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<br />
<br />IlSURED
<br />
<br />
<br />PRODUCER
<br />Willis of Arizona. Inc.
<br />11201 Nor1h Tatum Blvd.
<br />Suite 300
<br />
<br />
<br />Becky Still. CIC
<br />
<br />:~qOV~A~\\;~ ...;;; ':':::' .:': .:..':\~>~~ .:t M/:';[ "'.;;" ,:::.i.':;;:;.~.: :j::!;":,':,':l;;,.:i/ (::!.!. j: ::~!~;'>i:;~!~;:'.;:.:.:::;{i\.~.:;..:'.;..~;::':~: ~:'..::: !~;:: ';'.~',<I;;:';~~i:::'-:- .:r:.. ....:.:.... .:'.: I.:.. .'~ ::::' ",.. :..... :'.: "
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<br />
<br />THIS IS TO CERTlFY THAT THE POUCIES OF INSJRANCE USTED BELOW HAVE BEEN ISSJED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REaJIREMENT. TERM OR CONDIT10N OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSJED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
<br />EXCWSIONS AND CONDITlONS OF SUCH POUCIES UMITS MAY HAVE BEEN REDUCED BY PAID CLAIMS
<br />
<br />lYPE OF IIlSURMCE
<br />
<br />POLICY NUMBER
<br />
<br />
<br />LlIIllS
<br />
<br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
<br />NAMED INSURED INCLUDES - 8FI WASTE SYSTEMS OF NORTH AMERICA. INC.
<br />
<br />Workers Compensation - Additional Policy:
<br />
<br />Insurance Company
<br />
<br />Policy I
<br />
<br />Eff./Exp. Dates
<br />
<br />American Home Assurance
<br />
<br />WC3475107
<br />
<br />09/30/99 - 01/01/01
<br />
<br />Employers Liability (Stop Gap) coverage for Monopolistic States is
<br />included:
<br />$1.000.000 Each Accident
<br />$1.000.000 Disease - Policy Limit
<br />$1.000.000 Disease - Limit Each Employee
<br />
<br />Certificate Holder is Additional Insured. except for Workers Compensation.
<br />if required by written contract.
<br />
<br />.:CEAllFICATE HOlDER.
<br />
<br />..~CELLAT;lOIII .. .~lary. ~C!...~: ~~l...-:., ....
<br />SHOULD AllY OF lHE ABOVE DESCRIBED POLICES BE CAIlCEWD BEFCIlE lHE
<br />
<br />... I,;. .. ,
<br />:WILL.IS 25W1 (9(95) .:;... .
<br />
<br />. .::. -: BFICrr.iES ' :......
<br />
<br />
<br />. e WILLIS 1995
<br />
<br />CITY OF LA PORTE
<br />604 WEST FAlRMONT
<br />LA PORTE TX 77571
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