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<br />HENKE INSlIRANCE
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<br />05/07/92 10:48
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<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFeRS
<br />NQ RlatHS UPON THe CERTlFICt. TE HOI.D!R. THIS ce~TIF1CATE DOES HOT AM&NO,
<br />EXTEND OR AllEn THE COVERAGE AFFORDED BY THE POLICIES IlELOW,
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<br />ISSUE DAn (MMi(10fYVI
<br />: 5/7/92
<br />
<br />Henke Insurance Agency
<br />503 East Fourth Street
<br />H~11ettsvil1e, Te~as 77964
<br />512/ 798-3637
<br />! Fax: 512/ 798-2302
<br />. 800/ 477/3637
<br />_....
<br />11-I5\1"C'''
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<br />COMPANIES AFFORDING COVERAGE
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<br />~~~NY A Indemnit.y Underwriters Ins. Co,
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<br />~~~NY 8 Lumbcrmans Mutual Casualty Co,
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<br />All Texas lJemonli~hit'lg
<br />5714 Darling Street
<br />Houston f Texas 77007
<br />
<br />COMPANY C
<br />LETTER
<br />
<br />COMPANY D
<br />LETTER
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<br />CO~1!'ANY II!!
<br />LETIF J\ s;,
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<br />TIllS IS TO CERTIFY THAT POLICIES OF 'NSURANC~ LISTED BELOW HAVE BEEN lSSUED10 THE INSVRED NAMEO ABOVE FOR THE POLICY PEnlOOINDICI\TED,
<br />NOTWllH$TANO'I-lQ ~NY ReQUIREME'~1. TERM OR CONDIlION OF ANY CONTFlACT OR OTHER OOCUMENT WITH RESPECT TO WIoIICH THIS CERTIFICATE MAY
<br />BE ISSUED OR ft(AY PERTAIN, THE INSURANce AFFOROED BY THe POllelliS DESCRIBED IlER~IN IS SVeJECT TO ALL THE TEAMS, EXCLUSIONS, AND CONDI.
<br />TIONS OF SUCH POllCIE$.
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<br />TYPE OF INSI)RArJCE
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<br />POllC'" NUME\rn
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<br />IIAIr IMWtJlJf(n
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<br />UABllll y UMITS IN THOUSANDS
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<br />GENERAL 1I1\BIlITY
<br />COMf'flFHFtlSlVl fOJ\M
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<br />GL14475
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<br />WORKeRS' COM PENS Q TlON
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<br />EUPLOVEns' 1I1\(lllIl'(
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<br />3BA021769000
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<br /> 1/20/92 1I0DJl~
<br /> 1/20/93 IrlJ1JRv $ $
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<br /> (lAMACE $ $
<br /> 9' & I'D $ 500 f 00 $CSL
<br /> l-:OM[JI"lW
<br /> PERSQNIII IHJUR)' $
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<br /> 2/3/92 2/3/93 --l~Igg- IEAl.H N:r.1DE N I )
<br /> IOISE A~H 1'01.10 lll.
<br /> $ 500 -.. ..
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<br />PERSONAL IN,1I1R'.
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