive of legal defense costs, which are exclusions of the policy.] subject to a separate limit under the policy. This coverage is provided under [policy number]. The I hereby certify that the wording of this instrument is identical to the wording in 40 CFR §280.97(b)(1) and effective date of said policy is [date]. that the [“Insurer” or “Group”] is [“licensed to transact 2. The insurance afforded with respect to such the business of insurance or eligible to provide occurrences is subject to all of the terms and conditions insurance as an excess or surplus lines insurer on one of the policy; provided, however, that any provisions or more states.”] inconsistent with subsections (a) through (e) of this Paragraph 2 are hereby amended to conform with [Signature of authorized representative or Insurer or subsections (a) through (e): Risk Retention Group] a. Bankruptcy or insolvency of the insured shall not [Printed name of person signing] relieve the [“Insurer” or “Group”] of its obligations under the policy to which this endorsement is attached. [Title of person signing], Authorized Representative of [name of Insurer of Risk Retention group]

[Address of Representative]

List Of Known Insurance Providers For UST Owners And Operators Page 18 November 2020

Model Of “Certificate Of Insurance” Criteria

Name: [name of each covered location] b. The [“Insurer” or “Group”] is liable for the payment of Address: [address of each covered location] amounts within any deductible applicable to the policy Policy Number: to the provider of corrective action or a damaged third Period of Coverage [current policy period]: party, with a right of reimbursement by the insured for Name of [Insurer or Risk Retention Group]: any such payment made by the [“Insurer” or “Group”]. Address of [Insurer or Risk Retention Group]: This provision does not apply with respect to that Name of Insured: amount of any deductible for which coverage is Address of Insured: demonstrated under another mechanism or combination of mechanisms as specified in 40 CFR 1. [Name of Insurer or Risk Retention group], [the 280.95-280.102 and 280.104-280.107. “Insurer” or “Group”], as identified above, hereby certifies that it has issued liability insurance covering c. Whenever requested by [a Director of an the following underground storage tank(s): Implementing Agency], the [“Insurer” or “ Group”] agrees to furnish to [the Director] a signed duplicate [List the number of tanks at each facility and the original of the policy and all endorsements. name(s) and address(es) of the facility(ies) where the tanks are located. If more than one instrument is used d. Cancellation or any other termination of the to assure different tanks at any one facility, for each insurance by the [“Insurer” or “Group”], except fir non- tank covered by this instrument, list the tank payment of premium or misrepresentation of insured, identification number provided in the notification will be effective only upon written notice and only after submitted pursuant to 40 CFR §280.22, or the the expiration of 60 days after a copy of such written corresponding state requirement, and the name and notice is received by the insured. Cancellation for non- address of the facility.] payment of premium or misrepresentation by the insured will be effective only upon written notice and for [insert: “taking corrective action” and/or only after expiration of a minimum of 10 days after a “compensating third parties for bodily injury and copy of such written notice is received by the insured. property damage caused by” either “sudden accidental releases” or “nonsudden accidental releases” or [Insert for claims-made policies: “accidental releases”; in accordance with and subject to e. The insurance covers claims otherwise covered by the limits of liability, exclusions, conditions, and other the policy that are reported to the [“Insurer” or “Group”] terms of the policy; if coverage is different for different within six months of the effective date of cancellation or tanks or locations, indicate the type of coverage non-renewal of the policy except where the new or applicable to each tank or location] arising from renewed policy have the same retroactive date or a operating the underground storage tank(s) identified retroactive date earlier than that of the prior policy, and above. which arises out of any covered occurrence that commenced after the policy retroactive date, if The limits of liability are [insert dollar amount of the “per applicable, and prior to such policy renewal or occurrence” and “annual aggregate” limits of the termination date. Claims reported during such Insurer’s or Group’s liability; if the amount of coverage extended reporting periods are subject to the terms, is different for different types or for different conditions, limits, including limits of liability, and underground storage tanks or locations, indicated the exclusions of the policy.] amount of coverage for each type of coverage and/or for each underground storage tank or location], I hereby certify that the wording of this instrument is exclusive of legal defense costs, which are subject to a identical to the wording in 40 CFR §280.97(b)(1) and separate limit under the policy. This coverage is that the [“Insurer” or “Group”] is [“licensed to transact provided under [policy number]. The effective date of the business of insurance or eligible to provide said policy is [date]. insurance as an excess or surplus lines insurer in one or more state.”] 2. The [“Insurer” or “Group”] further certifies the following with respect to the insurance described in [Signature of authorized representative of Insurer or Paragraph 1: Risk Retention Group] a. Bankruptcy or insolvency of the insured shall not [Printed names of person signing] relieve the [“Insurer” or “Group”] of its obligations under the policy to which this certificate applies. [Title of person signing], Authorized Representative of [name of Insurer or Risk Retention Group]

[Address of Representative]

List Of Known Insurance Providers For UST Owners And Operators Page 19 November 2020

United States Land And Emergency July 2020 Environmental Pro tection Management www.epa.gov/ust Agency 5401R