|
PA I I/-%%.-•111V1 C.I NI I v
<br /> A DATE(MM/DD/YYY1)
<br /> CERTIFICATE OF LIABILITY INSURANCE 8/14/2017
<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 CONTACT
<br /> NAME:
<br /> Ames&Gough PHONE 703-827-2277 FAX 703-827-2279
<br /> 8300 Greenboro Dr. (A/c�,o„Fr* (A/C.No):
<br /> Suite 980 AI HESS:admin@amesgough.com
<br /> McLean VA 22102 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Continental Casualty Company(CNA) 20443
<br /> INSURED FREEAND-02 INSURER B Hartford Fire Insurance Company A+ 19682
<br /> Freese and Nichols, Inc. INSURER c:Hartford Casualty Insurance Company 29424
<br /> 4055 International Plaza, Suite 200 INSURER D:Trumbull Insurance Company A+(XV) 27120
<br /> Fort Worth TX 76109
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 1448917887 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 /> INSR ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
<br /> B x COMMERCIAL GENERAL LIABILITY 42UUNN16224 10/23/2016 10/23/2017 EACH OCCURRENCE $1,000,000
<br /> DAMAGE TO RENTED
<br /> CLAIMS-MADE X OCCUR PREMISES(Eaoccurrence) $1,000,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY X PECOT- LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER: $
<br /> C AUTOMOBILE LIABILITY 42UENN16305 10/23/2016 10/23/2017 COMBINED aBINED;accident) 41,000,000 LIMIT $1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> AUTOWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> NON-OWNED PROPERTY DAMAGE
<br /> HIRED AUTOS AUTOS (Per accident)
<br /> $
<br /> C X UMBRELLA LIAB X OCCUR 42RHUN15748 10/23/2016 10/23/2017 EACH OCCURRENCE $10,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000
<br /> DED X RETENTION$10,000 $
<br /> D WORKERS COMPENSATION 42WBCU2821 10/23/2016 10/23/2017 X
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> YN
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE NN/A E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> A Professional Liability AEH008214422 10/23/2016 10/23/2017 5,000,000/per claim 10,000,000 aggr
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Uhland Road Project
<br /> The City and its employees,officers,officials, agents and volunteers are included as additional insureds with respects
<br /> to General and Auto Liability. Waiver of Subrogation applies to General,Auto and Workers Compensation as required
<br /> by written contract and allowed by law.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of San Marcos THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Attn: Capital Improvements Department ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 630 East Hopkins
<br /> San Marcos TX 78666
<br /> AUTHORIZED REPR�ATNE
<br /> ©1988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
<br />
|