Laserfiche WebLink
'`� ° CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM /DD/YYYY) <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />5/7/2015 <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(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 />Upstream Brokers <br />2020 North Memorial Way <br />NAMEACT Michelle Serrell <br />PHONE (713) 869 -3100 FAX <br />(713)869 -9920 <br />-MAIL ,ADDRESS: <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />Houston TX 77007 <br />INSURERA Llc ds Of London <br />INSURED <br />INSURER B:Liberty Mutual Insurance CO <br />23043 <br />Espey Consultants, Inc. dba RPS <br />INSURER C.Liberty Mutual Fire Ins Co <br />23035 <br />411 N. Sam Houston Pkwy <br />INSURERDACE American Insurance Co <br />22667 <br />Spite 400 <br />INSURER E: <br />Houston TX 77060 <br />INSURER F: <br />$ 1,000,000 <br />COVERAGES CERTIFICATE NUMBER- CL14102905013 RFVICInN MI IMRFR• <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 />POLICY NUMBER <br />POLICY EFF <br />MM /DD/YYYY <br />POLICY EXP <br />MM /DD/YYYY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />PREMISES Ea occurrence <br />$ 1,000,000 <br />MED EXP (Any one person) <br />$ 10,000 <br />A <br />CLAIMS -MADE FX__1 OCCUR <br />SM0255314 <br />1/5/2014 <br />1/5/2015 <br />X Professional Liab $1MM <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />X <br />Contr Pollution $1241 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP /OPAGG <br />$ 2,000,000 <br />X POLICY 7 PRO LOC <br />$ <br />AUTOMOBILE <br />LIABILITY <br />BINED(SINGLE LIMIT <br />Ea <br />1 000 000 <br />X <br />BODILY INJURY (Per person) <br />$ <br />B <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />6- 641 - 439037 -024 <br />1/5/2014 <br />1/5/2015 <br />BODILY INJURY Per accident <br />( ) <br />$ <br />HIRED AUTOS X NON -OWNED <br />AUTOS <br />X <br />PROP <br />PROPERTY DAMAGE <br />$ <br />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 11, 000, 000 <br />X <br />AGGREGATE <br />$ 11, 000, 000 <br />A <br />EXCESS LIAB <br />CLAIMS -MADE <br />L0255414 <br />DED I I RETENTION <br />$ <br />1/5/2014 <br />1/5/2015 <br />C <br />WORKERS COMPENSATION <br />WC STATU- OTH- <br />AND EMPLOYERS' LIABILITY Y / N <br />X I <br />I TORY LIMITS FR <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />N/A <br />E.L. DISEASE - EA EMPLOYE <br />$ 11000,000 <br />(Mandatory In NH) <br />C- 641 - 439037 -014 <br />1/5/2014 <br />1/5/2015 <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS below <br />D <br />Foreign Package <br />HFD38248819 <br />1/5/2014 <br />1/5/2015 <br />See Notes <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) <br />Project - San Marcos Water Reuse System Expansion Project <br />City of San Marcos and Texas Water Development Board are included as Additional Insured(s) as required <br />under written contract on General Liability and Auto Liability. Waiver of Subrogation in favor of City <br />of San Marcos and Texas Water Development Board as required under written contract and permitted by law. <br />City of San Marcos <br />Attn: Engineering & Capital Improvements <br />630 E. Hopkins <br />San Marcos, TX 78666 <br />wsn2.ri r9mnn.m m <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 />AUTHORIZED REPRESENTATIVE <br />Fontaine /MLS <br />v 1VSS -ZU1U ACURD CORPORATION. All rights reserved. <br />Tha Annon nnma nnA Inns era ranicfararl mnr4a of Annon <br />