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Verizon-CS120924 A`�R° CERTIFICATE OF LIABILITY INSURANCE DA19i2o err) 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. APORTANT: 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 CONTACT Marla Cunningham NAME: g The Cashion Company, Inc. ((A/C.No,EXU: (501)376-0716 FAX NO): (501)376-2118 P 0 Box 550 nooRless:marlac @cashionco.com PRODUCER - - - 1CUSTOMER ID#�QOOD 669 - - Little Rock AR 72203 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A Twin City Fire Insurance Co. 29459 INSURER B:Hartford Insurance Company of 37478 Klaasmeyer Construction Company, Inc. INSURER c:National Union Fire Ins. Co. of 19445 PO Box 847 INSURER D: INSURER E Conway AR 72033 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 --- ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 300,000 PREMISES occurrence) $ A CLAIMS-MADE FXJ OCCUR Y Y 38CQT2475 8/1/2012 8/1/2013 MED EXP(Any one person) $ 10,000 X Blanket Contractual Liab PERSONAL&ADV INJURY $ 1,000,000 X XCU Coverage Included GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY I c PRO LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ 38UENQT2476 8/1/2012 8/1/2013 B ALL OWNED AUTOS Y y 38 BODILY INJURY(Per accident) $ SCHEDULED AUTOS -X PROPERTY DAMAGE $ HIRED AUTOS (Per accdent) X NON-OWNED AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 15,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 15,000,000 DEDUCTIBLE $ C X RETENTION $ 10,000 Y Y 16604357 8/1/2012 8/1/2013 I $ A WORKERS COMPENSATION X I C LAMBS t_ _JOER_-_ AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1r 000 000 OFFICER/MEMBER EXCLUDED? N N/A --- - --- - -- r----- (Mandatory in NH) 38WEQT2474 8/1/2012 8/1/2013 E.L.DISEASE-EA EMPLOYEE $ 1000,000 If Yes,describe uOF Onder - - --- -- - - -- DESCRIPTION PERATIONS below Y E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) See Attached Comments/Remarks Section CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Coppell Texas Attn: Keith Marvin 255 Parkway Blvd AUTHORIZED REPRESENTATIVE Coppell, TX 75019 Jim Allbritton/CLH001 cyvs'L � -- ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 mows) The ACORD name and logo are registered marks of ACORD KLAASMEYER CONSTRUCTION COMPANY,CO INCM.MENTS/REMARKS ENDORSED ADDITIONAL INSURED: If required by written contract, certificate holder is included as an additional insured on a primary and noncontributory basis. ENDORSED WAIVER OF SUBROGATION: If required by written contract, waiver of subrogation applies in favor of certificate holder. OFREMARK COPYRIGHT 2000, AMS SERVICES INC.