ST9301-CS060629
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'.MARSH'
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CERl"IFICjlf'fEc>FII,StJ_GS< ..
CERTIFICATE NUMBER
LOS-000397126-16
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
POLICY. THIS CERTIFICATE OOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES DESCRIBED HEREIN.
PRODUCER
Marsh Risk & Insurance Services
license#: 0437153
777 S. Figueroa Street
Los Angeles, CA 90017-5822
Atln: Reginald Sutton (213) 346-5257 Fax (213) 346-5886
COMPANIES AFFORDING COVERAGE
8408 -Renew-CAS-06/07
DALLA TX
JCI
GYOU 07_05
I COMPANY
N N/A
COMPANY
B ACE American Insurance Company
COMPANY
C N/A
INSURED
JACOBS CIVil INC.
6688 N. CENTRAL EXPRESSWAY
SUITE 400
DALLAS, TX 75206
COMPANY
D
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
co
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DDIYY) DATE (MMlDDIYY)
LIMITS
THE PROPRIET'
PARTNERS/EXI ~UTIVE
OFFICERS ARE:
R
INCL
, EXCL
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
PERSONAL & ADV INJURY $
EACH OCCURRENCE $
$
MED EXP $
COMBINED SINGLE LIMIT $
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EACH OCCURRENCE
AGGREGATE
250,000
250,000
250,000
250,000
250,000
GENERAL LIABILITY
B X COMMERCIAL GENERAL LIABILITY H DO G20592916
CLAIMS MADE [8] OCCUR
OWNER'S & CONTRACTOR'S PROT
X TUAL LIABILITY
07/01/06
07/01/07
AUTOMOBILE lIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
ANY AUTO
EXCESS LIABILITY
UMBRELILA FORM
OTHER THAN UMBRELILA FORM
WOR ArlON AN
EMPLOYERS" L1llB1ur....
EL DISEASE-POlICY LIMIT
EL DISEASE-EACH EMPLOYEE $
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICUESlSPECIAL ITEMS
PROJECT NO. C3X35200. SANDY LAKE ROAD, KIMBEL KOURT TO EASTERN CITY LIMITS.
*THE TERMS, CONDITIONS, AND LIMITS PROVIDED UNDER THIS CERTIFICATE OF INSURANCE WILL NOT EXCEED OR BROADEN IN ANY WAY
THE TERMS, CONDITIONS, AND LIMITS AGREED TO UNDER THE APPLICABLE CONTRACT.*
SHOULD ANY OF THE POUCIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
THE INSURER AFFORDING COVERAGE W1U ENDEAVOR TO MAIL ---3Q DAYS WRITTEN NOTICE TO THE
CITY OF COPPElL, TEXAS
255 PARKWAY
P.O. BOX 9478
COPPELL, TX 75019
CERTIFICATE HOLDER NAMED HEREI\I, BUT FAIWRE TO MAIL SUCH NOTICE SHALL NPOSE NO OBUGATION OR
UABILrTY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE. rrs AGENTS OR REPRESENTATNES. OR THE
ISSUER OF THIS CERTIFICATE.
MARSH USA INC.
BY: Charles M. Beckmann &/.-..c" .'$ ~....t