WA9801-CS 990902 (2)Insurance Network of Texas
143 East Austin
Giddings, TX 78942-3299
Executive Administrative Services
Inc
4414 Centerview, Suite 293
San Antonio, TX 78228
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ONLY AND CONFERS NO RiGH~ U~ ~E CBTIFI~TE
H~. ~lS CBTIFI~TE DO~ NOT AMID, ~T~D ~
~T~ ~E ~BAGE ~F~D~ ~ ~E ~ICIB B~.
~P~l~ ~F~DING ~BAGE
AColonial Casualty Insurance
B
C
COMPANY
D
CO 'PfPEOF INSURANCE
LTR
GENERAL LIAEILITY
AUTOMOBILE LIABILITY
ANYAUTO
ALL OWNED AUTOS
ECHEDULED AUTOE
HIREDAUTOS
NON-OWNED AUTOE
POLICYNUMBER
POLICYEFFECTIVE FOLICYEXPIRATION
DATE(MM/DDh~q OATE(MM/DDrfq
LIMITE
GENERALAGGREGATE $
GARAGELIASILITY AUTOONLY-EAACOIDENT
NYAUTC GTEERTHANAUTCONLY:
EACH ACCIDENT S
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLAFORM AGGREGATE $
OTHERTHANUMBRELLAFOR~
WORNE.ECGMPENEAT,ONA.D HC985143 10/18/98 10/18/99 ISTATU~OEYU~,TE
EMPLOYERS' UABI LIlY
EACHACCIL:)ENT $1,000,000
THERRORR~OR/ ~ ~NCL D~S~SE-~UCYUM~T $1,000,000
PASTN ERS/EXEGUTIVE
OFFICERS AEE: EXCL D~SEASE-EACH EMPLOYEE Sl, 000,000
OTHER
DESCRIPTION OF OPERATIONEILOCATIONSlVEffiDLES/SPECIAL ITEMS
Project: Project State Highway 121 Water Line
Project No. WA98-01; Bid No. Q0199-02
(See Attached Schedule. )
SHOULDANYOFTHEABOVEDESCRIBEDPOLiDIEEBECANCELLEDBEFORETHE
City of Copp911 EXPIRATION DATETHEREOF, THEISEUINGCOMPANYWILLENDEAVORTOMAIL
255 Parkway Blvd. lff DAYSWRITTENNoTICEToTHECERTIFIcATEHOLDERNAMEDTOTHELEFT,
P,O- BOX 478 BUTFAILURETOMAILEUDRNOTICESHALLIMPOSENOOBLI~ATIONORLIABILIIY
Coppell, TX 75019 oF ANY KIND UPON THE COMPANY, iTS AGENT~ OR REPRESENTATIVE~.
H & W Utility Contractors is an Alternate Employer in regards to Workers
Comp Policy.
City of Coppell in named in favor on Waiver of Subrogation on Workers
Comp policy.
Insurance Network of Texas
143 East Austin, Giddings, TX 78942-3299
409-942-3666 * FAX 409-542-3220
F~TO:
To Whom It May Concern
City of Coppell
19723043570
SagiFAX Cover Sheet
FAXFROM:
Joyce Minze
Insurance Network of Texas
409-542-3666 / FAX 489-542-3220
FAX DATE: September 3, 1999 FAX TIME: ll:46am NUMBER OF PAGES (INCt,UD ING COVER): 3
COMMENTS:
Please see attached Certificate of Insurance.