~
ACORD'"
DATE IMMJDDfYVVV)
CERTIFICATE OF LIABILITY INSURANCE
~
03/31/2015
THIS CERTIFICATE IS ISSUED AS A MAnER
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 certificato holder is an ADDITIONAL INSURED, 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),
NTA T
PRODUCERWillls
of Texas, Inc.
~~~~~------------------F-AX
c/o 26 Centu~y Blvd
P.O. Box 305191
Nashville, TN
372)05191
[AIC. No, EIIt!: 1.: 87.7-..: ..24 5~73
E-MAIL
78
ADDRESS:certi flea tes\h'l
USA
INSURER@..AFFORD...!-NG
INSURER A :Ame,!lcan
INSUREDMCA Con-rnunications,
525 Northville
Houston,
TX
Inc.
Zur ich
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JH
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NAIC_' __
COVE~AGE
Insurance
INSUR_~!'l-_~_:_~~;:j.calLQ\!...~~_~tee
St
77037
B 8..:-~ li1.:.2
(AlC, No):1.:8
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INSURER F :
CERTIFICATE
COVERAGES
REVISION
NUMBER-W834857
NUMBER'
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LlSTED BElOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLlCY PERIOD
NOTvVlTHSTANDING
ANY REQUIREMENT,
TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT \NITH RESPECT
TO WHICH THIS
INDICATED
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 POL~CI_ES LIMITS SHOWN MAY HAVE BEEN RED~C~_D ~:,PAID_~0~MS
INSR
ADOL SUBR
I,::OLICY EFF
POLICY EXP
LIMITS
l TR
TYPE OF INSURANCE
POLICY NUMBER
MMIODIYYVYIIMMIOOfYYYY'I
1
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7.":::::1-:,';.:::':
L~COMMERCIAL GENERAL LIABILITY
I CLAIMS.MADE @ OCCUR
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y
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~
03/30/2015
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03/30/20l~
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B
HIRED AUTOS
=
I
X
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AUTOS
j
EXCESS
L1AB
CP04.88679905
SCHEOULEO
_ AUTOS
NON.QWNED
AUTOS
~
L1AB
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03 30
/ /2°"
BODilY INJURY (Per acc,denll
1
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AUC4886802-05
C~'''''-M.'OEI
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I
DED
RETENTION 5
WORKERS COMPENSAnON
IANYPROPRIETOR'PARTNER/EXECUTIVE
AND EMPLOYER"
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2,000,000
2,000,000
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BODilY INJURY (Per pl!rsofl)
$
PROPERTY D"MAGE
(p~LaccidenIJ
LIABILITY
OFfiCER/MEMBER EXCLUDED?
jMandalory In NH)
II! ves deswbe under
'Of:SCRIPTION OF OPERATIONS below
YIN
I
0
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I
I 03/30/2016
AGGREGATE
1
X
PER
~IUTE
WC488680005
03/30/2015
1-1ER9)"-
0)/)0/2016
El
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l
E
l,OOO,COO
1,000,000
•
,
,
1.000,000
DISEASE. EA EMPLOYES S
1.000,000
DISEASE. POLICY LIMIT
1,000,000
,
I
I
,
S
E L. EACH ACCIDENT
I
S
•
EACH OCCURREt,CE
03/l0/20"
, 000
I.
I
UMBRELLA
1,000,000
I
LIABILITY
X
,
•
•,
PRODUCTS - COMPlOP AGG_i :
OTHER
~OMOBILE
PERSONAL & ADVINJURY
GENERAL AGGREGATE
IDloc
POLICY DpRO- JECT
l,_~~~
I
lftCH OCCUR;;:ENCE
AMAGE:-TORtNTE1)
PREMISES. (Ea occurrence)
I
I
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORO 101, Additional RelTlolrksSchedule, may bilaUachtld IFmore space Is required)
Stephen
t. AUlltin State
Univerllity
to General
Liability
and AutolllObile
The Gec ••ral [,iability
purchased
by Additional
CERTIFICATE
aDd Autolllo(lbile
Insureds,
its oUicials,
Liability.
[,iability
directors,
policies
ell.ployees,
shall
be Pri.ary
reprellentativell
and volunteerll
and Non_Contributory
HOLDER
with
are
any other
named
all Additional
insurance
in
Insuredll
fore •• tor
with
or which
respect
lllay be
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCelLED
BEFORE
THE EXPIRATION
DATE THEREOF,
NOTICE
WILL BE DELIVERED
IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Stephen
Y. Austin
State
elnployeea,
tepresentatives
1936 North St.
Ila.cogdoc:hes,
TX 7S96J
University,
itll officials,
and volunt •••••::s
directot.
AUTHORIZEDREPRESENTATIVE
@
ACORD 25 (2014101)
The
ACORD
name
and
logo
are
registered
1988-2014
marks
ACORD
of ACORD
SR 10:8816650
CORPORATION.
All rights
BATCH:Batch
reserved.
.:
127789
AGENCY CUSTOMER 10:
lOC#:
_
----------
ADDITIONAL REMARKS SCHEDULE
Page
2
of
2
NAMED INSURED
AGENCY
Willis
of Texas.
Inc.
MCA Communica~ions.
Inc.
525 Northville St.
Houston, TX
77037
POLICY NUMBER
See Page 1
CARRIER
NAIC CODe
See Page 1
See
ADDITIONAL
25
Waiver
applies in
ACORD
EFFECTIVEDATE: See
Page
1
REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER:
Subrogatioll
The Umbrella
1
REMARKS
THIS ADDITIONAL
of
Page
Policy
FORM TITLE: Certificate
favor
of
Owner
with
ot Liability
respect_
to
Insurance
WOrk'H"' CompenBatioD
coveraglllB,
••.• peI'1llitted
by
la•••••
'0110 •••.• FOnD.
101 (2008/01)
@2008ACORDCORPORATION.
The ACORD name and logo are reaistered marks of ACORD
8816650
B~ch _= 127789
w834857
All rights
reserved.