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AC01`R1:> CERTIFICATE OF LIABILITY INSURANCE <br />�. <br />DATE (MM /DD/YYYY) <br />11/21/2013 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />McLaughlin Brunson Insurance Agency, LLP <br />12801 North Central Expressway <br />Suite 1710 <br />CONTACT <br />NAME: Joe A Bryant <br />PHONE FAX <br />A/C No Ext: (214) 503 -1212 A/C No: (214) 503 -8899 <br />A MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />Dallas TX 75243 <br />INSURER A: XL Specialty Insurance Company <br />37885 <br />San Marcos TX 78666 <br />INSURED <br />INSURER B: Travelers Lloyds Ins. Company <br />41262 <br />INSURERC:Travelers Indemnity Company <br />25658 <br />CP &Y, Inc. <br />INSURER D: Travelers Indemnity Co of CT <br />25682 <br />1820 Regal Row <br />INSURER E: Hartford Casualty Insurance Co. <br />29424 <br />Ste 200 <br />Dallas TX 75235 <br />6/1/2013 <br />6/1/2014 <br />MED EXP (Any one person) <br />INSURER F: <br />f%^1100Ar±ce f%I=0T1=1rATG KI11MRFR• rort- Tn 222RI REVISION NumbEK: <br />V V r L-1 \/'L V L_ V <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />IN R <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM /DD/YYYY <br />POLICY EXP <br />MM /DD/YYYY <br />LIMITS <br />630 East Hopkins <br />GENERAL LIABILITY <br />+ � <br />U 0 V <br />San Marcos TX 78666 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGE TORENTED <br />PREMISES Ea occurrence <br />$ 1,000,000 <br />B <br />X COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />PACP1951L895 <br />6/1/2013 <br />6/1/2014 <br />MED EXP (Any one person) <br />$ 10,000 <br />CLAIMS -MADE XX OCCUR <br />Valuable Papers <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />X Contractual Liab <br />$2,245,000 <br />X <br />Severability of Int. <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP /OP AGG <br />$ 2,000,000 <br />$ <br />POLICY X E LOC <br />AUTOMOBILE LIABILITY <br />CMBINED <br />Ea acccidentSINGLE LIMIT <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />D <br />X ANY AUTO <br />Y <br />Y <br />BA3865M855 <br />6/1/2013 <br />6/1/2014 <br />BODILY INJURY (Per accident) <br />$ <br />ALL OWNED SCHEDULED <br />AUTOS NO OWNED <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />HIRED AUTOS AUTOS <br />C <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />Y <br />Y <br />CUP2D349003 <br />6/1/2013 <br />6/1/2014 <br />EACH OCCURRENCE <br />$ 10, 000, 000 <br />AGGREGATE <br />$ 10,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />__ <br />DED RETENTION $ <br />$ <br />E <br />WORKERS COMPENSATION <br />Y <br />46WEZI4881 <br />1/1/2013 <br />1/1/2014 <br />X WC STATU- OTH- <br />TORY LIMIT ER <br />E.L. EACH ACCIDENT <br />$ 500,000 <br />AND EMPLOYERS' LIABILITY Y <br />ANY PROPRIETOR /PARTNER /EXECUTIVE <br />E.L. DISEASE - EA EMPLOYE <br />$ 500, 000 <br />OFFICER /MEMBER EXCLUDED? ❑ <br />(Mandatory in NH) <br />N / A <br />E.L. DISEASE - POLICY LIMIT <br />$ 500,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />A <br />Professional Liability <br />N <br />Y <br />DPR9706855 <br />4/1/2013 <br />4/1/2014 <br />Per Claim/ $ 3,000,000 <br />Annual Aggregate <br />$ <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />The claims made professional liability coverage is the total aggregate limit for all claims <br />presented within the policy period and is subject to a deductible. Thirty day notice of <br />cancellation in favor of the certificate holder on all policies. City of San Marcos, Texas is shown <br />as an additional insured on the general, auto & umbrella liability coverages as required by <br />contract. A waiver of subrogation is shown in favor of the City of San Marcos, Texas on the general, <br />auto & umbrella liability coverages and the workers compensation coverage. Ten (10) day notice <br />of cancellation if canceled due to non - payment of premium. RE: Cottonwood Creek 24" WL - <br />CP &Y Project # SMAR14003.00 <br />AL- PIT L- L^ATL- u^ L n�o f_ANCFI 1 ATInKI <br />�L__rtI FLVr+LL_ LLVL -vL-L� <br />- - - -- - <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />City of San Marcos, Texas <br />Attn: Engineering and Capital Improvements Dept. <br />AUTHORIZED REPRESENTATIVE <br />630 East Hopkins <br />+ � <br />U 0 V <br />San Marcos TX 78666 <br />U 1988 -2ui U ALUKU UUKVUKA I IUN. An ngnis reserveu. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />