ACORD®
I
CERTIFICATE OF LIABILITY INSURANCE
~
DATE (MMIDD/YYYY)
12/1/2015
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 INSURED, the policy( ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain pol icies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
NAME7~' Bet ty Kammerdiener
Bel. l Insur a n ce
r.~.2'tt ~-"· ( 97 21501-4000
fN Nol· (9 72) 58 1 -48 50
I
~~~~~~~ . be ttyk@bellgroup . com
16980 Dallas Parkway#210
INSURER($) AFFORDING COVERAGE
75248
TX
Dallas
NAIC #
:Markel Ins . Co.
INSURER B :De positors Ins . Co .
INSURER c :T e xas Mutual
INSURER A
INSURED
Coyles Pest Control of Longview Inc .
P . O . Box 12409
42587
INSURER D :
INSURER E :
TX
Longview
75607
INSURER F :
CERTIFICATE NUMBER:2015/2016
COVERAGES
#2
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEE N ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDI CATED. NOTWITHSTANDING ANY REQUIREM ENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CE RTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TH E POLICIES DESCRIBED HEREIN IS SU BJECT TO ALL THE TERMS ,
EXCLUSIO NS ANO CONDITIONS OF SUCH POLIC IES. LIMITS SHOWN MAY HAVE BEE N RED UCED BY PAID CLAIMS.
INSR
LTR
~!'.!- ~~::
TYPE OF INSURANCE
POLICY NUMBER
(~~}r\g~,
POLICY EXP
GENERAL LIABILITY
t--
x
t--
A
t--
w
COMMERCIAL GENERAL LIABILITY
D
CLAIMS-MADE
PC P20 02 0894- 0 2
OCCUR
12/1/2015
12/1 / 2016
t--
-
GEN 'L AGGREGATE LIMIT APPLIES PER:
rxi
POLICY
n
n
r.rR-r
-
x
ANY AUTO
ALL OWNED
t - - AUTOS
HIRED AUTOS
-
t--
c
-
-
UMBRELLA LIAB
EXCESS LIAB
$
1 , 000 , 000
PREMISE
uA~uc:0 ~~E~~.'
c:u
occurrence\
$
MED EXP (Anv one cerson\
$
PERSONAL & ADV INJURY
$
100 , 000
5 , 000
1,000,000
GENERAL AGGREGATE
$
PRODUCTS • COMP/OP AGG
$
2,000,000
2,000,000
$
LOC
AUTOMOBILE LIABILITY
B
LIMITS
EACH OCCURRENCE
SCHEDULED
AUTOS
NON-OWNED
AUTOS
~CPBAPD3016953734
1 2/1/201 5
12/1 / 2016
H
l.UM~INt:u SINGLt LIMI I
I E• accidenl\
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accid0<11) $
PROPERTY DAMAGE
I P@r a r.ddAnt l
$
Schedule Mod Factor 1
s
OCCUR
EACH OCCURRENCE
$
CLAIMS-MADE
AGGREGATE
s
I I
RETENTION$
OED
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/M EMBER EXCLUDED?
(Mandatory In NH)
D
1 000 000
$
Il~~JT~J,¥~ I
10,;r~-
E.L. DISEASE - EA EMPLOYEE $
500 000
500 000
E.L. DISEASE • POLICY LIMIT
500 000
E.L. EACH ACCIDENT
N/A
iSBP0 0 0110 2 849
1 /16/2 0 1 6
1/16/2017
~~~~~~~ir~ O~~PERATIONS below
$
$
DESCRIPTION OF OPERATIONS I LO CATIONS I VEHICLES (Attach ACORD 101 , Add itional Remarks Schedule, if more spac e is required)
The General Liability policy i ncludes a blanket automatic Addi tional Insured endorsement that provides
additional insured status to the certifi cate holder only when t here is a written contract between the
named insured and the additional insured t h a t requires such status .
CANCELLATION
CERTIFICATE HOLDER
purchase@sfasu . edu
Stephen F . Austin State University, its
officials, directors, employees,
representatives and volunteers
1936 North Street
75962
Nacogdoches , TX
ACORD 25 (2010/05)
INS025 (201oos 1.0 1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF , NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH TH E POLICY PROVISIONS .
AUTHORIZE D REPRESENTATIVE
Vincent V . Bell/BEK
(_J ~::;tb "& · ~
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