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COR�® CERTIFICATE OF LIABILITY INSURANCE OP ID BN DATE (MM /DDIYYYY) 07/03/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL im RED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). POLICY NUMBER 6307201X328 (MM /DD/YYYY) 01/15/12 PRODUCER Robertson Ryan & Assoc., Inc. Two Plaza East, Suite 650 330 East Kilbourn Avenue Milwaukee WI 53202 NAME: PRUNE 1C, No): ac, No Exc: ADDRESS: Ro CUSTOMERID #: AMESI -1 INSURER(S) AFFORDING COVERAGE NAIC# Phone:414- 271 -3575 Fax:414- 271 -0196 INSURED INSURERA: THE TRAVELERS INSURANCE CO GENERAL AGGREGATE INSURER B: Alterra America insurance Co. American Signal Corporation ANS Services, LLC David M. Zinggsheim 8600 W. Bradle Rd Milwaukee WI 53224 INSURERC: $ 2000000 INSURER D: INSURER E: INSURER F ncvlclAN tJ11MRf =R• GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT AUTOMOBILE LIABILITY A _ L;UVCKAVC0 VGI\ I IF IVA 1 v THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [K OCCUR INSR X WVD X POLICY NUMBER 6307201X328 (MM /DD/YYYY) 01/15/12 (MM /DD/YYYY) 01/15/13 LIMITS EACH OCCURRENCE $ 1000000 A PREMISES (Ea occurrence) $ 100000 MED EXP (Any one person) $ 5000 PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 PRODUCTS - COMP /OP AGG $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT AUTOMOBILE LIABILITY A COMBINED SINGLE LIMIT (Ea accident) $ $ 1000000 A X ANY AUTO BA5684B944 01/15/12 01/15/13 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ALL OWNED AUTOS PROPERTY DAMAGE (Per accident) $ SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X UMBRELLA LIAB I j( OCCUR X EXCESS LIAB CLAIMS -MADE MAXA3EC50000138 01/15/12 01/15/13 EACH OCCURRENCE $ 6000000 A AGGREGATE $ 6000000 DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIV YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A X UB3205R305 (OTHER STATES) UB3206R744 (WI ONLY) 01/15/12 01/15/12 01/15/13 01/15/13 X H- TORY LIMITS ER A E.L. EACH ACCIDENT :s]500000 0000 E.L DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT 0000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RFP #212 -006. In accordance with contract requirements it is understood and agreed City of San Marcos, TX is named as an additional insured with respects to insureds product. Waiver of Subrogatin is affroded under CGL and Workers Com ensation. Cancellation:Policies in force comply with State of WI Insurance S ?atutes. Subject to policy forms, terms and conditions. UtK I II-It+A 1 C nvl_vCr% SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITYS94 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of San Marcos, Texas 630 East Hopkins San Marcos TX 78666 ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD