Sandy Lk Cross 2R-CS080730
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ACORD~ CERTIFICA TE OF LIABILITY INSURANCE OP 10 O~ DATE (MMIDDIYYYY) ~
DAVIS-F 07/30/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Frost Insurance - Dallas HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
5710 LBJ Freeway Ste 460 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Dallas TX 75240
Phone: 214-515-4145 Fax:214-515-4199 INSURERS AFFORDING COVERAGE NAlCfI.
INSURED INSURER A: Bi tuminou8 Inauranc. company
INSURER B: Texas Mutual Insurance Co.
Davis Excavation Inc INSURER c:
POBox 1169 INSURER D:
Van Alstyne TX 75495 INSURER E:
S oJ6-
01
Z~
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.
LTR NSRI TYPE OF INSURANCE POLICY NUMBER PD~~iM~fJ8Jv~ P8k~Y,i"J'J,Ro'~<r LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
-
A ~ COMMERCIAL GENERAL LIABILITY CLP3255674 07/31/08 07/31/09 ~~~~~~s (Ea occurence) $ 100,000
- ~ CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5,000
PERSONAL & ADV INJURY $1,000,000
-
GENERAL AGGREGATE $ 2,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COM PlOP AGG $ 2,000,000
I POLICY /il :;~gT n LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
-
A ~ ANY AUTO CAP3523671 07/31/08 07/31/09 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS (Per accident)
-
PROPERTY DAMAGE $
(Per eccident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $5,000,000
A ~ OCCUR o CLAIMS MADE CUP2583198 07/31/08 07/31/09 AGGREGATE $ 5,000,000
$
~ DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND X ITORY L1MITSl IUJ~-
B EMPLOYERS' LIABILITY 0952057 07/31/08 07/31/09 E.L. EACH ACCIDENT $ 1,000,000
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under E.L. DISEASE - POLICY LIMIT $1,000,000
SPECIAL PROVISIONS below
OTHER
A Equipment Floater CLP3255674 07/31/08 07/31/09 Per Item $200,000
Leased/Rented Deductibl $1,000
DESCRIPTION OF OPERATIONS I LOCA TIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
City of Cappel!
Attn: Engineering Department
P.O. Box 9478
Coppell TX 75019
CANCELLATION
C I COP- 3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
J~~~'E
@ACORD CORPORATION 1988
CERTIFICATE HOLDER
ACORD 25 (2001/08)