MCI-CS090617ACO OR ®
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM /DD /YYYY)
INSR
ADD'
06/17/2009
PRODUCER
Aon Risk Services Northeast, Inc.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
New York NY Office
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
TYPE OF INSURANCE
199 water Street
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
POLICY EXPIRATION
DATE MM/DD /YYYY
New York NY 10038 -3551 USA
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC#
PHONE-066) 283 -7122 -- (847) 953 -5390
06/30/2010
INSURED
INSURERA: American International Specialty Lines
26883
MCI, LLC and Subsidiaries
dba verizon Business -
w
INSURERB: National Union Fire Ins Co of Pittsburgh
19445
140 west Street
New York NY 10007 -2109 USA
1410
INSURER a Illinois National Insurance Co
23817
CLAIMS MADE OCCUR
X Includes "X,C,U" Coverage
ElGENERAL
b
INSURERD: New Hampshire Ins Co
23841
PREMISES (Ea occurrence)
w
MED EXP (Anv one person)
d
c
INSURER E: Insurance Company of the State of PA
119429
COVERAGES CTR nnnliac nar tarmc and rn- 14tinr,c of tho --I17 . �i
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUMEMENT, 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. LIMITS SHOWN ARE AS REQUESTED
INSR
ADD'
LTR
1INSR1
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
ATE MM/DD/Y
POLICY EXPIRATION
DATE MM/DD /YYYY
LIMITS
B
NERAL LIABILITY
0907418
06/30/2009
06/30/2010
EACH OCCURRENCE
$1,000,000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
$2,000,000
CLAIMS MADE OCCUR
X Includes "X,C,U" Coverage
ElGENERAL
PREMISES (Ea occurrence)
MED EXP (Anv one person)
PERSONAL & ADV INJURY
$1,000,000
AGGREGATE
$2,000,000
GENT. AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP /OP AGG
$2,000,000
❑X POLICY El PRO- ❑ LOC
]ECT
B
B
B
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
0919448
ADS
0919449
MA
0919450
VA
06/30/2009
06/30/2009
06/30/2009
06/30/2010
06/30/2010
06/30/2010
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
BODILY INJURY
(Perperson)
HIRED AUTOS
BODILY INJURY
NON OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
ANY AUTO
H
OTHER THAN EA ACC
AUTO ONLY:
AGG
B
EXCESS / UMBRELLA LIABILITY
3323782
06/30/2009
06/30/2010
EACH OCCURRENCE
,
OCCUR ❑ CLAIMS MADE
AGGREGATE
$5,000,000
eDEDUCTIBLE
RETENTION
B
B
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABH.ITY
N
ANY PROPRIETOR /PARTNER / EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
60168 71
AOS
60168872
CA
60168873
06/30/2009
06/30/2009
06/30/2009
06/30/2010
06/30/2010
X
We STATU-
RY LIMIT
oTH-
ER
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE -EA EMPLOYEE
$1,000,000
E.L. DISEASE - POLICY LIMIT
$1,000,05-0
Ifyes, describe under SPECIAL PROVISIONS below
FL
OTHER
DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS
Re: Project 043400 Building Add, Depository Trust & Clearing Corp. 1333 Crestside, Coppell, Tx 75019.
City of Coppell, Texas is included as Additional Insured.
XCU IS NOT EXCLUDED.
CERTIFICATE HOLDER CANCELLATION -
City of Coppell . Texas SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Attn : Engineering Department DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
255 Parkway Blvd. 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Coppell , Tx 75019 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE Jv.
ACORD 25 (2009/01) 01988 -2009 ACORD CORPORATION. All rights reserve
The ACCIRTI names and Inan aTP rPUiCfPYaI V. of ACnil)n
O
Ln
n
N
O
M
O
Lri
O
O
z
R
v
U
OL L9 ZOS £OOL S : ON a;cauWaa
SNOISIAOd'MJ3dS /IN3W3SN0(IN3 Ag 03QOV SNOISII'IDX3 /Sa ID[H3A/SNOIIV307/SNOI.LtlN3d0 d0 NOI.LdRIDS30
s ;nUTj ioTjod Io3 uuo3 a;eogpioo
QgpDd aq; uo Amlod ft uodsomc) aq; o; aa;ai `uoi euou! IIij apnjom lou sop moaqim * L3I
xa-ulsm
'daunsm
WMMSM
'dau Ism
S3I3I'I0d 'IVNOI.LI(tav
VSn 60TZ -L000T AN JJOA MaN
laail5 IsaM ObT
ssaULsna uozLuaA eqp
saiue�pisgns pue JIl 'IJW
aaansNl
od oq; ut pou!lnuoa suoisnjoxo io sa3L:aanoo `suouipuOO `SUua; jjE Ulejuoo ;oa saop ;uannjot a siL(Z (s)IamsLn aq; iq paplo j>
a8ezanoo aLj; Io uoi;duosap j�uoi ;tppe se a ;eogiwo pauoudeo aq; o; pagoL4L igalaq we nnojaq pa ;ou suoisTnold pug suouipuoo `suua; aq j
sa ue �p �sgn5 put, Jll ' IJw do3 alT;ag.POD Crd0jVV of 3uacugavnV
OTOZ /0£/90
60OZ/OE/go
IM'AN'NW'IW
LL889TO9
(]
OTOZ /0£/90
60OZ/OE/go
ao
bL889T09
e
OTOZ /0£/90
6 OOZ/OE/9c
Xl
SL889TO9
4
OTOZ /0£/90
600Z/OE/90
VA 'Nl 'VW 'aV
9L889TO9
3
NOIIVSN3dWO3 S83NNOM
S11Nll7
NOIZVNIdXa
AJI7od
aALLJadda
AJI70d
NOIIdINJSaa AJI7Od
HaawaN AJI'IOd
aJN`✓imsm 30 adAl
CMSDII
'LQQV
NJ.7
TISNI
s ;nUTj ioTjod Io3 uuo3 a;eogpioo
QgpDd aq; uo Amlod ft uodsomc) aq; o; aa;ai `uoi euou! IIij apnjom lou sop moaqim * L3I
xa-ulsm
'daunsm
WMMSM
'dau Ism
S3I3I'I0d 'IVNOI.LI(tav
VSn 60TZ -L000T AN JJOA MaN
laail5 IsaM ObT
ssaULsna uozLuaA eqp
saiue�pisgns pue JIl 'IJW
aaansNl
od oq; ut pou!lnuoa suoisnjoxo io sa3L:aanoo `suouipuOO `SUua; jjE Ulejuoo ;oa saop ;uannjot a siL(Z (s)IamsLn aq; iq paplo j>
a8ezanoo aLj; Io uoi;duosap j�uoi ;tppe se a ;eogiwo pauoudeo aq; o; pagoL4L igalaq we nnojaq pa ;ou suoisTnold pug suouipuoo `suua; aq j
sa ue �p �sgn5 put, Jll ' IJw do3 alT;ag.POD Crd0jVV of 3uacugavnV