Document x5g0OrYy707099JJKdnMGrz9Q

SHELTON INSURANCE AGENCY, INC. General Insurance & Bonds August 21, 1992 TO WHOM IT MAY CONCERN: The enclosed certificate of insurance is replacement for certificate issued to you earlier. The policies issued by Scottsdale Insurance Company were cancelled 8-10-92 and have been rewritten by Generali effective 8-10-92. If you have any questions, please feel free to call on us. Sincerely, Shelton Insurance Agency, Inc. end. 1227 Third Street * P. O. Box 2727 Corpus Christi. TX 78403 (512) 882-5586 FAX 882-7935 CED0006211 | aokh. | CERTIFICA*2 OF INSURANCE [ ISSUE DATE (MM/PO/YY) = 8-25-92db PROOUCEft Shelton Insurance Agy Inc P 0 Box 2727 Corpus Christi TX 78403 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE INSURED Gilman Insulation Company, Inc P 0 Box 4074 Corpus Christi TX 78469 ACOMPANY LETTER COMPANY d LETTER Generali (A+XV) COMPANY LETTER COMPANY n LETTER u COMPANY c LETTER c COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES. CO LTR TYPE OP INSURANCE GENERAL LIABILITY A X COMPREHENSIVE FORM X PREMISES/OPRATlONS X UNDERGROUND EXPLOSION S COLLAPSE HA2AR0 X PROOUCTS/COMPLETEO OPER. X CONTRACTUAL X INDEPENDENT CONTRACTORS X BROAD FORM PROPERTY DAMAGE-- X PERSONAL INJURY AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS < Priv. Pass. ) ALL OWNED AUTOS! > HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY EXCESS LIABILITY A X UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION POLICY NUMBER TH0124091/18B 0MB7305533 EMPLOYERS' LIABILITY other POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DD/YY) DATE (MM/OO/YY) LIMITS 8-10-92 8-10-93 BOOfLY INJURY OCC. BODILY INJURY AGG. PROPERTY DAMAGE OCC. PROPERTY DAMAGE AGG. Bl & PO COMBINED OCC. Bl l PD COMBINED AGG. PERSONAL INJURY AGG. $ S % t * 1.000.000. * 1.000.000. _* 1.000.000. 8-10-92 8-10-93 BODILY INJURY (Par peron) BODILY INJURY (Par accident) PROPERTY DAMAGE BODILY INJURY & PROPERTY OAMAGE COMBINED EACH OCCURRENCE AGGREGATE 5.000.000. * 5.000.000. | STATUTORY LIMITS EACH ACCIDENT s DISEASE--POLICY LIMIT $ DISEASE-EACH EMPLOYEE s DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Blanket Waiver of Subrogation and Additional Insured provided to certificate holder. CERTIFICATE HOLDER Coastal States Refinery P.0. Box 109 Corpus Christi, TX 78405 CANCELLATION SHOULD ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION OATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL -3Q- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLOER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF^NYJOND UPON THE COMMRRAANNXX,J.JJW-KGEENRTT5 OR REPRESENTATIVES. AUTHORIZED ACORO 25 (7/90) ACOF. CORPORATION 1990 CED0006212 mm NOTICE OF INSURANCE CHANGE ---------------------------------------- ----------- INSURED Gilman Insulation Company, Inc. P 0 Box 4074 Corpus Christi, Texas 78469 /Jo /to E .issuKrkr (ctty and state) g0 l .JU'- 0 cA 'u Cor|ffi Christi, Texas 1 OJ i. -S7 NAME ANO ADDRESS OF CERTIFICATE HOLDER \>/> DATEisftED ..................................... XC,c, Coastal Refining & Marketing P 0 Box 521 ;^rfly 16, 1992 * POLICY NUMBER(S) Corpus Christi, TX 78403 WC-2957977 EFFECTIVE DATE OF CHANGE 7-26-92 In accordance with the terms of any Certificate or other evidence of Insurance In your possession for the policies shown hereon, you are hereby notified of the following changes effective 12:01 kM. Standard Time on the date Indicated opposite the policy or policies. The above referenced policy is terminated with these companies on the "Effective Date of Change." ; TECO 3835-F (12-W) EMPLOYERS CASUALTY COMPANY EMPLOYERS NATIONAL INSURANCE COMPANY EMPLOYERS CASUALTY CORPORATION EMPLOYERS NATIONAL INSURANCE CORPORATION EMPLOYERS OF TEXAS LLOYD'S BY (Signed) (Typed) James CED0006213