DATE(MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
10/23/2015
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 tNSURER(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 policies may require an endorsement A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
CONTACT
NAME;
PRODUCER
MARSH RISK & INSURANCE SERVICES
345 CAUFORNIA STREET. SUITE 1300
CAUFORNiA UCENSE NO.0437153
PHONE
FAX
IMC. No. Extl:
E-MAIL
AnDRES.A;
IMC. NoJ:
SAN FRANCISCO. CA 94104
INSURERIS)AFFORDING COVERAGE
Attn;[ninavatirado(g!marsh.com /-^1415 7438234
INSURER A:
101830377-STND-GAW-15-16
INSURED
NAICd
24147
Republic Insurance Co
INSURER B:
AGILENT TECHNOLOGIES, INC.
GLOBAL RISK MANAGEMENT
5301 STEVENS CREEK BLVD.
INSURER C:
INSURER D:
Mail Stop: 1A-IR
SANTA CLARA. CA 95051
INSURER E:
INSURERF:
COVERAGES
CERTIFICATE NUMBER:
SEA-003001153-02
REVISION NUMBER:2
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.
ADDL SUBR
INSR
LTR
TYPE OF INSURANCE
POUCY EFF
POUCY NUMBER
lUSQ.mo.
MWZY305618
COMMERCIAL GENERAL LIABILITY
fMM/DP/YYYYI
POUCY EXP
(MIWPD/YYYY1
11/01/2015
11/01/2016
UMITS
5,000.000
EACH OCCURRENCE
DAMAGE TO RENTED
CLAIMS-MAOE
OCCUR
GEN L AGGREGATE LIMIT APPUES PER:
^POLICY I
I S'ligF I
MED EXP(Any one person)
5.000.000
5.000
PERSONAL & ADV INJURY
5,000.000
GENERAL AGGREGATE
5,000.000
PRODUCTS ■ COMP/OP AGO
5.000,000
PREMISES(Ea occurrencel
I LOG
OTHER:
MVVrB305525
AUTOMOBILE UA.BiUTY
11/01/2015
11/01/2016
COMBINED SINGLE UMIT-
lEa aceidenti
ALL OWNED
AUTOS
SCHEDULED
AUTOS
NON-OWNED
PROPERTY DAMAGE
HIRED AUTOS
AUTOS
{Per acddentl
UMBRELLA LIAB
EXCESS UAB
DED
5,000,000
BODILY INJURY(Per person)
ANY AUTO
BODILY INJURY(Per accident)
OCCUR
EACH OCCURRENCE
CLAIMS-MAOE
AGGREGATE
RETENTIONS
WORKERS COMPENSATION
AND EMPLOYERS'LIABIUTY
ANY PROPRIETOR/PARTNERCXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NK)
If yes. describe under
Y/N
H
MWC30561900(CA)
11/01/2015
11/01/2016
MWC30561700(AOS)
11/01/2015
11/01/2016
N/A
DESCRIPTION OF OPERATIONS below
V
PER
STATUTE
OTH
ER
E.L EACH ACCIDENT
5,000,000
E.L. DISEASE•EA EMPLOYEE
5,000,000
E.L DISEASE - POUCY UMIT
5,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ACCRD101,Additional Remarks Schedule, may be attached if more space la required)
Re: Quote(#3(XX)057355)•repair a pece of eqiupment for the College of Forestry
Evidence of Insurance
CERTIFICATE HOLDER
Stephen F.Austin State University
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
FO Box 13030
THE EXPIRATION
NacDgdodies,TX 75962
ACCORDANCE WITH THE POUCY PROVISIONS.
DATE THEREOF, NOTICE WILL BE DELIVERED
IN
AUTHORIZED REPRESENTATIVE
of Marsh Risk & Insurance Services
Minerva Tirade
1
ACORD 25(2014/01)
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