ST8201-CS 881129 COLLIER COBB & ASSOCIATES
OF DALLAS, INC.
. -, .... : ,~ . ~, ,x--~,>:..~CE, 57~0 F'[NELANDi)R[VE, DALLAS, TEXAS 75231
,_'54>
November 29, 1988
TO WHOM IT M~Y CONCERN:
Attached is the renewal certificate of insurance for L. H. Lacy
Company evidencing General Liability and Automobile Liability
coverages for the policy'period 11/30/88 to 11/30/89.
The Workers' Compensation coverage has been bound effective
11/30/88 with the Texas Workers' Compensation Asigned Risk Pool,
and a certificate of insurance evidencing same will be forwarded
to you as soon as possible.
I trust this will be satisfactory for your requirements; however,
if I may be of further assistance, please feel free to contact
me.
Yours truly,
Administrative Assistant
Att.
L. H. Lacy Company
P. 0. Box 541297
Dallas, Texas 75354-1297
INSURANCE · BONDS · RISK MANAGEMENT · EMPLOYEE BENEFITS
· [ .
COLLIER COBB & ASSOCIATES
OF DALLAS, 1NC.
37~, i i.'-,~_AND PLACE, 5750 PINELAND DRIVE, DALLAS, TEXAS 75231
2t4~ 739-4991
November 29, 1988
TO WHO~ IT ~Y CONCERN:
Attached is the renewal certificate of insurance for L. H. Lacy
Company evidencing General Liability and Automobile Liability
coverages for the policy'period 11/30/88 to 11/30/89.
The Workers' Compensation coverage has been bound effective
11/30/88 with the Texas Workers' Compensation Asigned Risk Pool,
and a certificate of insurance evidencing same will be forwarded
to you as soon as possible.
I trust this will be satisfactory for your requirements; however,
if I may be of further assistance, please feel free to contact
me.
Yours truly,
Jay Taylor
Administrative Assistant
Att.
CC:
L. H. Lacy COmpany
P. O. Box 541297
Dallas, Texas 75354-1297
A4, 4Ntil, CERTIFICAT,- OF INSURANCE ,SSUE DATE,MM,DD,YY)
11/29/88
PRODUCER THIS CERTIFICATE IS ISSUED AS A MA'rTER OF INFORMATION ONLY AND CONFERS
COLLIER COBB & ASSOCS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
' OF DALLAS, INC. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
5750 PINELAND DR., STE. 308
DALLAS, TX 75231 COMPANIES AFFORDING COVERAGE
PHONE: (214) 739-4991
COMPANY A St. Paul Insurance Companies
LETTER
CODE SUB-CODE
COMPANY I~
INSURED LETTER
COMPANY
L. H. LACY COMPANY, et al LETTER C
P. O. Box 541297
COMPANY
Dallas, Texas 75354-1297 LETTER D
COMPANY
LETTERE
COVERAGES
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.
POLICY EFFECTIVE POLICY EXPIRATION
CO TYPE OF INSURANCE POLICY NUMBER ALL LIMITS IN THOUSANDS
LTR DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL LIABILITY GENERAL AGGREGATE -X' $ 2 ~ 000
A X COMMERCIAL GENERAL LIABILITY 691NH34i5 ** 11/30/88 11/30/89 PRODUCT~COMP/OPS AGGREGATE $ 2,000
CLAIMS MADE X OCCUR. PERSONAL & ADVERTISING INJURY $ '] , 000
OWNER'S & CONTRACTOR'S PROT. -~ Aggregate applies EACH OCCURRENCE $ 1 ~ 000
~ect FIRE DAMAGE (Any one fire) $ 50
Per
Pro
MEDICAL EXPENSE (Any one person) $ 5
AUTOMOBILE LIABILITY COMBINED
SINGLE $
A X ANYAUTO 691NH3415-1 ** 11/30/88 11/30/89 LIMIT
ALL OWNED AUTOS BODILY
INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY
INJURY $
NON-OWNED AUTOS (Per accident)
GARAGE LIABILITY PROPERTY
DAMAGE $
EACH AGGREGATE
EXCESS LIABILITY OCCURRENCE
OTHER THAN UMBRELLA FORM
STATUTOR~
WORKER'S COMPENSATION
See Attached $ (EACH ACCIDENT)
AND $ (DISEASE--POLICY LIMIT)
EMPLOYERS' LIABILITY $ (DISEASE--EACH EMPLOYEI
OTI4ER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
RE: Denton Tap Road Improvements from Sandy Lake Road to Denton Creek
** Additional Insureds, per policy terms 'and conditions: City of Coppell and Ginn, Inc.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
CITY OF COPPELL, TEXAS 30
MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
~. O. BOX 4'78 LEFT, BUT ~AI~'I~TO MAlL SUCH NOTICI~SHALL IMPOS~NO OBLIGATION OR
Coppell, Texas 75019 LiABiLiT~d~AN~KiNDUPONTHECOMP~Y~,TSAGENT~O~FREPRESENTATiVES.~////
AUTHOR~EED REPRESENTATIVE
ACORD 25-S (3188)
CERTIFICATE OF INSURANCE ,SSUEDATEIMM;DD,YY)
11/29/88
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
COLLIER COBB & ASSOCS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
OF DALLAS, INC. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
5750 PINELAND DR., STE. 308
DALLAS, TX 75231 COMPANIES AFFORDING COVERAGE
PHONE: (214) 7394991
COMPANY ALETTER St. Paul Insurance Companies
CODE SUB-CODE
COMPANY
INSURED LETTER B
COMPANY C
L. H. LACY COMPANY, et al LETTER
P. O. Box 541297
COMPANY
Dallas, Texas 75354-1297 LETTER D
COMPANY
LETTER S
COVERAGES
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 REOUlREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHE~ 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.
CO POLICY EFFECTIVE POLICY EXPIRATION
TYPE OF INSURANCE POLICY NUMBER ALL LIMITS IN THOUSANDS
LTR DATE (biM/DDIYY) DATE (MM/DD/YY)
GENERAL LIABILITY GENERAL AGGREGATE ~ $ 2 000
,
A X COMMERO'ALGENERALL'AB'L'TY 691NH3415 ** 11/30/88 11/30/89 PRODUCTS-COMP'OPSAGGREGATE $ 2,000
CLAIMS MADE X OCCUR. PERSONAL & ADVERTISING INJURY $ 1,000
OWNER'S & CONTRACTOR'S PROT. ~ Aggregate applies EACH OCCURRENCE $ 1,000
Per Project FIRE DAMAGE (Any one fire) $ 50
MEDICAL EXPENSE (Any one person) $
AUTOMOBILE LIABILITY COMBINED
SINGLE $
A X ANY AUTO 691NH3415-1 ** 11/30/88 11/30/89 LIMIT l, 000
ALL OWNED AUTOS BODILY
INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY
INJURY $
NON-OWNED AUTOS (Per accident)
GARAGE LIABILITY PROPERTY
DAMAGE $
EACH AGGREGATE
EXCESS LIABILITY OCCURRENCE
$
OTHER THAN UMBRELLA FORM
STATUTORY
WORKER'S COMPENSATION
AND See Attached $ (EACH ACCIDENT)
$ (DISEASE--POLICY LIMIT)
EMPLOYERS' LIABILITY $ (DISEASE--EACH EMPLOYEE
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
RE: Denton Tap Road Improvements from Belt Line Road to Sandy Lake Road
** Additional Insureds, per policy terms & conditions: City of Coppell and Ginn, Inc.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO
CITY OF COPPELL, TEXAS 30
MAIL DAYS~RITTEN NOTICE TO THE CERTIFICATE ii,OLDER NAMED TO THE
?.
0.
Box
/+?8
LEFT, BUT~i$,~E TO MAIL SUCH ,O?~E SHALL IM~J~E "O OBLIGATION OR
C oppe ll, T e xas ? 5 019 LIARr OF~Y KIND UPON THE C O~Y, ITS A~E~OR REPRESENTATIVES.
A UTI~RIZED ,~E P "ESEN TATI VE ~ ~='~'~ ,~1 ~
/.
ACORD 2S-S (3/88)
/ -