Chesapeake-CS080627
A CORD", CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDD/YYYY)
6/27/2008
PRODUCER (405)235-6633 FAX: (405)235-6634 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Meyers-Reynolds & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1230 N. Robinson Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Oklahoma City, OK 73154
linda@mrains.cam INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Liberty Mutual Ins. Co.
Chesapeake Operating, Inc. INSURER B: AEGIS Limited
P.O. Box 18496 INSURERc:American Int' 1. Group
Oklahoma City, OK 73154-0496 INSURER 0:
INSURER E:
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 INSURAN;~T~F:~~~~D BY THE POLICIES DESC~~~~I~,EREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
I II MAY 1-ll>.\I~ R~~ ~ rll>.I~AC:
I~~ I~~~ TYPE OF INSURANCE POLICY NUMBER P6>AI{~~ri~6~E Pgj!fll~':'~~N LIMITS
~NERAL LIABILITY $ 1,000,000
X COMMERCIAL GENERAL LIABILITY SELF INSURED ~AMAGE TO RENTED n~"\ $
I CLAIMS MADE 0 OCCUR MED EXP I An" one ~rson\ $
- . ^ "" INJURY $
- r.EN"RAL A""R""ATE $
~'LAGGREnE LIMIT AFlES PER: oo.m, 'I'T" _ ~()MP/()P A"r.: $
POLICY ~~R;: LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
- $
~ ANY AUTO (Ea accident)
A ALL OWNED AUTOS AS1691522861038 7/1/2008 7/1/2009 BODILY INJURY
- (Per person) $
f-- SCHEDULED AUTOS
~ HIRED AUTOS BODILY INJURY $
~ NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
~GE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN "A A~r. 's
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY "A~'" S 6,000,000
o OCCUR [!] CLAIMS MADE AGr.:REr.:ATE $ 6,000,000
$
B g DEDUCTIBLE X0630A1A08 7/1/2008 7/1/2009 $
X O"T""'TI""' e 1 000.000 Is
A WORKERS COMPENSATION AND ALL STATES EXCBPT SBLF X I T~~TflT,!J.-;, I Ol~-
EMPLOYERS' LIABILITY 1,000,000
ANY PROPRIETOR/PARTNERlEXECUTIVE INSURED IN OK & WV E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? WAl-69D-522861-068 6/30/2008 07/1/2009 E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under 1,000,000
C:PE~IAL PRrWISIONC: ""Inw E.L. DISEASE. POLICY LIMIT $
OTHER
C Pollution Liability PLC6207816 7/1/2008 7/1/2009 Each Incident $6,000,000
Aaareaate $6,000,000
DESCRIPTION OF OPERATlONSlLOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
The City of Coppe11, its officials, employees, agents and officers shall be included as Additional Insureds. except
Workers' C~ensation . and shall be extended a waiver of SUbrogation on all coverages as required by written
contract.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Coppell, Texas EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
255 Parkway Blvd. ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
Coppell, TX 75019 FAILURE TO DO SO SHALL IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE
INSURER. ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE 7':J?ML~,~
Mark Bush/MANDY
--- --
ACORD 25 (2001/08)
INS025 (0108).OBa
@ ACORD CORPORATION 1988
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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)
INS025 (0108).OBa
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