TR9801-CS 980817CERTIFICATE OF INSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN
INSURANCE POLICY AND DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY IES LISTED BELOW.
This is to Certif that
DURABLE PPECIALTIES, INC.
P. O. BOX 381788
DUNCANVILLE, TX 75138
is. at the issue date of this certificate. insured by the Comoanv under th
Name and
In Ured °f LIBERTY
MUTUAL
e policy(ies) listed below. The insurance afforded by the listed policy(ies)
is subject to all their terms, exclusions and conditions and is not altered by any requirement, term or condition of any contract or other document
with raenart to which this rartifirata may Fva ifcuad
* IF THE CERTIFICATE EXPIRATION DATE IS CONTINUOUS OR EXTENDED TERM, YOU WILL BE NOTIFIED IF COVERAGE IS TERMINATED OR REDUCED
BEFORE THE CERTIFICATE EXPIRATION DATE. HOWEVER, YOU WILL NOT BE NOTIFIED ANNUALLY OF THE CONTINUATION OF COVERAGE.
SPECIAL NOTICE - OHIO: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER,
SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD.
NOTICE OF CANCELLATION: 30 (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS LIBERTY MUTUAL GROUP
ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT
CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL
UNTIL AT LEAST 30 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: _
City of Coppell
CERTIFICATE P O Box 478 PAM PADGETT
HOLDER Coppell, TX 75019 Authorized Representative
8/17/98 BB IRVING
This Certificate is executed by LIBERTY MUTUAL GROUP as respects such insurance as is afforded by Those Companies
CERTIFICATE EX P. DATE
TYPE OF POLICY
* ❑ CONTINUOUS
POLICY NUMBER
LIMIT OF LIABILITY
EXTENDED
XQ POLICY TERM
Coverage Afforded Under WC
Law of the Following States:
EMPLOYERS LIABILITY
WORKERS
5/31/99
WC7- 191- 419383 -018
TEXAS
Bodily Injury By Accident Each
500,000 Accident
COMPENSATION
Bodily Injury By Disease Policy
500,000 Limit
Bodily Injury By Disease Each
500,000 Person
GENERAL LIABILITY
General Aggregate -Other than Prod /Completed Operations
2,000,000
CLAIMS MADE
5./31/99
YY2- 191- 419393 -048
Products /Completed Operations Aggregate
1,000,000
RETRO DATE
Bodily Injury and Property Damage Liability Per
1,000,000 Occurrence
Personal and Advertising Injury Per Person/
0 OCCURRENCE
1,000,000 Organization
Other: FIRE LEGAL
Other: MEDICAL PAYMENTS
$50,000
$5,000
AUTOMOBILE
$1,000,000 Each Accident - Single Limit -
LIABILITY
B. I. and P. D. Combined
MX
5/31/99
AS7- 191- 419393 -038
Each Person
0 NON -OWNED
Each Accident or Occurrence
M HIRED
Each Accident or Occurrence
OTHER
UMBRELLA EXCESS
LIABILITY
5/31/99
TH 1- 191- 419393 -027
$3,000,000 Bodily Injury, Property Damage, Pers. Injury
Advertising Injury
$3,000,000 General Aggregate (Other Than Products/Completed
operations 8 Automobile)
$3,000,000 Products/Completed Operations Aggregate Limit
RE Traffic Signals Installation Belt Line Rd. at Airline Dr. TR 98-01
The City of Coppell TX is listed as additional insured as respects GL & Auto
* IF THE CERTIFICATE EXPIRATION DATE IS CONTINUOUS OR EXTENDED TERM, YOU WILL BE NOTIFIED IF COVERAGE IS TERMINATED OR REDUCED
BEFORE THE CERTIFICATE EXPIRATION DATE. HOWEVER, YOU WILL NOT BE NOTIFIED ANNUALLY OF THE CONTINUATION OF COVERAGE.
SPECIAL NOTICE - OHIO: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER,
SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD.
NOTICE OF CANCELLATION: 30 (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS LIBERTY MUTUAL GROUP
ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT
CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL
UNTIL AT LEAST 30 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: _
City of Coppell
CERTIFICATE P O Box 478 PAM PADGETT
HOLDER Coppell, TX 75019 Authorized Representative
8/17/98 BB IRVING
This Certificate is executed by LIBERTY MUTUAL GROUP as respects such insurance as is afforded by Those Companies