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57 <br /> lay 25 12 01 : 56p Employee Pro 9042780558 p , 1 <br /> DATE IMMID0IYYYY) <br /> 1, <br /> CERTIFICATE OF LIABILITY INSURANCE , S �Tr <br /> ER'T � ` � � ° ` F" <br /> 40 RIGHTS UPON T-H <br /> THIS CERTIFICATE <br /> CATE DOES NOT AFDFIRMA7IVELY OR NEGATIVELY AMEND , EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW . <br /> THIS CERTIFICATE I <br /> THIS IFICA OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S ), AUTHORIZED REPRESENTATIVE <br /> OR PRODUCE AND THE CERTIFICATE HOLDER, III I SEEN <br /> III <br /> IMPORTANT: If the cerficate holder is Missan ADDITIONAL INSURED , the policy( ies) must be endorsed . if SUBROGATION IS WAIVED , <br /> subject to the terms and conditions of the policy , certain policies may require an endorsements a statement on this certificate <br /> r ement s - <br /> ' s ( 1 <br /> does not confer rights to the certificate holder in lieu of such endoc <br /> CoN7ACT NAME: <br /> PRODUCER Fax lxc. hoc (972 ) 404-0380 <br /> wWW Iaa, No, EW: (800) 728 .0623 <br /> Highpoint Risk Services LLCaaa aooeess: <br /> 5510 LBJ Freeway , Suits e <br /> 1200 INSURERS AFFORDING COVERAGE NAICf <br /> Dallas , TX 75240 <br /> INSURER A Coapa n _ o� F _ npe [ [y and Cas •ialty Iniura �cc Ccnpan,' <br /> INSURED: PPS 1 / c / f : INSURER B: ION <br /> T :dG1" I 'C Rri �� INSURER C . <br /> CONTR-4CTTNG , INC - <br /> 260 Sh 0 ;.7 DIXIE HWY SUITE i06 URER <br /> i'G7. � BCr.r'H , FT. 22562 INSURER E : <br /> U6 - 4 -' 34 Fa ;: : O - INSURER <br /> wsssssIs <br /> COVERAGESIIIII U REVISION NUMBER: <br /> CERTIFICATE NUMBER: AC12 - 18 , 00165 - 111 ON <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE IN5URED NAME ABOVE FOR THE POLICY PERIOD INDICATED . <br /> CERTIFICATEICH THIS POLICIES ISSUED O <br /> 3 ANY � LCONTRACT <br /> DOCUMENT <br /> 8S AND CONDITIONS OF SUCH . LIM$TS SHOWN <br /> PERTAIN , THE INSURANCE ES DESCRIBED CRNS SUBJECT TO ALL TERMS, EXCLUSION <br /> ADDL UBR POLICY NUMBER POLICY EFF POLICY EXP pticrQ BY PAID LIMITS <br /> NRR TYPE OF INSURANCE INSH DATE MMIDOIYY DATE M DD <br /> EACH OCCURRENCE 5 <br /> GENERAL LIABILITY .aAce o EA D — <br /> 5 <br /> COMMERCIAL GENERAL LIABILITY PREMISES (Ea xourtMul <br /> 5 <br /> CLAIMS MADE F1 OCCUR ❑ F1 MED EXP (Anyone person) <br /> PERSONAL & ADV INJURY 5 <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 5 <br /> S <br /> POLICY JECT LOC <br /> AUTOM0131LE LLA61LITY COMBINED SINGLE LIMIT 5 <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY (Per Person) $ <br /> ALL OWNED AUTOS ❑ ❑ 5 <br /> BODILY INURY (Per accident) <br /> SCHEDULED AUTOS <br /> PROPERTY DAMAGE 5 <br /> HIRED AUTOS (Per accident) <br /> NON-OWNED AUTOS $ <br /> 5 <br /> UMBRELLA UABC(AtMS-MADE EACH OCCURRENCE 5 <br /> EXCESS LIAR HOCCURAGGREGATE 5 <br /> DEDUCTIBLE 5 <br /> S <br /> RETENTION 5 <br /> WORKERS COMPENSATION AND X wRSDTH. <br /> TORY L "TWAYS <br /> EMPLOYERS ' LIABILITY YIIN $ 1000000 <br /> ANY PROPERIETORIEXECUTIVE N E.L . EACH ACCIDENT <br /> OFFICER . MEMBER EXCLUDED? NIA DPE00120440160 01 / 01 / 2012 01 / 01 / 2013 E . L. DISEASE - EA EMPLOYEE S 1000000 <br /> A (Mand dory In NN) <br /> IT yes, describe under IT E. L . DISEASE - POLICY UMS 1000000 <br /> SPECIAL PROVISION below <br /> 11 D <br /> DESCRIPTION OF OPERATIONSILOCATIONSeVEHICLES(Atteched AGORDID7 , Additional Remarks Schedule , it more space is required <br /> I . This certif }' cate - m i s in effec ro ided the client s ccount is In gqcod standin <br /> w PPS . <br /> Cov ra e is - aa L p ov ede � oor env e p oV Q Yor which the riienaL. <br /> Cg p� t r Q L wa �Lo I? ?5 • <br /> Apglele Cp U a tS�ie m to e5 - o PS leased to T ? MQTHY ROSE CUNIRA� TC ` , �I � C� . , � <br /> e eve <br /> '0 ' ft 011 - ZF In � uredVI a1Y4raed 4 kers Compensat op 6 Em loye � s is ility as a <br /> cn - employer under <br /> the policy for employeeseasetl Yrom P � S . i . RE : s10 Roa�way Improvement <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF , NOTICE WILL BE DELIVERED IN ACCORDANCE WITH <br /> I tl f> : .yN RT 'dER COUNTY <br /> PURCHA. STNG DEPARTMENT THE POLICY PROVISIONS . <br /> 185C " 71: h STREET <br /> '•' ERO iEACI ! , FT x960 AUTHORIZED REPRESENTATIVE <br /> ACORD 25 ( 2010/05) © 1989 -20100 ACORD CORPORATION . All right reserved <br />