WA9801-CS 991018 DATE (MIWD D~f~
10/].8/~9
,TH S CERTIFICATE IS ISt~UED A,i A MATtPER OF INFORMATION
~ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
0 BY THE POLICIES BELOW.
COMPANtES AFFQRDI.N,e COVERAGE
AColonia'l ~_a_sUal~y 'r~s~=ce
ACORD, CERTIFICATE OF INSURANCE
PRODUOER
Insurance NetWork of Texas
143 Eas; Austin
Giddi~s, TX 78942-3299
Executive Administrative services
Inc
4414 Centerview, Suite 293
San/LEtohio, TX 78228
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE Lis~rEi~ eiI,ow HA';/E aEI5%l ISSUED TO THE INSURE[~ NAMED/.~10VE FOR THE POLICY PERIOD
~NDICATEO, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTNN, THE ~N,SURANCE AFFORDED BY THE POUCIEE DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSt0NS.AND CONDITIONS OF SUCH POLICIES..~I.MITS SHOWN MAY HAVE BERN REDUCED BY P~D .C._LAtMS.
Co
GENERAL UABILITY
GARAGE LIAEILIPf .~t{T.O ONLY4tA ACCIDENT
ANY AUTO OTHER THAN AUI'~ ONLY:
__ EACH ACCIIDENT
A WORKEIR,~iCOMPENSAllONAND WC996474 10718/99 10/18/00 ..XV~A'nn'ORVUM,TS
EMPLOYBIle* U~MIILITY EACH ACCIQliNT
OFFICERS ARI~: OlJilIASB* EACH EMPLOYEE
Copp 11, TX 750Z9 qF ANY ~ND UPON THE C~Y, I~ ~EN~ ~ ~PR~INTA~II~
A~HOE EPRE8~
, ..
ACORD,~.(I)~ ~ 2 ~S336:?~/~33:6:2J · ' ':: ': ' ,015 &~O~DC~II~3
100'd 0ZZ£Z~60H:qH~ XH£ J0 ~H011HN
OEE£EPS60~I
£[:01 ({]Htd) 66.0Z-'i90
DESCRIPTIONS (Cor'tinUed from-page 1 ~)
Workers
Comp PolfCy.
City of Coppell in named in favor on Wai~er of Subrogation on Workers
Comp policy-
POst*iP Fax Note 7671 Date
¢ISSEMMa(~)2 of 2 #S3.3675/M3'3624
~00 'd
XT[i :-I0 ){)I0~AIqN SNI H:0I (G3~A)66,0~- '190