CERTIFICATE OF LIABILITY INSURANCE (994) 7E11VIWD.%Yyy}
CERTIFICATE CSF LIABILITY INSURAN EI1)1
TRIS CERTIFICATE IS ISSUER 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(les)must have ADDITIONAL INSURED provisions or 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 In lieu of such endorsement(s).
PRODUCER ., CONTACT
Aon Risk services southwest, Inc. PHONE
Houston Tx Office '„'t, fi (ATC,.No.Ex1): (866) 283-7122 (800) 363-0105 as
5555 San Felipe a E-MAIL
Suite 1500 ADDRESS:
Houston Tx 770563 LISA
_ INSURER(S)AFFORDING COVERAGE NAIL#
INSURED ,` INSURER A: Ironshore specialty Insurance Company 25445
Trillium Transportation Fuels, LLC , INSURER B: ACE American Insurance Company 22667
PO Box 20210
Oklahoma City OK 73126 LISA INSURER C: ACE Fire Underwriters Insurance Co. 20702
URERD: Indemnity Insurance CO of North America 43575
INSURER E: National Eire & marine Ins Co 20079
INSURER F: Westchester Fire Insurance Company 10030
COVERAGES CERTIFICATE;NUMBER:570079277886 REVISION NUMBER:
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. Limits shown are as requested
LTR TYPE OF INSURANCE IND WVD POLICY LIMBER' MrygyDp D LIMITS
POLICY EXP
X COMMERCIAL GENERAL.LIABILITY XSLG �iffi EACH OCCURRENCE $1,000,000
CLAIMS-MADEI x JOCCtIR SIR applies per policy terns & conditions - S1,000,000
LPREMISES €a occurrence
MED EXP(Any one person) EXCIUded
PERSONAL$ADV IN URY $1,000,000
OD
GEN•LAGGREGATE LIMIT APPI.IES PER: GENERAL AGGREGATE $8,000,000
X POLICY LOG PRODUCTS-COMPIOPAGG $8,000,000 p
JECTc
OTHER:
B Y Y ISA H25287083 12/01/201912/01/2020 COMBINEDSINGLELIMIT
AUTOMOBILE LIABILITY
$5,000,000n ry '
(Ea ccido- ..�.,. ..
BODILY INJURY(Par Person) G
X ANY AUTO z
OWNED SCHEDULED BODILY INJURY(Par amident) qd
LY AUTOS
H REIS AuTC,S NON-OWNED RROPUd DAMAGE M
ONLY AUTOS ONLY Par acc4deseL.
t
a?
E X UMBRELLA LIAB x. OCCUR 42umo30948001 1.2/01/2019 12/01/2020 EACH OCCURRENCE 510,000,000
EXCESS LL46 CLAIMS-MADESIR applies per policy terns & conditions AGGREGATE $10,000,000
DEO X RIzrENTiOIJ
D WORKERS COMPENSATION AND Y WLRC 5037538 12 01-172-0 1-9 1201 2020.. X PER STATUTE I JOTH-
B EMPLOYERS'LYABILITY YIN Y WLRc66037575 12/01/2019 12/[)1/2020 _ R_ --
ANY PROPRIETOR 1 PARTNER J EXECUnVE E.L.EACH ACCIDENT $1,000,000
c OFFICER+MEMSEREXCLUDED? NIA Y SCEC660376L7 12/01/2019 12/02{2020
(Mandatory In W E.L.DISEASE-EA EMPLOYEE $1,000,000'
II ysts describe nndor ---
DESI;RIPTION OF OPERATIONS below -E.L.DISEASE-POLICY LIMIT $1,000,000—
A Env Site Liao 002568601 12/01/2018 12/01/2021 Aggregate $10,000,000�
DESCRIPTION OF OPERATIONS 1 LOCATIONS)VEHICLES(ACORD 101,Additional Remarks Schedule,rosy be attached It more space Is required)
MCS90 and CA9948 are included on the above referenced Automobile Liability policy.. certificate Holder is included as
Additional Insured in accordance with the policy pprovisions of the Auto Liability and General Liability policies. A waiver of
subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the workers Compensation,
Auto Liability and General Liability policies. w
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE. WITH THE
POLICY PROVISIONS,
Clearwater Gas AUTHORIZED REPRESENTATIVE
400 N. Myrtle Ave.
Clearwater FL 33755 OSA
01988-2015 ACORD CORPORATION..All rights reserved.
ACORD 25(2016103) The ACORD naive and logo are registered marks of ACORD