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CoI - VINeera Chemicals
DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 11/29/2018 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 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). CONTACT PRODUCER Marsh Wortham, a division of Marsh USA, Inc Marsh Wortham, a division of Marsh USA, Inc NAME: FAX PHONE PO Box 1388 713-526-3366 713-521-1951 (A/C, No): (A/C, No, Ext): Houston, TX 77251-1388 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # www.worthaminsurance.com INSURER A :State National Insurance Company, Inc12831 INSURED INSURER B :Texas Mutual Insurance Company 22945 VINeera Chemicals, LLC INSURER C : 24044 Cinco Village Center Blvd. INSURER D : Suite 100 Katy TX 77494 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: 45576048 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. ADDLSUBR INSR POLICY EFFPOLICY EXP TYPE OF INSURANCE LIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY A MEB0692712 11/6/201811/6/2019 EACH OCCURRENCE$ 3 1,000,000 DAMAGE TO RENTED CLAIMS-MADEOCCUR$ 3 300,000 PREMISES (Ea occurrence) MED EXP (Any one person)$ 10,000 PERSONAL & ADV INJURY$ 1,000,000 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- POLICY LOC PRODUCTS - COMP/OP AGG$ 2,000,000 JECT $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY$ A MEC0692712 11/6/201811/6/2019 1,000,000 (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$ AUTOS ONLY AUTOS NON-OWNED HIRED PROPERTY DAMAGE $ 3 3 (Per accident) AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB A NEF0692712 11/6/201811/6/2019 EACH OCCURRENCE$ 3 3 OCCUR 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE$ 1,000,000 3 10,000 $ DED RETENTION$ PER OTH- WORKERS COMPENSATION B 0002005970 11/6/201811/6/2019 3 STATUTE ER AND EMPLOYERS' LIABILITY Y / N ANY P RO PR IET OR/PAR TNE R/EXE CU TI VE E.L. EACH ACCIDENT$ $1,000,000 N / A OFFICER/MEMBER EXCLUDED?N (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ $1,000,000 If yes, describe under E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below$1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Additional Insured and Waiver of Subrogation afforded to the certificate holder per the attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Salina THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 300 West Ash ACCORDANCE WITH THE POLICY PROVISIONS. Salina KS 674002 AUTHORIZED REPRESENTATIVE Marsh Wortham, a division of Marsh USA, Inc. © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD 45576048 | 10VINEECHE | 18/19 Master Certificate | (HOU) David Rojas | 11/29/2018 10:59:20 AM (CST) | Page 1 of 4 1.ADDITIONALINSUREDBYCONTRACT,AGREEMENTORPERMIT Under SectionII-WhoIsAnInsured,Paragraph 4.isaddedasfollows: 5.a.Anypersonororganizationwithwhomyouagreed,becauseofawrittencontract,writtenagreementor permit,isaninsured,butonlywithrespectto: (1)"Yourwork"fortheadditionalinsured(s)atthelocationdesignatedinthecontract,agreementor permit. (2)Facilitiesownedorusedbyyou. Thisinsuranceappliesonaprimarybasisifthatisrequiredbythewrittencontract,writtenagreementor permit.However: (1)Theinsuranceaffordedtosuchadditionalinsuredonlyappliestotheextentpermittedbylaw;and (2)Ifcoverageprovidedtotheadditionalinsuredisrequiredbyacontractoragreement,the insuranceaffordedtosuchadditionalinsuredwillnotbebroaderthanthatwhichyouarerequired bythecontractoragreementtoprovideforsuchadditionalinsured. b.Thisprovisiondoesnotapply: (1)Unlessthewrittencontractorwrittenagreementhasbeenexecutedorpermithasbeenissued priortothe"bodilyinjury","propertydamage","personalinjury"or"advertisinginjury". (2)Toanypersonororganizationincludedasaninsuredbyanendorsementissuedbyusandmade partofthisCoveragePart. (3)Toanypersonororganizationincludedasaninsuredunderitem 2.ofthisendorsement. (4)Toanylessorofequipment: (a)aftertheequipmentleaseexpires;or (b)ifthe"bodilyinjury","propertydamage","personalinjury"or"advertisinginjury"arisesoutof solenegligenceofthelessor. (5)Toany: (a)Ownersorotherinterestsfromwhomlandhasbeenleasedwhichtakesplaceafterthelease forthatlandexpires;or (b)Managersorlessorsofpremisesif: (i)theoccurrencetakesplaceafteryouceasetobeatenantinthatpremises;or (ii)the"bodilyinjury","propertydamage","personalinjury"or"advertisinginjury"arisesout ofstructuralalterations,newconstructionordemolitionoperationsperformedbyoron behalfofthemanagerorlessor. c.Withrespecttotheinsuranceaffordedtotheseadditionalinsureds,thefollowingisaddedto SectionIII -LimitsOfInsurance: Ifcoverageprovidedtotheadditionalinsuredisrequiredbyacontractoragreement,themostwewill payonbehalfoftheadditionalinsuredistheamountofinsurance: (1)Requiredbythecontractoragreement;or (2)AvailableundertheapplicableLimitsofInsuranceshownintheDeclarations; whicheverisless. ThisendorsementshallnotincreasetheapplicableLimitsofInsuranceshownintheDeclarations. `2197GL0814(TX)IncludescopyrightedmaterialofInsuranceServicesOffice,Inc.withitspermission.Page2of9 45576048 | 10VINEECHE | 18/19 Master Certificate | (HOU) David Rojas | 11/29/2018 10:59:20 AM (CST) | Page 2 of 4 11 45576048 | 10VINEECHE | 18/19 Master Certificate | (HOU) David Rojas | 11/29/2018 10:59:20 AM (CST) | Page 3 of 4 45576048 | 10VINEECHE | 18/19 Master Certificate | (HOU) David Rojas | 11/29/2018 10:59:20 AM (CST) | Page 4 of 4