PERMFILE113020

• Permit No: C1992080
• IBM Index Class Name: Permit File
• Doc Date: 12/11/2001
• Section_Exhibit Name: APPENDIX 3-3 CERT OF INSURANCE
• Media Type: D
• Archive: No

C TEXAS STANDARD POLICY
FEDERAL INSURANCE COMPANY
diuete
................. ..........................................................................
• NAMED INSURED ANO MAILING ADDRESS AGENCY NAME AND H111(LING ADDRESS
• OAKRIDGE ENERGY INC ACCRED-TNOMPSOX-WLSON-DAUGHERTY
• 400 FIRST NATIONAL RUI LO ING 17D0 TENTH STREET
• 71B EIGHT STREET P. D. BOX 1071
• YICHITA FALLS, TX 76301 YICH ITA FALLS, TX 76301
• (817)723-D771 1-13174
• EXPIRES: 12/05/92 POLICY NUMBER: 3530 49 37
• PROPERTY: See Blank Schedule RENEYAL OF NUMBER: 3530 49 37 '
• LOCATION: See Blank Schedule PREMIUM: j21B
.............................................. ..........................................................................

In Cons tderetton of the stipulations and conditions herein or added hereto wh lch arc mode a part of this
policy, end of the Dremfums Drovided DOES INSURE OAKRIDGE ENERGY INC
end legal representettves, FROM 12/05/91 TO 12/05/92 RT 12:01 A.M. STANDARD TIME AT THE LOCATION DF PROPERTY
against direct lass resulting from any of the Perils (listed below) YHICN HAVE A PREMIUM INSERTED OPPOSITE THERETO
(Column 6) end only on the property described end located as Drovided hereon.
.......................................................................................................................
1 I 2 I 3 I 4 I 5 I 6
I ILOINSURANCEI TOTAL I TERM I
Coveregel PERILS I APPLICABLEI INSURANCE I RATE I PRENIIM
-------- I----------------------------------------------------- I ----------- I --------------- I ----°-- I -------------------
F IFIRE end Lightning I 80k I j125,D00.001vrs. INOrmal
I I I I IF. R.
I I I I IActael S25
E IEXTENDEO COVERAGE - Windstorm, Hurricane, Hail, I I Ivn. I S9D
I Explosion, Riot, C1vi1 Conmwtion,l I I I
I Smoke, Aircraft and Lend Vehicles) I I I
X (EXPLOSION I I I I
(OFFICE CONTENTS SPECIAL FORM I I Ivn. I S1D3
R (RENTS or Rental Value (Not to Exceed S a Month) I I I I
( TOTAL PREMIUM S21B
.......................................................................................................................
ITEM I AMOUNT Of I DESCRIPTION OF PROPERTY ( RATE
N0. I INSURANCE (See deft nltlons of Building, Household Goods, Stock, Furniture, Fixtures, and, I ANALYSIS
I for Machinery, end Contents
_____ I _____________ I ___________________________________________________________________________.._____ I _______________
~ (the '^' SEE BLANK SCHEDULE ATTACHED •• butldtngl Basis
N O. STORIES-CONSTRUCTION-TYPE OF ROOF IROOf
I I
I I Texas Exposure-
( ILOCAT ION STREET -- ADD I TION -- TOYN Key Rate__
I I I Total
I I ________LOT________BLK__________MAp__________FILE___________OCCUPANCY___________ Ex Per. #_
I I I Annuel_
I IFORMg ATTACH EO: 29,29C,65,136,164 I Gross
Exper. k_
Total
Coins. A
Annual
Unless othen,ise Drovided, Insurance on personal property
shell cover only xhile to the described building.
______________________________________________________________________________________________________________________
If the Coinsurance Clouse is not applied, no other fire insurance is permitted unless the total amount, including this
policy, on each item is inserted in the blanks which fall or: Item No.
Loss on building items shell be payable to
Address es Mortgagee or Trustee, es their interest
may appear et time of loss, sub,) act to Mortgage Clause (without contribution) printed elsewhere in this policy.
Sub,f act to Art tole 6.13 of the Taxes insurance Code, 1951, liability hereunder shell not exceed the actual cash value of
the property et the time of loss, ascertained with proper deduction for depreciation; nor shall it exceed the amount it
would cost to repair or reDlece the property with materiel of like kind and qualiTy, with proper deduction for
depreciation, within a reasonable time after the loss, without allowance for any increased tort of repair or reconstruction
by reason of any ordinance or law rcgulating construction or repair, end without compensation for loss resulting from
interruption of business or manufacture; nor shell ft exceed the. interest of the insured, or the specific amounts shown
under °Amount of Insurance.' ~`=
COUNTERSIGNATURE GATE:--~ BY:
Ass tgnment of this oltcy he 1 not be velfd except rl th the written consent of ihts Company.
. Dec 13, 1991 (AGENT)
FOR iNFORl7AT10N, OR TO MAKE A COMPLAINT, CALL: 1-B00-362-4822