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DR0401-CS050831 ACORD.._ CERTIFICATE OF LIABILITY INSURANCE . iTE-6CS" c.J DATE MM,UU I08/31/05 PRODUCER Jackson & Harmon Ins. Agency 510 N. Valley Mills Dr., #701 Waco TX 76710 Phone:254-772-6074 Fax:254-772-6864 INSURED 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 POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A Bituminous Casualty ~NSURERB~ Texas Mutual Insurance Comps INSURERC Great American Ins. Co. of NAIC # ny Whitewater Construction, Inc. 6640 Old Mexia Road INSUBERO Waco TX 76705 COVERAGES THE POLICIES OF INSURANCE L~STED 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 POL C ES DESCR BED HERE N S SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS IN~I~ ~U[J'I I I POLICY EFFECTIVE IPOLICY EXP'RATION ! LIMITS LTR NSRI T'(PE OF INSURANCE POLICY NUMBER DATE tMM/DD/Yyt DATE iMMiDD/yy~ GENERAL LIABILITY EACH OCCURRENCE ~[ $ i ~ 000 ~ 000 A X X~ COMMERCIALGENERALLIASILITY CLP3195845B 09/01/05 09/01/06 PREMIsEsL)~'FVtAt~ IU~tP~,tU(Ea OCCu~er~Ce) I $ lOO, ooo MED EXP (Any one person) $ 5 t 000 ' I C._AIMS MADE ~x~ occu~1 i PERSONAL & ADV iNJU,y GENERAE AGGREGATE $ 2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/DP AGG $ 2,000 ~ 000 POLICY ~ JPERcO~ ~LOC Sm~ Ben. 1,,000,000 AUTOMOBILE LIABILITY i COMBINED SINGLE LIMIT $ 1 ,. 000 ~ 000 A X ~ ANY AUTO CAP3195843B 09/01/05 09/01/06 (Ea accident) ALL OWNED AUTOS BODILY iNJURY SCHEDULED AUTOSii (Per person) $ , _ H~RED AUTOS I I BODILY INJURY I NON-OWNED AUTOSI , I (Per accident) I i PROPERTY DAMAGE (Per acciderR) $ ! GARAGE LIABILITY r AUTO ONLY - EA ACCIDENT AUTO ONLY: AGO ~ ESS/UMBRELLA LIABILITY EACH OCCURRENCE $ I ~ 000 ,. 000 A ! ~ OCCUR ~ CLAIMSMADE CUP2573955B 09/01/05 i 09/01/06 'AGGREGATE $ DEDUCTIBLE $ RETENTION $ ~. 0 , 000 $ WORK RSEMPLOYERSi LIA"ILI COMPENSATION AND, I TOR UMITS I x I TSF0001109515 I 10/01/04 10/01/05 ELEACHACCIDENT $1000000 OFFICER/MEMBER EXCLUDED? I I E L DISEASE- EA EMPLOYEE $ '1000000 SI~ECIALPR0VlSIONSbelow I EL 01SEASE-POLICYLIMIT $ 1000000 I C Equipment Floater IMP6696849 09/01/05 09/01/06 $1,000 Per Schedul C Install/Builders R IMP6696849 09/01/05 i 09/01/06 $1,000 $2,000,000. DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Re: Oakcrest Drainage Project #DR04-01. Certificate holder is named as additional insured on auto and general liability policies. Waiver of Subrogation in favor of certificate holder on workers compensation policy. CERTIFICATE HOLDER CANCELLATION CITCO-3 City of Coppell ATTN: Ken Griffin P.O. Box 9478 255 Parkway Blvd. Coppell TX 75019 ACORD 25 (2001108) 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 OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Ben Perry © AO0kD~ (~0F~#ORATION '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 (2001/08)