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<br />03/07/2006 09:33 6027789880 <br />"U''''U",VVD IV."tl ~1I/1 1I1,nq,::I::lb4BO <br /> <br />SUNWESTINSURANCE <br />Naughton Insurance <br /> <br />PAGE 02/02 <br /> <br />~ 002/002 <br /> <br />TXOOT Form 1560 (Flev 041200l) Previous edillOnll Of this form may not be Ulied. <br />Page 1 of2 <br /> <br />I <br /> <br />Texas Deparbnent of Transportation (TxDOT) <br />CERTIFICATE OF INSURANCE <br />Prior to 1M beginning tlfWOTk, tN! Con1l'aaor shall obtain Ihe mitVrnum Nurance aNIl!1\dOl1lllmenls ~ed. Only In8 TxDOT ~ bf ilsul'llf1te fDIm i& <br />acceptlltHe Be proof" D' Insurance for Cfepam,m eonb'acll, Agenl5 IItIouId CC/TlPI9l8 !he fomt PfUVlding al r8lIuested inIomlaticn lhlll'llll!tllr fax or maP 1IIIt form <br />dIrecIly 10 !he IdclmlS islBel on !he bllok err tnis rorm, CopIea of B1d1:i1ll.,,;nlS nsled below I~ not reqlJlrecl as attllChnlems to Ihi!; alrtl1lcate. <br />InQured: Rall v Partn~~~ Ine. d/h / a Greatral!1! <br />SlreetlMOliling Address: F ~ O. Box 887 <br />CltylStateJZip: San Mare-olil ~ TX 78667-088' <br />Phone Number: Area CodeL800 '989-7223 <br />WORKERS' COMPENSATION INSURANCE COVERAGE: <br />I!:ndorsed with a Walvar of Sub atien ," fsvcr or TlI'DOT. <br />CarrIer Name: <br />AcldNIS: <br />of Insurance EtreDti_ Date LkniIs of Lllbll . <br /> <br />Worker.l' CampenslIUon <br /> <br /> <br /> <br />No! Leae Thllll: SlaMoty ~ T eJQI5 <br /> <br />COMPREHENSIVE GENERAl- LIABR.rrv ,NSUAANCE: <br /> <br />I <br /> <br />Enc:lOnled with T'/IIDOT 018 Addltlcn\,r Insured IInd with a Waiver oL~ub",aation In fa~r cfTxOOT. <br />CArrier Namll: St. Paul Surnluc lin~~ Ins. Co. CarrlE!r Phono f: 401-433-4000 <br />Addreee: 385 Washington St:t'eet Clt;v. State. Zip: St. Paul. :HN 55102 <br />Type or InflUl':IIhce: Policy Number: EHftctlve Dllte: Ellplratlon Date; Limits or Uablllty; <br />ComprMenlii,,- ~neral Not Leu Tllan: <br />~biJty In!lutance $lJOOO:oOOO <br />Bod... Injury ~II;IICII ell'*' OCCUfrence <br />Proptlrty Damlltge $ 100,000 eacn OcwrrenCII <br />OR S 100.000 for aggregate <br />Comme~1 General LCOO210662 6/14/2005 6/14/2006 OR <br />liabllltv Insuran~ S 6oo.ooD I;Qmbl~., single Ilmil <br /> <br />COMPREHENSIVE AUTOMOBIL! UABILrrY INSURANCE: <br /> <br />E"dOl'$ed with TxDOi as AddltlonBllnsured and with a WI!IWT of Sllbroaa- 'on In Favor ofTxDOT. <br />Cal'TlerName: St. Paul Fir~ and Marine Ins. Co. C:lrrier Phor'te #: 401-433-4000 <br />Addn!55: Cltyl Sate. Zip: St. Paul. :HN 55102 <br />Type &:If In9UrllnGll: f'glicy Number.: Efleeti'fe Date: ~piratlon DAte: Limits of liability: <br />Cornllrl!l'lenshlC! AulomobllE! CA00201239 6/14/2005 6/14/2006 <br />WaZllllly lraeUl1Inge. OR Tllxal Nt!! Lur. Than~ <br />Bueirlelili A~omClblle Policy ~ ell'*' perllll(l <br />Bodily Injury !lXIIIXb eitli'l O~ <br />Prop@rtY Damllge '.~ ~~rrrence <br /> <br /> <br /> <br />&01-4 -4000 <br /> <br />Limits of l..iablllty: <br />.$4,000,000 <br />City, State Zip Code <br />Pro~idenee. RX 02940 <br />b/ ~ fer- <br />Date' <br /> <br />Umbrenll Policy <br /> <br />IXG-394241A 6 14/2005 <br />Address <br />P.O. Box <br /> <br />Agency Name <br />Naughton InsuraneQ~ Iue. <br /> <br /> <br />Area Code ( 401 ) 433-4000 <br />Authorized Agent's Phone Number <br /> <br />I <br /> <br />Tnll CertmCl:lle or Insurance nelll'll!r alrlrl1l81lftly nor Nega~\I8I)' amendll, Illltendll, llr alllll3 the coverCllil1! BffordlCl by !he above inAul':\l'Iea Plllleies jS!jlUllu:l <br />t1)' Ihe named InSllI'BRCa campan)'. CIlnt;ellallon of lhl! insurance Ilollcles Inall nol be made urnIl THIRTY gAYS AFTER 1tle lIgent Ilt lhe InIlUl'lJI1t:e <br />company hlUl sent wrltlen nOlIce by cenlfllld mall to IIlIl contractor and tht\ Texal!l Oepartmllnt 01 Trllnllportadon, <br /> <br />iHIS IS TO CERTIFY to thII Texas Oelllll1mslll or Tranlportation 'cling on b@half o' the stam of Texas Ihllt !he IntUranal policie5 Illlrnl!d meet sU the <br />~Q1J1rwn8JI1s sllpufllllld am S\lch pOI~I aJ'1!I In full fgrce md lltrect. "rh~ tll/lTf t& '-111 by ~miJe mllCf1ins (i'rJJI), the sMder alMp~ rhe ~ument <br />~/IIV~ by 1:;.007 as a r:JUP/icsl8 Dl/glnaJ ant! adopt, IfJ9 sIgtlllrJfeprodi.lcl!Jd by'''S riC8/v/nR fil~ m.chille as lh~ sew",'to grig/mJ/ algmltu,., <br /> <br />Tne Texas Depllr1metl1 of TranegortaUDn mainlalnll the Information cQlrSCled tnroLlgh !hIs farm. Wlttl few e~tionl, you are e"killed IIf'I rsquelt to be <br />infoJTlled Ilbauf ths informltlon thaI wa cDned ;bout )'OU. Unaer lIE<;Uons 652.021 -no 552,023 ~ t/'lll Texas Gll'Iemrnenl CDde. you .190 .re entlllecl LD <br />leCl4li\le and l'tllliew thlll infonnatlon. Under section 659.004 Of the Go\lE!mmenl Code, )IOU are BIIO 81\IJnld to ha~ us g;Jr1eclll'lftllTTl.~(l" al:ioU1 \/01.1 ltllll <br />ill: incorrle!. <br />