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ST9302-CS010619 (2)ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE,M.DD ) 7, = 06/19/2001 PRODUCER (817)457-6700 FAX (817)457-7246 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION THE SWEENEY COMPANY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1121 E. Loop 820 South ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P 0 Box 8720 Fort Worth, TX 76124-0720 INSURERS AFFORDING COVERAGE INSURED Humphrey & Norton Construction Company, Tnc. INSURERA: St. Paul Fire & Marine Tns Co P.O. Box 8057 INSURERB: St. Paul Mercury Tns Co Fort Worth, TX 76124 ,NSURERC: R L T Tnsurance Company · INSURER D: I INSURER E: 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 POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE IMM/DD/YY~ DATE IMM/DD/YY) LIMITS GENERAL LIABILITY 06/20/2001 06/20/2002 EACH OCCURRENCE $ 1,000, OOC X I COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ 100100C I I CLAIMS MADE ~-~ OCCUR I(K09101386 MHD EXP (Any one person} $ 10,00( A X Per Proj Agg PERSONAL&ADVINJURY $ 1,000,00¢ GENERAL AGGREGATE $ 2,000, O0C GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/DP AGG $ 2 i 000 ~ 000 I POLICY ~]PRO' JECT ~] LOC AUTOMOBILE LIABILITY 06/20/2001 06/20/2002 COMBINED SINGLE LIMIT $ X ANY AUTO ILR09100159 (La accident) 1 ! 000 ! 000 X ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) B X HIRED AUTOS BODILY iNJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ I ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY 06/20/2001 06/20/2002 EACH OCCURRENCE $ 2,000,000 ] OCCUR [---I CLAIMS MADE AGGREGATE $ 2! 000! 000 C DULO048070 $ I DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND IdVK9101637 06/20/2001 06/20/2002 X wc STATU- OTH- TORY L M TS ER EMPLOYERS' LIABILITY A E.L. EACH ACCIDENT $ 500,000 ~.g. DISEASE- EA EMPLOYEE $ 500,000 E.L. DISEASE- POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 30 DAYS NOTTCE OF CAN(: AMENDED TO 10 DAYS FOR NON-PAY OF PRENTUN CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: __ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ~ MAIL 30 DAYS WRITrEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, C:[TY OF COPPELL P O BOX 478 THORIZEDR.EPRESFANTATIVE COPPELL, TX 75019 AU ACORD 25-S (7197) .... ©ACORD ~:~RPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between 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-S (7~97)