New Mexico Administrative Code › Title 20 - ENVIRONMENTAL PROTECTION › Chapter 5 - PETROLEUM STORAGE TANKS › Part 117 - FINANCIAL RESPONSIBILITY › Section 20.5.117.1757 - FORM DOCUMENTS FOR INSURANCE AND RISK RETENTION GROUP COVERAGE

Current through Register Vol. 35, No. 13, July 16, 2024
To use insurance to satisfy requirements of 20.5.117.1703
				  NMAC, as described in 20.5.117.1707 NMAC, each insurance policy shall be
				  amended by an endorsement worded as specified in Subsection A of this section
				  or evidenced by a certificate of insurance worded as specified in Subsection B
				  of this section, except that instructions in brackets shall be replaced with
				  the relevant information and the brackets deleted:
A. Required wording for endorsement.
ENDORSEMENT
Name: [name of each covered location]
Address: [address of each covered location]
Policy Number:
Period of Coverage: [current policy period]
Name of [Insurer or Risk Retention Group]:
Address of [Insurer or Risk Retention
								Group]:
Name of Insured:
Address of Insured:
Endorsement
1. This endorsement certifies that the policy to
								which the endorsement is attached provides liability insurance covering the
								following storage tanks:
[List the number of tanks at each facility and the
								name(s) and address(es) of the facility(ies) where the tanks are located. If
								this instrument is used to assure both underground and above ground storage
								tanks, identify each storage tank as underground or above ground and list the
								tank identification number provided in the notification submitted pursuant to
								20.5.102.202 New Mexico Administrative Code (NMAC). If more than one instrument
								is used to assure different tanks at any one facility, for each tank covered by
								this instrument, list the tank identification number provided in the
								notification submitted pursuant to 20.5.102.202 NMAC and the name and address
								of the facility.]
For [insert: "taking corrective action" and/or
								"compensating third parties for bodily injury and property damage caused by"
								either "sudden accidental releases" or "non-sudden accidental releases" or
								"accidental release"; in accordance with and subject to the limits of
								liability, exclusions, conditions, and other terms of the policy; if coverage
								is different for different tanks or locations, indicate the type of coverage
								applicable to each tank or location] arising from operating the storage tank(s)
								identified above.
The limits of liability are [insert the dollar
								amount of the "each occurrence" and "annual aggregate" limits of the Insurer's
								or Group's liability; if the amount of coverage is different for different
								types of coverage or for different storage tanks or locations, indicate the
								amount of coverage for each type of coverage and/or for each storage tank or
								location], exclusive of legal defense costs, which are subject to a separate
								limit under the policy. This coverage is provided under [policy number]. The
								effective date of said policy is [date].
2. The insurance afforded with respect to such
								occurrences is subject to all of the terms and conditions of the policy;
								provided, however, that any provisions inconsistent with Subsections a through
								e of this Paragraph 2 are hereby amended to conform with Subsections a through
								e:
a. Bankruptcy or insolvency of the insured shall
								not relieve the ["Insurer" or "Group"] of its obligations under the policy to
								which this endorsement is attached.
b. The ["Insurer" or "Group"] is liable for the
								payment of amounts within any deductible applicable to the policy to the
								provider of corrective action or a damaged third-party, with a right of
								reimbursement by the insured for any such payment made by the ["Insurer" or
								"Group"]. This provision does not apply with respect to that amount of any
								deductible for which coverage is demonstrated under another mechanism or
								combination of mechanisms as specified in 20.5.117.1705 through 20.5.117.1712
								NMAC and 20.5.117.1714 NMAC through 20.5.117.1717 NMAC.
c. Whenever requested by the Secretary of the
								Environment Department, ["Insurer" or "Group"] agrees to furnish to the
								Secretary a signed duplicate original of the policy and endorsements.
d. Cancellation or any other termination of the
								insurance by the ["Insurer" or "Group"], except for non-payment of premium or
								misrepresentation by the insured, will be effective only upon written notice
								and only after the expiration of 60 days after a copy of such written notice is
								received by the insured. Cancellation for non-payment of premium or
								misrepresentation by the insured will be effective only upon written notice and
								only after expiration of a minimum of 10 days after a copy of such written
								notice is received by the insured.
[Insert for claims-made policies:
e. The insurance covers claims otherwise covered by
								the policy that are reported to the ["Insurer" or "Group"] within six months of
								the effective date of cancellation or non-renewal of the policy except where
								the new or renewed policy has the same retroactive date or a retroactive date
								earlier than that of the prior policy, and which arise out of any covered
								occurrence that commenced after the policy retroactive date, if applicable, and
								prior to such policy renewal or termination date. Claims reported during such
								extended reporting period are subject to the terms, conditions, limits,
								including limits of liability, and exclusions of the policy.]
I hereby certify that the wording of this
								instrument is identical to the wording in Paragraph (1) of Subsection A of
								20.5.117.1757 NMAC and that the ["Insurer" or "Group"] is ["licensed to
								transact the business of insurance or eligible to provide insurance as an
								excess or surplus lines insurer in one or more states"].
[Signature of authorized representative of Insurer
								or Risk Retention Group]
[Name of person signing]
[Title of person signing], Authorized
								Representative of [name of Insurer or Risk Retention Group]
[Address of Representative]
B.
				Required wording for certificate of insurance.
CERTIFICATION
Name: [name of each covered location]
Address: [address of each covered location]
Policy Number:
Endorsement (if applicable):
Period of Coverage: [current policy period]
Name of [Insurer or Risk Retention Group]:
Address of [Insurer or Risk Retention
								Group]:
Name of Insured:
Address of Insured:
Certification
1. [Name of Insurer or Risk Retention Group], [the
								"Insurer" or "Group"], as identified above, hereby certifies that it has issued
								liability insurance covering the following storage tank(s):
[List the number of tanks at each facility and the
								name(s) and address(es) of the facility(ies) where the tanks are located. If
								this instrument is used to assure both underground and above ground storage
								tanks, identify each storage tank as above ground or underground and list the
								tank identification number provided in the notification submitted pursuant to
								20.5.102.202 New Mexico Administrative Code (NMAC). If more than one instrument
								is used to assure different tanks at any one facility, for each tank covered by
								this instrument, list the tank identification number provided in the
								notification submitted pursuant to 20.5.102.202 NMAC and the name and address
								of the facility.]
For [insert: "taking corrective action" and/or
								"compensating third parties for bodily injury and property damage caused by"
								either "sudden accidental releases" or "non-sudden accidental releases" or
								"accidental releases"; in accordance with and subject to the limits of
								liability, exclusions, conditions, and other terms of the policy; if coverage
								is different for different tanks or locations, indicate the type of coverage
								applicable to each tank or location] arising from operating the storage tank(s)
								identified above.
The limits of liability are [insert the dollar
								amount of the "each occurrence" and "annual aggregate" limits of the Insurer's
								or Group's liability; if the amount of coverage is different for different
								types of coverage or for different storage tanks or locations, indicate the
								amount of coverage for each type of coverage and/or for each storage tank or
								location], exclusive of legal defense costs, which are subject to a separate
								limit under the policy. This coverage is provided under [policy number]. The
								effective date of said policy is [date].
2. The ["Insurer" or "Group"] further certifies the
								following with respect to the insurance described in Paragraph 1:
a. Bankruptcy or insolvency of the insured shall
								not relieve the ["Insurer" or "Group"] of its obligations under the policy to
								which this certificate applies.
b. The ["Insurer" or "Group"] is liable for the
								payment of amounts within any deductible applicable to the policy to the
								provider of corrective action or a damaged third-party, with a right of
								reimbursement by the insured for any such payment made by the ["Insurer" or
								"Group"]. This provision does not apply with respect to that amount of any
								deductible for which coverage is demonstrated under another mechanism or
								combination of mechanisms as specified in 20.5.117.1705 through 20.5.117.1712
								NMAC and 20.5.117.1714 NMAC through 20.5.117.1717 NMAC.
c. Whenever requested by the Secretary of the
								Environment Department, the ["Insurer" or "Group"] agrees to furnish to the
								Secretary a signed duplicate original of the policy and all
								endorsements.
d. Cancellation or any other termination of the
								insurance by the ["Insurer" or "Group"], except for non-payment of premium or
								misrepresentation by the insured, will be effective only upon written notice
								and only after the expiration of 60 days after a copy of such written notice is
								received by the insured. Cancellation for non-payment of premium or
								misrepresentation by the insured will be effective only upon written notice and
								only after expiration of a minimum of 10 days after a copy of such written
								notice is received by the insured.
[Insert for claims-made policies:
e. The insurance covers claims otherwise covered by
								the policy that are reported to the ["Insurer" or "Group"] within six months of
								the effective date of cancellation or non-renewal of the policy except where
								the new or renewed policy has the same retroactive date or a retroactive date
								earlier than that of the prior policy, and which arise out of any covered
								occurrence that commenced after the policy retroactive date, if applicable, and
								prior to such policy renewal or termination date. Claims reported during such
								extended reporting period are subject to the terms, conditions, limits,
								including limits of liability, and exclusions of the policy.]
I hereby certify that the wording of this
								instrument is identical to the wording in Subsection B of 20.5.117.1757 NMAC
								and that the ["Insurer" or "Group"] is ["licensed to transact the business of
								insurance, or eligible to provide insurance as an excess or surplus lines
								insurer, in one or more states"].
[Signature of authorized representative of Insurer
								or Risk Retention Group]
[Type name of person signing]
[Title of person signing], Authorized
								Representative of [name of Insurer or Risk Retention Group]
[Address of Representative]