Waterside P1-CS 920221 CERTIFICATE OF INSURANCE ,SSUEDATE
PRODUCER 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
NO~[_,/~AV~S ~co~o~'~ed POLICIES BELOW .............................................
3~00 Hon~ce~o, ~300. L~ 5 COMPANIES AFFORDING COVERAGE
DelI~,~, TX 75205
COMPANY
LETTER A P[~ne~ ~ ~
COMPANY
COMPANY
COMPAXY
LETTERE
COVERAGES
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 REOUIREMENT. 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·
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MM.'DD.'YY DATE :MM.'DD.'YY)
~ COMMERC:AL GENERAL LIAB:L'TY PRODJCTS-COMP.'OP AGG. S
CL~S MADE Z OCCUR PR,SO,AL ~ A~V. *.JC,V S ~ 000000
OWNER'S & CONTRACTORS PROT. EACH OCCURRENCE
F.RE DAMAGE ,As-y os.e '.re)
MED. EXPENSE ,A,y o~e person} S 5 0 0 0
~ AUTOMOBILE LIABILITY ~H1647327--02 8/01/9~ ~,/C)~/92 COMB~NEDS~NGLE
S
~ ANY AUTO LIMit
ALL OWNED AUTOS BOD;LV INJUR~
S
SCHEDULED AUTOS .Per ~erson)
~ .~RE~ AUTOS BODILY IN.URv
~ NON-OWNED AJTOS ~Pe' acc'clem,
GARAGE LIABILITY
PROPERTY ~AMAGE S
C ~xcEssu~u~ ~U1~94~31 1~/19/91 8/01/92 E~C, OCCU..ENCE S ~000000
X UMBRELLA FORM AGGREGATE S
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION STATUTORY L;MITS
EACH ACC:DENT
AND
DISEASE--PCL.CY L.MIT S
EMPLOYERS' LIABILITY
DISEASE--EACH EMPLOYEE
OTHER
DESCRIPTION OF OPERATIONSlLOCATIONSIVEHICLESISPECIAL ITEMS
~: WATERSIDE ESTATES PHASE I
,~I.VY OF c~c)PPELr.
-CERTIFICATE 'HO[.'~ER CANCELLATION -
SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO
C I TY O? COPPELL MAIL ~L 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
°;-,, LARRY DAVIS LEFT· BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
?. o. Box 478 LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES·
COPPELL, TX 75019 A u T R 0 R,Z E D R E p R=[--..i.T;;T,7-T..,.~ ....................
· ACORD 25-S (7190) ........... .~_ ............ .,~.ACORD CORPORATION 1990
3- C~