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WA0101-CS050804 ACORD. CERTIFICATE OF LIABILITY INSURANCE' 0 /05/05 PRODUCER THIS CERTIFICATE IS ISS~B~J~ A MATTER OF INFORMATION Guaranty Insurance Services ONLY AND CONFERS NO~RTGHTS UPON THE CERTIFICATE One Arlington Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1112 'R. Cop~land Rd. #100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Arlington TX 76011-4996 Phone: 817-226-3710 Fax: 866-652-9333 i~$URED Rusty Vinson ConstructionJ 700 Georgia Ave ~ Burleson TX 7~ COVERAGES INSURERS AFFORDING COVERAGE NAIC# 19380 24074 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. I~%ADD% ! POLICY EFFECTIVE POLIDY EXPIRATION LTR ~NSRq TYPE OF INSURANCE i POLICY NUMBER DATE (MM/OD/YY) DATE {MM/DD/YY) GENERAL LIABILITY B X COMMERCIALOENERALUABILITY BHO0553250068 08/31/04 CLAIMS MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC LIMITS EACH OCCURRENCE i $ 1,000 ~ 000 PREMISES (Ea occurence) ! $ ~- U U t MED EXP (Any one person) $ 10 ~.000 PERSONAL & ADW~UUR¥ $ 1,000,0~00 GENERAL AGGREGATF j$ 2 ~ 000 ~.000 PRODUCTS- COMB/DP AGO _ $ 2, 000,000 AUTOMOBILE LIABILITY B ~ ANY AUTO ( BAO0553250068 31/04 08/31/05 ALL OWNED AUTOS SCHEDULED AUTOS XHIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ i ~ 000 t 000 BODILY INJURY $ PROPERTY DAMAGE $ (Per accident) AUTO ONLY EA ACCIDENT $ EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY B X OCCUR CLAIMS MADE BXO0553250068 08/31/04 DEDUCTIBLE X RETENTION $10 ~. 000 WORK1ERS COMPENSATION AND EMPLOYERS' LIABIUTY 9549761 08/31/04 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If es. describe under SI~E ClAL PROVISIONS below OTHER EACH OCCURRENCE $ i, 000,000 08/31/05 AGGREGATE $ I, 000,000 $ $ $ WC STATU- OTH* TORY LIMITS ER 08/31/05 .EL EACH ACCIDENT $ lr000w000 EL DISEASE EAEMPLOYEE $ I ~. 000 ~ 000 E.L. DISEASE - POLICY LIMIT $ I ! 000 ! 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY E Excavation :E RTl FICAT E,17~R'~ ~ ~ity of Coppell ~ttn: Larry Davis ACORD 25~1108) CANCELLATION CITCOP3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OB REPRESENTATIVES. © ACORD CORPORATION 1988 ACORD. CERTIFICATE OF LIABILITY INSURANCE CSR .. RUST-V2 08/05,/05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Guaranty Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE One Arlington Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1112 E. Copaland Rd. #100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Arlington TX 76011-4996 / Phone: 817-226-3710 Fax:866-652-9333 / INSURERS AFFORDING COVERAGE , NAIC# INSURED INSURERA: .~=~.¢an ~ A~su~-anc. Co* I 19380 iNSURERB: Ohio Casualty Insurance CO. ' 24074 At~: ~esha Vinson ~ INSURER C: 700 ~orgia Ave / (NSURERD: Burleson ~ 76028 ~ ~ COVE~GES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOT~NITHSTANDING 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 NSR DD'L ; POMCYEFFECTIVE POLICYEXPiRATION LT~ ~SRr~ TYPE OF INSURANCE POLICY NUMBER DATE (MM~DD,'YY) DATE {MM/DD/YY} LIMITS i ! GENERAL LIABILITY i EACH OCCURRENCE $ 1 · 000 f 0__00 B i X COMMERCIAL GENERAL LIABILITY ! BHO0653250068 08/31/05 08/31/06 DAMAC~b PREMISES(ES occurence~ $ 100,000 I CLAIMS MADE X OCCUR MED EXP (Any one person) $ 10 t 000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE . $ 2 ~ 000,000 i GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AG~ I PRO- I POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 t 000 · 000 B ! X A~AUTO BAO0653250068 08/31/05 08/31/06 (Eaaccident) BODILY INJURY ALL OWNED AUTOS // I I ~/ (Per person) $ SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY X NON-OWNEDAUTOS (Per accident) $ ill (Per accident) $ GARAGE L[AEIILITY ~1~ '~ ~ AUTO ONLY - E~ ACCIDENT $ ANY AUTO · OTHER THAN EJ~ ACC EXCE~IUMBRELLA LIABILITY EACH OCCURRENCE $ I, 000,000 '[~ X OCCUR CLAIMSMADE USO065325 08 /05 08/31/06 AGGREGATE $ l~000t000 $ [ DEDUCTIBLE $ i IX RETENTION $10f000 WC STATU- nTH- $ WORKERS COMPENSATION AND TORY LIMITS L ER X ~ EMPLOYERB' LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE WC1842588 08/31/05 08/31/06 E L EACH ACCIDENT $ 100000~ OFFICER/MEMBER EXCLUDED? ~ E.L DISEASE- EA EMPLOYEE $1000000. If es. describe under S~ECIAL PROVISIONS below ~ E.L. DISEASE - POLICY LIMIT $ 1000000 'OTHER CERTIFICApDER ~City of Coppell ~ Attn: Lar~ Davis ~P. O. Bo~9478 ~ 75019 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO BO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. CITCOP3 ACORD 25 (2001108) © ACORD CORPORATION 1988