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ST0003-CS080421 .. Valenti Trobec Chandler Inc. 1175 West Long Lake Road Suite 200 Troy, MI 48098 confirm net Insurance Certificate Experts USA Ci ty of Coppel! Dir of Engineering/Public Works Attn: Ken Griffin, P.E. P.O. Box 9478 Coppell, TX 75019 USA This document was brought to you by Valenti Trobec Chandler Inc. via CertificatesNow. If you have questions regarding the content of this document, please contact the Producer/Agent listed on the certificate of insurance at 248-828-3377 or the Named Insured listed on the form. To find out how you can send and receive all of your certificates of insurance either by email, high speed fax or standard mail, email customercare@confirmnet.com. or visit our website at www.confirmnet.com cc: The data included in this notice and in the attached document is confidential to ConfirmNet and the party responsible for bringing you this information. Powered By CertificatesNowl1l ACORQ. CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNY) 04/21/08 PRODUCER 1-248-828-3377 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Valenti Trobec Chandler Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1175 West Long Lake Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 200 Troy, MI 48098 INSURERS AFFORDING COVERAGE Delano Valenti INSURED INSURER A: Zurich American Insurance ComDany Tiseo paving Company, Inc. INSURER B: Zurich American Guarantee Insurance Company P.O. Box 270040 INSURER C: St Paul Travelers Insurance Company Dallas, TX 75227 INSURER D: I INSURER E: 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 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I~~: TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A ~NERAL LIABILITY GL0930734805 11/01/07 11/01/08 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anv one fire) $ 300,000 I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $ 5,000 X Blanket AI PERSONAL & ADV INJURY $ 1,000,000 - ~ Waiver of Subrogation GENERAL AGGREGATE $ 2,000,000 ~'L AGGRGlE LIMIT APnS PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY x~~R;: LOC A ~TOMOBILE LIABILITY BAP591712402 11/01/07 11/01/08 COMBINED SINGLE LIMIT $1,000,000 X ANY AUTO (Ea accident) - - ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) - ~ HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) - X Blanket AI End't PROPERTY DAMAGE - $ X Waiver of Subrogation (Per accident) ==rAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ B EXCESS LIABILITY AUC926299700 11/01/07 11/01/08 EACH OCCURRENCE $ 10,000,000 ~OCCUR D CLAIMS MADE AGGREGATE $ 10,000,000 $ ==i DEDUCTIBLE $ RETENTION $10,000 $ A WORKERS COMPENSATION AND WC930734905 11/01/07 11/01/08 X I T~l6,)lT ;<lI,!f;,1 IOl~- EMPLOYERS' LIABILITY $1,000,000 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 OTHER $ C Leased/Rented Equipment QT660945X2322TLC06 11/01/07 11/01/08 Ded: $1,000 250,000 $ $ DESCRIPTION OF OPERATlONSlLOCATlONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS project: Coppell Road project (from Sandy Lake Road to Cooper Lane) 1ST 00-03 Certificate Holder is Named Additionally Insured Waiver of Subrogation Applies CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Coppell DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN Dir of Engineering/Public Works NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn: Ken Griffin, P.E. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. Box 9478 REPRESENTATIVES. Coppell, TX 75019 AUTHORIZED REPRESENTATIVE ~ 4,J/t.. .p- I USA ACORD 25-S (7/91) mtaylor 8570024 @ ACORD CORPORATION 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 25-5 (7/97) POLICY NUMBER: GL093073480S COMMERCIAL GENERAL LIABILITY CG 25 03 03 97 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT{S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard", and for medical expenses under COVERAGE C regardless of the number of: 8. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products-completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. CG 25 03 03 97 Copyright, Insurance Services Office, Inc., 1996 D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Limits Of Insurance (SECTION III) not otherwise modified by this endorsement shall continue to apply as stipulated. CG 25030397 Copyright, Insurance Services Office, Inc., 1996 Additional Insured - Automatic - Owners, Lessees Or Contractors - Broad Form @ ZURICH Policy No. Eff Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer Add'!. Prem Return Premo $ $ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. WHO IS AN INSURED (Section II) is amended to include as an insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement. B. The insurance provided to additional insureds applies only to "bodily injury", "property damage" or "personal and advertis- ing injury" covered under Section I, Coverage A, BODILY INJURY AND PROPERTY DAMAGE LIABILITY and Coverage B, PERSONAL AND ADVERTISING INJURY LIABILITY, but only if 1. The "bodily injury" or "property damage" results from your negligence; and 2. The "bodily injury", "property damage" or "personal and advertising injury" results directly from: a. Your ongoing operations; oc b. "Your work" completed as included in the "products-completedoperationshazard", performed for the additional insured, which is the subject of the written contract or written agreement. C. However, regardless of the provisions of paragraphs A. and B. above: 1. We will not extend any insurance coverage to any additional insured person or organization: a. That is not provided to you in this policy; or b. That is any broader coverage than you are required to provide to the additional insured person or organization in the written contract or written agreement; and 2. We will not provide Limits of Insurance to any additional insured person or organization that exceed the lower of a. The Limits of Insurance provided to you in this policy; or b. The Limits of Insurance you are required to provide in the written contract or written agreement. D. The insurance provided to the additional insured person or organization does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" that results solely from negligence of the addi- tional insured; or Includes copyrighted material of Insurance Services Office, Inc. with its permission. U-GL-I 175-A CW (9/03) Page 10f2 2. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering or failure to render any professional architectural, engineering or surveying services including: a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and b. Supervisory, inspection, architectural or engineering activities. E. The additional insured must see to it that: I. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim: 2. We receive written notice of a claim or "suit" as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by an- other insurer under which the additional insured also has rights as an insured or additional insured. F. The insurance provided by this endorsement is primary insurance and we will not seek contribution from any other in- surance available to any additional insured person or organization unless the other insurance is provided by a contractor other than you for the same operations and job location. Then we will share with that other insurance by the method de- scribed in paragraph 4.c. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS. Any provisions in this Coverage Part not changed by the terms and conditions of this endorsement continue to apply as writ- ten. U-GL-I 175-A CW (9/03) Page2of2