CERTIFICATE OF LIABILITY INSURANCE (166)T ®
'`` ° CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
0612(2013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
Marsh USA Inc.
701 Poydras Street, Suite 4125
neworleans.certrequest @marsh.com
New Orleans, LA 70139
Schlum- STC -P- ALL -13 -14
CONTACT
FAX
(A/C. N . Ext) FAX No):
E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC i
INSURER A : Travelers Property Casualty Co. Of America
25674
INSURED
Schlumberger Technology Corporation
300 Schlumberger Drive MD6
Sugar Land, TX 77478
INSURER B :
TC2JGLSA169X8388- TIL -13
INSURER C :
07101/2014
INSURER D :
$ 1,000,000
INSURER E :
N/A
$
INSURER F :
$ N/A
COVERAGES
CERTIFICATE NUMBER:
HOU- 002070425 -17
REVISION NUMBER: 4
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 AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR
LTR
TYPE OF INSURANCE
ADDL
INSR
SUBR
WVD
POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MMIDD/YYYY)
LIMITS
A
GENERAL
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
TC2JGLSA169X8388- TIL -13
07/01/2013
p
07101/2014
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES (Ea occurrence)
N/A
$
MED EXP (Any one person)
$ N/A
CLAIMS -MADE
X
OCCUR
PERSONAL & ADV INJURY
1,000,000
$
X
Contractual Liability
ry
GENERAL AGGREGATE
$ 1,000,000
PRODUCTS - COMP /OP AGG
$ 1,000,000
GEN'L AGGREGATE
POLICY
LIMIT APPLIES
JECT
PER:
LOC
$
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS
x
SCHEDULED
AUTOS
NON -OWNED
AUTOS
TC2JCAP257T0343 -TI Tr f 1 J
_... .
Q7/4)�12013
07101/2014
EO MBIINED SINGLE LIMIT
1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
`'' •
EACH OCCURRENCE
$
AGGREGATE
$
$
DED
RETENT ON $
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Y / N
N
N / A
TC2KUB257T0411- IND -13
07/01/2013
07/01/2014
X
WC STATU-
TORY LIMITS
OTH-
ER
E.L. EACH ACCIDENT
1,000,000
$
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
1,000,000
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Certificate Holder and others as required under the contract are included as Additional Insureds and Underwriters rights of subrogation against Certificate Holder and others as required under the contract are
waived, but (both) only if required by the contract and only to the extent of liabilities expressly accepted or assumed by the Insured under its contract with Certificate Holder. All operations of the insured and all
automobiles owned or operated by the insured in the United States of America, its territories Or possessions or Canada.
NCELLATION
City of Clearwater
PO Box 4748
Clearwater, FL 33758 -4748
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Philip McCann
ACORD 25 (2010/05)
m 1988 -2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORO®
AGENCY CUSTOMER ID: Schlum
LOC #: New Orleans
ADDITIONAL REMARKS SCHEDULE
Page 2 of 3
AGENCY
Marsh USA Inc.
POLICY NUMBER
CARRIER
NAIC CODE
NAMED INSURED
Schlumberger Technology Corporation
300 Schlumberger Drive MD6
Sugar Land, TX 77478
EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER. 25 FORM TITLE. Certificate of Liability Insurance
NAMED INSURED LISTING:
@balance, a Schlumberger Company
Coil Tubing Services, a division of Schlumberger Technology Corporation
Data and Consulting Services, a division of Schlumberger Technology Corporation
DBR Technology Center Division
Dowell
Dyna -Drill
E &P Wireline Services
Extreme Engineering Limited
Ho-Tech Testing, Inc.
Geoservices, Inc., a Schlumberger Company
GeothermEx, Inc.
Gunn Energy Services, A Schlumberger Company
Innerlogix, A Schlumberger Company
lntergrated Project Management
Lonkar Services (U.S.), LLC.
Lonkar Services Ltd.
Lonkar Well Testing Ltd.
Lightning Wireline
Mega Diamond
MegaStir Technologies LLC
M -I LLC
Omni Seals, Inc.
Parker Energy Services, a Schlumberger Company
Pathfinder, a Schlumberger Company
Petro Tech Tools
Production Wireline and Cased Hole Services Group, LLC, a Schlumberger Company
Schlumberger Canada Limited
Schlumberger Canada Limited - Carbon Division
Schlumberger Canada Limited (Water Services Division)
Schlumberger Carbon Services, a Division of Schlumberger Technology Corporation
Schlumberger Geothermal Services
Schlumberger Information Solutions
Schlumberger Lift Solutions LLC
Schlumberger Limited
Schlumberger NYL, Inc.
Schlumberger Omnes Inc., dba Network and Infrastructure Solutions
Schlumberger Technology Corporation
Schlumberger Technoloogy Corporation dba K &M Technology Group
Schlumberger Water Services, USA Inc., a subsidiary of Schlumberger Technology Corporation
Schlumberger Well Services
Sensor Highway Limited, dba Sensa
Smith Bits
Smith International, Inc.
Smith Services
SPT Group, a Schlumberger Company
TerraTek, Inc., a subsidiary of Schlumberger Technology Corporation
ACORD 101 (2008/01)
® 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD®
AGENCY CUSTOMER ID: Schlum
LOC #: New Orleans
ADDITIONAL REMARKS SCHEDULE
Page 3 of 3
AGENCY
Marsh USA Inc.
POLICY NUMBER
CARRIER
NAIC CODE
NAMED INSURED
Schlumberger Technology Corporation
300 Schlumberger Drive MD6
Sugar Land, TX 17478
EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER. 25 FORM TITLE: Certificate of Liability Insurance
Thomas Energy Services LLC.
ThruBit L.L.C.
Water Management Consultants, Inc., a Schlumberger Company
Westbay Instruments, Inc.
Wireline Control Systems, a Schlumberger Company
Z -Seis, a subsidiary of Schlumberger Technology Corporation
ACORD 101 (2008/01)
0 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
0005237 SP 0190 - C01- P05239 -I
City of Clearwater
PO Box 4748
Clearwater, FL 33758 -4748