MA 09/10-CS110210FEB- 10- 20111THU) 16:19 BRADLEY INSURANCE
(FAX)817 +332 +8289 P.001 /001
AC() M. CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DDKY
z l0 2011 1
PRODUCER
Bradley Insurance Agency
1415 Summit Avenue
Fort Worth, TX 76102
817- 332-8288
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAICA
INSURED Laughley Bridge & Construction, Inc.
Laughley, Charles
B.O. BOX 123800
Fort Worth, TX 76121
817 401 -3306
INSURERA Companion Property & Casualty
22945
INSURER B: Texas Mutual Insurance Company
LIMITS
INSURER G
INSURER D.
INSURER E:
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
uN
L
NSRD
TYPE OF INSURANCE
POLICY NUMBER
DATE MMICDYY
DATE MM1QD1YY
LIMITS
AUTHORIZED REPRES6I1 -?.TX
GENERAL LIABILITY
EACH OCCURRENCE
$ 10000 .000
COMMERCIAL GENERAL LIABILITY
PREMISES (Ea occurence)
$ 00
CLAIMSMADE 10 OCCUR
MED EXP (Any one person)
$ 5 000
A
X
DJGL097879
2/5/2011
2/5/2012
PERSONAL &ADV INJURY
S 1,000,000
GENERAL AGGREGATE
$
GE N'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOPAGG
S 2 000 000
POLICY JET LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$
ANY AUTO
(Ea accident)
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
HIRED AUTOS
BODILY INJURY
$
NON- OWNEDAUTOS
(Perecadent)
PROPERTY DAMAGE
$
(Perecadent)
GARAGE LIABILITY
AUTOONLY- EAACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$
$
AUTOONLY: AGG
ECCESS!UMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR CI CLAIMSMADE
S
DEDUCTIBLE
RETENTION $
$
WORKERS COMPENSATION AND
TORYLIMITS I ER
ANYPROER5LIPARTNY
ANY PRCPRIETOR,PARTNEWEXEW TIDE
TSF0001166538
3/6/2010
3/6/2011
E.L. EACH ACC
$ 500,000
B
OFFICEPNEMBER ExcwDEO7
EL. DISEASE - EA EMPLOYEE
S 50� 000
Ryyes, describe under
SPECIALPROVISIONSbelow
E.L. DISEASE - POLICY LIMIT
S
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
City of Coppell
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
255 Parkway B1
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
Coppell , TX 7 75 5019
NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES. . ....... ........ .............
AUTHORIZED REPRES6I1 -?.TX
ss(cwvua) V 1' tACQRDCQ$t'C7_Oi 1988