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North Lake PP-CS110907 CHIEFO2 OP ID: LW ACC,R °' CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 09/07/11 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 817- 877 -1884 CONTACT Linda Weber EnRisk- -Fort Worth PHONE FAX 6100 Western Place, Suite 100 (A/C. No, Ext): (A/C, No): Fort Worth, Tx 76107 ADDRESS: lweber @enriskservices.com John Ludwig INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : St. Paul Fire and Marine Ins. INSURED Chief OII & Gas, LLC INSURER B: Texas Mutual Insurance Co 5956 Sherry Lane, Suite 1500 Argonaut Insurance Company Dallas, TX 75225 INSURER c INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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. INSR LTR TYPE OF INSURANCE I SR S WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM /DD/YYYY) (MM /DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X X VK04210861 09/01/11 09/01/12 DAMAGE TO RENT 1,000,000 PREMISES (Ea occurrence) $ CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 X POLICY JECT 1 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) 1,000,000 A X ANY AUTO X X VK04210861 09/01/11 09/01/12 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON -OWNED PROPERTY accident) DAMAGE HIRED AUTOS AUTOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE X X VK04210861 09/01/11 09/01/12 AGGREGATE $ 5,000,000 DED RETENTION $ $ WORKERS COMPENSATION X C STA OTH- AND EMPLOYERS' LIABILITY TORY LIMIT S ER Y /N B ANY PROPRIETOR/PARTNER/EXECUTIVE X TSF0001141115 09/01/11 09/01/12 E.L. EACH ACCIDENT $ 1,000,000 C (Mandatory in NH EXCLUDED? N / A NH) 09/01/11 09/01/12 ry ) WC477468282114 E .L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below 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 CANCELLATION COPPELL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Coppell ACCORDANCE WITH THE POLICY PROVISIONS. Engineering Department AUTHORIZED REPRESENTATIVE 255 Parkway Blvd. 014 Coppell, TX 75019 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CHIEFO2 PAGE 2 NOTEPAD INSURED'S NAME Chief Oil & Gas, LLC OP ID: LW DATE 09/07/11 Certificate Holder named as Additional Insured on in icated policies an Waiver of Subrogation is provided as required by written contract but only to extent of such contract and only for operations performed by or for the Named Insured. 1