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WA0601-CS081210
ACORD CERTIFICATE OF LIABILITY INSURANCE 12 /i ;2D 8' PRODUCER (972)864 -0400 FAX (972)278 -8400 Davis - Dyer -Max, Inc. a Member of the Insurors Group P.O. Box 495429 land, TX 75049 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 NAIC # INSURED Jim Bowman Construction Co., L.P. 1111 Summit Avenue Suite 1 Plano, TX 75074 INSURERA: UBI, A Division of AmTrust NA POLICY EFFECTIVE INSURERB: Trinity Universal 198870 INSURERC: Texas Mutual Insurance Co. INSURER D: SPP1002469 INSURER E: 12/12/2009 COVERAGES 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. INSR ADD*L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS AUTHORIZED REPRESENTATIVE !� 1PerryMax GENERAL LIABILITY SPP1002469 12/12/2008 12/12/2009 EACH OCCURRENCE $ 1,000,000. X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100, 00( CLAIMS MADE I OCCUR MED EXP (Any one person) $ 5,00( A X Contractual Liab PERSONAL &ADVINJURY $ 1,000,00 X I Includes X C U GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY X PRO LOC JECT AUTOMOBILE LIABILITY ANY AUTO SPP1002469 12/12/2008 12/12/2009 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY AGG EXCESSIUMBRELLA LIABILITY MMB1001576 12/12/2008 12/12/2009 EACH OCCURRENCE $ 5,000,000 X OCCUR ❑ CLAIMS MADE AGGREGATE $ 5,000,000 B $ $ DEDUCTIBLE X RETENTION $ 10,00 $ WORKERS COMPENSATION AND TSF0001152913 12/12/2008 12/12/2009 X I WC sTATU- OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,00( E.L. DISEASE - EA EMPLOYEE $ 1,000,00( OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00( A OTHE�R equipment Floater SPP1002469 12/12/2008 12/12/2009 $300,000 Leased Equipment $2500 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS roject: Water Line Installation Hunterwood Park COnnection.C.I.P. Project WA06,01 City of Coppell is included as additional insured on the general liability. cFRTI9:I[_ATF binl nro reur_cl I Arinu ACORD 25 (2001108) © ACORD CORPORATION 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Coppel 1 , Texas BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 255 Parkway OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Coppel l , TX 75019 AUTHORIZED REPRESENTATIVE !� 1PerryMax /SDJ ACORD 25 (2001108) © ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A stat( on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08)