ST9802-CS 990902INSURED
McMahon Contracting, Inc.
P. O. Box 153086
Irving, Texas 75015 -3086
DATE (MMIDD/YY)
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 t
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANY
A Travelers Lloyds Insurance Co.
COMPANY
B Travelers Indemnity of Connect
COMPANY
C
COMPANY
D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
T
TYPE OF INSURANCE
POLICY NUMBER
I POLICY EFFECTIVE
DATE (MMOD/YY)
POLICY EXPIRATION
DATE (MWDD/YY)
LIMITS
A
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ® OCCUR
OWNER'S & CONTRACTOR'S PROT
Per -Pro! Aga
Contractual
OT- CO- 209D212- 5- TLC-99
09/30/99
0 9/ 3 0/ 0 0
GENERAL AGGREGATE
S
BODILY INJURY
(Per accident)
PRODUCTS - COMP/OP AGG
$ ,2
$
PERSONAL & ADV INJURY
$
DTSM- CUP- 209D214- 9- TCT -99
EACH OCCURRENCE
$ 1
X
FIRE DAMAGE (Any one fire)
$
MED EXP (Any one person)
1 $ 5_nm
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
DL- CAP- 209D211 -3-99
09/30/99
0 9/ 3 0/ 0 0
COMBINED SINGLE LIMIT
$ 1,000,000
OTHER THAN AUTO ONLY:
BODILY INJURY
(Per person)
$
EACH ACCIDENT
$
BODILY INJURY
(Per accident)
$
AGGREGATE
$
PROPERTY DAMAGE
$
DESCRIPTION OF OPERATIONSA .00ATKMIS/VEHICLES/SPECIAL ITEMS
RE:Dividend Drive Drainage,Water,Sewer & Paving Improvements (PID) Bid
#9- 0399 -01 /Certificate holder is an additional insured with regard to
liability as required by written contract /Waiver of subrogation in
favor of certificate holder as required by written contract
City of Coppell
ATTN: Ken Griffin /Asst. City Mgr.
P.O. Box 478
Coppell TX 75019
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SU TICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND U P1 COMPANY, ITS /T( &m o* REPRESENTATIVES.
AUTHORIZED REPRESEN
GARAGE
LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN AUTO ONLY:
EACH ACCIDENT
$
AGGREGATE
$
B
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
DTSM- CUP- 209D214- 9- TCT -99
09/30/99
0 9/ 3 0/ 0 0
EACH OCCURRE _
$
AGGREGATE
$ 2
$
B
WORKERS COMPENSATION AND
WORKERS LIA BILITY
THE PROPRIETOR/ �( INCL
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL
DTE- UB- 2ND213 -7 -99
09/30/99
WC STATU- I SM-
T ORY LIMITS ER
EL EACH ACCIDENT
$
EL DISEASE - POLICY LIMIT
$
EL DISEASE - EA EMPLOYEE 1
$
OTHER
DESCRIPTION OF OPERATIONSA .00ATKMIS/VEHICLES/SPECIAL ITEMS
RE:Dividend Drive Drainage,Water,Sewer & Paving Improvements (PID) Bid
#9- 0399 -01 /Certificate holder is an additional insured with regard to
liability as required by written contract /Waiver of subrogation in
favor of certificate holder as required by written contract
City of Coppell
ATTN: Ken Griffin /Asst. City Mgr.
P.O. Box 478
Coppell TX 75019
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SU TICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND U P1 COMPANY, ITS /T( &m o* REPRESENTATIVES.
AUTHORIZED REPRESEN