TR0301-CS070314
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ACORQM CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY)
03/14/2007
PRODUCER (817)868-7979 FAX (817)267-5223 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brooke Agency Services Company LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 700937 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Dal las, TX 75370
INSURERS AFFORDING COVERAGE NAIC#
INSURED Roadway So I ut ions Inc INSURER A: Tudor Insurance Company
2524 N IH 35 East INSURER 8: Unitrin Insurance Company
Carrollton, TX 75006 INSURER C Texas Mutual Insurance
INSURER D
INSURER E
~3
COVERAGES
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 MAYBE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
l!'l~ ~~~! TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY GLO 0005125 03/15/2007 03/15/2008 EACH OCCURRENCE $ 1,000,000
I---
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50,000
e-- tJ CLAIMS MADE 0 OCCUR
MED EXP (Anyone person) $ EXCLUDED
I--
A X Blanket Add' I Ins PERSONAL & ADV INJURY $ 1 , 000 , 000
I---
X Blanket Wa i ver GENERAL AGGREGATE $ 2,000,000
I---
GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS - COMP/OP AGG $ 2,000,000
h POLICY [Xl j~g n LOC
AUTOMOBILE LIABILITY CAP0013035 01 03/15/2007 03/15/2008 COMBINED SINGLE LIMIT
I--- $
~ ANY AUTO (Ea accident) 1,000,000
ALL OWNED AUTOS BODILY INJURY
I-- $
SCHEDULED AUTOS (Per person)
B I---
X HIRED AUTOS BODILY INJURY
I--- (Per accident) $
X NON-OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $
=:J OCCUR 0 CLAIMS MADE AGGREGATE $
$
=1 DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND TSFOOOl166385 03/07/2007 03/07/2008 X I T~9.~T~.~~~ I IOJ~-
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000
C ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEI $ 1,000,000
If yes, Qescribe under 1,000,000
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
f<THE;R CAP0013035 01 03/15/2007 03/15/2008 Leased/Rented Equipment
B qUlpment Floater $50,000
$1,000 Deductible
DESCRIPTION OF OPERA noNS I LOCATIONS J VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICA TE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSU~ER WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
City of Coppell BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
255 Parkway Blvd, OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
Coppe I I , TX 75019 AUTHORIZED REPRESENTATIVE ~~
Roaer Cunninaham/ROXX
ACORD 25 (2001108) FAX:
(972)245-2299
@ACORDCORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the pOlicy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the pOlicies listed thereon.
ACORD 25 (2001/08)