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FREEAND -02 MIXON
<br />. ilo R CERTIFICATE OF LIABILITY INSURANCE
<br />�''
<br />DATE 12612D/YYYY)
<br />1 /26/2015
<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(les) 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 Ileu of such endorsement(s).
<br />PRODUCER
<br />Ames & Gough
<br />8300 Greensboro Drive
<br />Suite 980
<br />CONTACT
<br />NAME:
<br />PHONE FAX
<br />At No E:d : (703) 827-2277 ac No : (703) 827 -2279
<br />E- MAIL
<br />ADDRESS: info@amesgough.com
<br />McLean, VA 22102
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC 0
<br />INSURER A: Travelers Lloyds Insurance Company
<br />PACP- 3C749897 (TX)
<br />10/23/2014
<br />INSURED
<br />INSURER B: Charter Oak Fire Insurance Company A+ (XV)
<br />25615
<br />INSURER C: Travelers Indemnity Company
<br />25658
<br />Freese and Nichols, Inc.
<br />INSURER 0: Travelers Casualty & Surety Co. of America A +, XV
<br />31194
<br />4055 International Plaza, Suite 200
<br />Fort Worth, TX 76109
<br />INSURER E: Continental Casualty Company (CNA) A(XV)
<br />20443
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<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 />ILNTRR
<br />TYPE OF INSURANCE
<br />IN SD
<br />POLICY NUMBER
<br />MM/IDD/YYYY
<br />MM/uDD�
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X..� OCCUR
<br />PACP- 3C749897 (TX)
<br />10/23/2014
<br />10123/2015
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />PREMISES Ea occurrence
<br />$ 1,000,000
<br />X
<br />MED EXP (Any one person)
<br />$ 10,000
<br />Contractual Llab.
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GENERAL AGGREGATE
<br />$ 2,000,00
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY I.XmI JECOT- I LOC
<br />X
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Eae.dent
<br />$ 1,000,000
<br />B
<br />X
<br />ANY AUTO
<br />8101179RSIA
<br />1012312014
<br />10/23/2015
<br />BODILY INJURY (Per person)
<br />$
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />X
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREGATE
<br />$ 10,000,00
<br />C
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />CUP- 4C453408
<br />10/2312014
<br />10123/2015
<br />DED X I RETENTION$ 10,000
<br />Is
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY IA YIN
<br />D . ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />'UB-
<br />3974T65A
<br />I
<br />10/2312014
<br />10/23/2015
<br />X PER STATUTE OTH-
<br />ER
<br />E. L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,00
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />E Professional
<br />AEH 008214422
<br />10/2312014
<br />1012312015
<br />Per Claim 5,000,000
<br />E ,Liability
<br />AEH 008214422
<br />10/23/2014
<br />1012312015
<br />Aggregate 10,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
<br />Policy Coverage Continued
<br />Commercial General Liability: All Other States (Occurrence Form)
<br />Policy Number: 680 - 30754140 (AOS)
<br />Insurer: Travelers Indemnity Company of Connecticut
<br />Policy Effective: 10/23/14 1 Policy Expiration: 10/23115
<br />Policy Limits: Equal to General Liability Policy listed above
<br />SEE ATTACHED ACORD 101
<br />CERTIFICATE HOLDER CANCFLLATIAN
<br />ACORD 25 (2014/01)
<br />©1988 -2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of San Marcos
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Attn: Capital Improvements
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />630 E. Hopkins
<br />AUTHORIZED REPRESENTATIVE
<br />San Marcos, TX 78666
<br />ACORD 25 (2014/01)
<br />©1988 -2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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