PA9601-CS 980629PAVECO97
~ROCUOER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Cadenhead Shreffler Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. BOX 1119 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Bedford, TX 76095 COMPANIES AFFORDING COVERAGE
COMPANY
~_AMaryland L_~oyds Insurance Company
I]flSURE D ! COMPANY
Pavecon, Inc. i BNorthern Insurance Company of NY
P.O. Box 535457
COMPANY
Grand Prairie, TX 75053 : CLumbermens Mutual Casualty Co.
I COMPANY
cov£R c s
THiS is TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDK~ATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDiTiON OF ANY CONTRACT OR OTHER DOCUMENT WFrH 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,
EXC LUSK)NS AND CONDITIONS OF SUCH POLICiES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
!GE.ERALL,AB,L,. EPA2957975 107/01/98 07/0 /99 GE.E ALAGGRE ATE ,2.000.000
A
~X ;OMMERCIALGENERALLIABILIT' I i PRODUCTS-COMPIOPASD ~1 , 000 t 000 _
ISLA[MSMADE~ OCCUF ! PERSONAL&ADVINJURY I1, 000,000
WNER'S&CONTRACTOR'SPRO~ lEACH OCCURRENCE ~1 / 000 Z 000
X ~k~~D I !FIRECAMAGE(Anyoneflre) 3q01000
i MED EXP(Anyone person) 10 ~ 000
B AUTOMOSI LE LIABILITY NAA31648836 07/01/98 07/01/99]
000
i SCHEDULED AUTOS
IRED AUTOS
X Blkt AI/30D NCC PROPERTY DAMAGE
C EXCE~LIABILITY 3SX05806200 07/01/98 07/01/99 EACHOCCURRENCE $10 , 000 100C
~ UMBRELLAFORM AGGREGATE $10, 000, 00C
B WORKERS COMPENSATION AN D TC969554377 J07/08/98
07/08/99
EMPLOYER~'LIABILITY Blkt WOS/30D NCC [ EACHACCIOENT $500, 000
OFFICERsPARTNERS/EXECUTIVEARE:[~ EXCL .I ! DISEASE-EACH EMPLOYEE 15500 t 000
RE: Copperstone Tra±l, Pro~ect #PA 96-01, Coppell TX
~R~i~i~TE HO~ER CANCELLATi°N
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANSE LEE D BEFORE THE
City of Coppell EXPIRATION OATETHEREOF, THEISSUINGCOMPANYWILLENDEAVORTOMAIL
c/o Purchasing Agent ~ 0 DAYSWRITTENNOTICETOTHECERTIFICATEHOLDERNAMEOTOTHELEFT,
Coppe 11, TX 75019 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZE D R.~E SE~;,VE
eACOj iCORPO TION