ST0202-CS031021MELSELE
ACORD. CERTIFICATE OF LIABILITY INSURANCE10/21103
THIS CERTIFICATE IS ISSUED AS A MA~ ~R OF INFORMATION
PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HRH insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
5520 LBJ Freeway, Sixth Floor ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Dallas, TX 75240
972 385-9922 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURERA; Employers Mutual Casualty Company
Mel's Electric Service, Inc. INSURER B:
1810 S. Akard INSURER C;
Dallas, Texas 75215 INSURER D:
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.
LTR IN,RI TYPE OF INSURANCE DATE (MM/DDIYY~ DATE
A GENE~ LIABILI~ :D2535904 0710t/03 07/01/04 ~C. ~URRS~E sl,00O,000
=ERSON~ & ADV INJURY $110001000
-- GENERAL AGGREGATE s2,000,000
A AUTOM~ILE LIABIL~ 2E2535904 07/01/03 0710tl04 COMBINED SINGLE LIMIT Sl,000,000
~~ (Per ac~dent)
A ~c;s~s~;~ uABa~ 2J2535904 07101/03 07101/~ ACH ~CURRENCE $10t0001000
X ~ occu. ~ C~,MS M~=E ~O.;=A~E ~10,000,000
X RETENTION $ 10000
A ~.~ co~.sA~ ~.o 2H2535904 07101103 07/01/~ ~ Tn.W,U,TS ~
S~ECIAL PROVISIONS below E.L. DISEASE - POLICY LIMtT $500~000
A O~R Inland 2C2535904 07/01/03 07101104 $100,000 Leased or
Marine Rented Equipment
$500 D~uctlble
Project: Bethel Sch~l Rd., Contra~om Job ~2425, Mels Job ~2-022
Ci~ of Coppell is additional Insured with a waiver of subrogation
provided for the General LiablliW Policy.
CERTIFICATE HOLDER CAHC_;L~ ATION
City ofCoppell
Engineering Department
255 Parkway Blvd.
Coppell, TX 75019
ACORD 25 (2001108) I of 2 #S122367/M112093
SHOULD ANy OF THE ABOVE DESCRIBED POLICIES SE CANCELLED SEFORE THE EXPIRA*I'ION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~0 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO $O SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, iTS AGENTS OR
REPRESENTATIVES.
KMC e ACORD CORPORATION 19t~=