CERTIFICATE OF LIABILITY INSURANCE (3) �c�Ro CERTIFICATE. OF LIABILITY INSURANCE DATE(MMraDrrrxr)
1010712022'
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 IINSURER(S), AUTHORIZED'
REPRESENTATIVE OR PRODUCER.AND.THE CERTIFICATE HOLDER,.
IMPORTANT. If the certificate holder is an ADDITIONAL INSURED,the policy(ies)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 holder in lieu:of such.endorsement(s).
PRODUCER CONTACT ,1+ilichaei Platt
Marsh USA Inc: NAME: — m µ
PHONE 214-435.38982929 Allen Pafkwayy,Suite Hit ❑ o A1C No
Houston,TX.77419 E-MAIL MEohaei.Praft rnarsh,0om
Aaw Hines.CertRequest@marsh.0om ADDRESS: -- -- •• _
_ IN5U ERIS)AFFORDING COVERAGE MAIC#
CN102038955-$0101V1-GAXW'22- -
----- . INsuRERk:Everest ttafi6nal Insurance CGmLlaoj 10124
..__.....
INSURED INSURFR.S:Allied World National Company 10690
SR 54.Land Associates,LLC T
clo Hines Interests Limited Partnership INSURER c:Everest Premier Insurance Company 18045 _
Alin: MerEditfi Katopodis Ixs31RER n Everest Denali Insurance Company ^� 18044
845 Texas Avenue,SiAe 3300 --- —
Houston,TX.77002 INSURER E:
INSURER F: mm.
COVERAGES CERTIFICATE NUMBER- HOU-003246325-26 REViSIO.N 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 OF? OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE i5SUED.OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS.SUBJECT TO ALL THE TERA.S,
EXCLUSIONS AND CONDITIONS OF SUCH.POLICIES.LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS-
IrR
LTR TYPE OF 1NSURANCE. N SD D -Vn POLICY NUMBER --- Ory rppmYY MO QDIY'FYY •~ LIMITS •
A 'X COMMERCIALGENERAL LIAMI I Y CG3GLO0048-221 I010MO22 IKV2023. EACH OCCURRENCE $. 2,400,400.
A� M—A—E TOTfr.T-
CLAIMS-MADE �OCCUR PREMISES Ea occurrence 250,000
MEP)E7(P.(Any we.persan) S Excluded
PERSONA L&ADV INJURY $
GEN'L AGGREGATE LIMITAP PLIES.PER: GENERALAGGREGATE S 4,4U0,000
POLICY L PROu LOC'. FRO
_. _ _ 4,004,000
IECT PRODUCTS-COINPIDPAGG $
OTHER. _ S.
D AUTOMOBILE LIABILITY C=A00057.22I 101.0.112022. 1910112023. COMBINED SINGLE LIMIT $ 1,000,400
jEa amdeni _..._.__._
x ANY AUTO BODILY INJURY(Per person) $ ._
OWNED" SCHEDULED BODILY INJURY per accident)$ m
AUTOS ONLY AUTOS [
HIRED NDN-OWNED PROPERTY DAMAGEm
AU.TOS ONLY AUTOS ONLY per accdent ___T_ $
$
x UMBRELLA.LIAS Yi .00CUR 0348.9798 10/01/2022 10/01/2023 EACH OCCURRENCE .$ 2,000,000
pJCCESSLtAB -_CLA]MS-MAGE AGGREGATE 2,004,000
�...DED E X RE7 ENTiON s 10,000
C WORKERS COMPENSATION CC3WC00057-221 10/0112023 x PER OTH-
AND EMPLOYERS'LIABILITY Y-1 N STATUTE ER _
ANYPROPRIETORIPARTNERIEY,ECUTIVE E.IL EACH ACCIDENT_ $ 1,00o;Qo0 �
OFFICERIMEM8EREXCLUDED7 LE N I A
(Mandatory In NH) E_L.DISEASE-EA EMPLOYEE $ 1,004,000
_
If yes,desWbe.Under
DESCRIPTION'OF=OPERATIONSbelow E.L.:1DISEASE-POLICY LIMIT .$ 1,000,000
DESCRIPTION OF OP ERATI ON S I LOCATIONS 1 VEH{C LES.(ACC RD 107,Additional Remarks Schedule,may be atttta0ed If more space Is required}
RE' Develnpmeri.ot nalurai gas dislribuli00 system in Asluna localed in parhnns of Tovmship 28,Ranges 17 and 17 East:Paseo Cutinty,FL;'
CERTIFICATE HOLDER CANCELLATION
Clearwater Gas System SHOULD ANY OF THE:ABOVE DESCRIBED POLICIES BE:CANCELLED BEFORE
Alin; Managing Director THE EXPIRATION DATE THEREOF, NOTICE WILL "BE DELIVERED IN
400 N.Myele Ave ACCORDANCE WITH THE POLICY PROVISIONS..
Clezmateri FL 33755
AUTHORIZED REPRESENTATIVE
01988-2016 ACORD CORPORATION. All rights reserved..
ACORD 25(2096103) The ACORD name and logo are registered rrlarks.of ACORD.