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• <br />• <br />I, <br />!~' ----- <br /> T. .= -•,. <br /> <br />3 _ ISSUE DATE (MM/DO/YY) , <br />O~ <br />~ <br />~ ~ <br />~' March 8, 1985 ' <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br /> NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, <br />KEN STRUM INSURANCE AGENCY, INC. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />P <br />BOX 1454 <br />O <br />. <br />. <br />La Porte, Texas 77571 COMPANIES AFFORDING COVERAGE <br /> COMPANY A <br /> LETTER U S F &G <br /> COMPANY <br /> LETTER <br />INSURED <br />DANIEL dba DANIEL DUMP TRUCK <br />R <br />J COMPANY <br />C <br />. <br />. LETTER <br />+ <br />ING <br />A <br />AND H <br />UL <br />401 North Seventh COMPANY D <br /> LETTER <br />77571 <br />La Porte, Texas <br /> COMPANY E <br /> LETTER <br /> <br /> <br />THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW H AVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY <br />BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BV THE P OLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI- <br />TIONS OF SUCH POLICIES. <br />CO POLICY EFFECTIVE POLICY EXPIRATION <br />LIABILITY LIMITS IN THOUSANDS <br />LTR TYPE OF INSURANCE POLICY NUMBER DATE (6aM'DO/1'Y) DATE IMM/D0/1'1') EACR <br /> <br />OCCURRENCE AGGREGATE <br /> GE NERAL LIABILITY <br />Booav <br />A X COMPREHENSIVE FORM INJURY $ 500 $ Nil <br /> <br /> PREMISES/OPERATIONS PROPERTY <br /> <br />X UNDERGROUND <br />EXPLOSION 8 COLLAPSE HAZARD DAMAGE $ 300 ~ 300 <br /> 100048250763 6/26/84 6/26/85 <br /> PROOUCTSICOMPLETED OPERATIONS <br /> CONTRACTUAL BI 8 PO <br />COMBINED <br /> INDEPENDENT CONTRACTORS <br /> BROAD FORM PROPERTY DAMAGE <br /> PERSONAL INJURY PERSONAL INJURY <br /> <br /> A UTOMOBILE LIABILITY BODILY <br />I4JURY <br /> <br />ANY AUTO <br />(~R PERSOn! Q <br />~D <br /> ALL OWNED AUTOS (PRIN. PASS.) BODILY <br /> I!uURY <br /> OTHER THAN <br />ALL OWNED AUTOS ~ pRIV <br />PASS IPER aCGOEen <br /> . <br />. <br />HIRED AUTOS PROPERTY <br /> NON-OWNED AUT05 DAMAGE <br /> GARAGE LIA81LIlY <br />BI 8 PD <br /> COMBINED <br /> EXCESS LIABILITY <br /> UMBRELLA FORM el 8 PD <br />COMBINED <br /> OTHER THAN UMBRELLA FORM <br /> STATUTORY <br /> <br />A WORKERS' COMPENSATION <br />2903104841 <br />6/26/84 <br />6/26/85 <br />$ (EACH ACCIDENT) <br /> AND <br />' (DISEASE~POLICY LIMIT) <br /> EMPLOYERS <br />LIABILITY <br />P <br /> (DISEASE~EACHEM <br />LOYEE), <br /> OTHER <br />A Equipment Floater SP 038347903 6/25/84 6/25/85 ount of Ins. - $93,50 <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS <br />L ~' <br />City of La Porte <br />P.O. Box. 1115 <br />La Porte, Texas 77571 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- <br />PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO <br />MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE <br />LEFT, BUT FAI RE TO MAIL SUC TK:E SHALL IMPOSE NO OBLIG/1TK)N OR LIABILITY <br />OF ANY KING PON jj1E COMPA ,ITS GENTS'OR REPRESENTATIVES. <br />AUTHORIZED R R NTATIVE <br />KEN <br />