168473
8
ACORD
DATE (MM/DD/YYYY)
I
CERTIFICATE OF LIABILITY INSURANCE
~
3/2/2016
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 policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
~~~1~cT Christin a Waller
Commercial Lines - (972) 588-6497
FAX No): 855-605-8264
rA~gNJo E•ll ' 972-588-6453
(A/C
E-MAIL
Wells Fargo Insurance Services USA, Inc.
christina
.
waller@wellsfargo
.com
ADDRESS:
5151 Belt Line Road , Suite 200
INSURER(S) AFFORDING COVERAGE
NAIC #
Dallas, TX 75254
15792
INSURER A : Underwriters at Lloyds, London (IL)
INSURED
11000
INSURER B : Sentinel Insurance Co. Ltd
Mooring Recovery Services, Inc.
36056
INSURER C: Navigators Specialty Insurance Company
2110 113th Street
22945
INSURER D: Texas Mutual Insurance Company
Grand Prairie, TX 75050-1240
/.:)
INSURER E: '
I I
#oL'. /
• .1\ /:1
/lou A
• LA.If' \
INSURER F :
\ REVISION NUMBef: See below
CERTIFICATE NUMBER: 10213878
COVERAGES
THIS IS TO CERTIFY THAT THE POLIC IES 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,
EXC LUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS .
INSR
TYPE OF INSURANCE
LIMITS
POLICY NUMBER
LTR
~ ~~~~ ~~;
~~~Mgry~~~ ~~~)"cl%h-~Vv,
X COMMERCIAL GENERAL LIABILITY
1,000,000
EACH
OCCURRENCE
$
PGIARK0259903
03/01/2016 03/01/2017
A I-500,000
CLAIMS-MADE
OCCUR
~~~~~~~?:S~~~r~encel $
Slop Gap Coverage
10,000
MED EXP (Any one person)
$
I
v
\ fflVItJit:lA l....,. IILWt IIIli\ (,{.,0\.l
.
•
7
I--
0
X
0
Conlraclual Liability
I--
=l
GEN'L AGGREGATE LIMIT APPLIES PER:
B
0
D
m?-r
POLICY
OTHER:
AUTOMOBILE LIABILITY
-X
c
-
X
03/01/2016 03/01 /2017
46U ENQT9989
-
ANY AUTO
ALL OWNED
AUTOS
~
X
X HIRED AUTOS
~
X $0 Liability De
-
LOC
SCHEDULED
AUTOS
NON-OWNED
AUTOS
$
2,000,000
Deductible
$
5,000
$
1,000,000
~OMBINED
Ea accident
SINGLE LIMIT
Je~=~~~t?AMAGE
H016EXC7747781C
03/01/2016
03/01 /2017 EACH OCCURRENCE
AGGREGATE
RETENTION $
OED
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
N/A
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
2/1/20 16
TSF0001153271
3/15/20 17
D
Contractors Pollution
Liabili ty
$
$
$
I
I I
OTHX PER
STATUTE
ER
E L. EACH ACCIDENT
$
5,000,000
$
5,000,000
$
$
E.L. DISEASE - EA EMPLOYEE S
~~~~~f~~~ o#oPERATIONS below
A
PRODUCTS - COMP/OP AGG
BODILY INJURY (Per accidenl)
I I
D
1,000,000
2,000,000
$
OCCUR
CLAI MS-MADE
EXCESS LIAB
$
$
BODILY INJURY (Per person )
M
UMBRELLA LIAS
PERSONAL & AOV INJURY
GENERAL AGGREGATE
E.L. DISEASE - POLICY LIMIT $
03/0 1/2016 03/0112017 3,000,000 Each Claim
10,000 Ded Per Claim
PG IARK0259903
1,000,000
1,000,000
1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER
Stephen F. Austin State University, its officials, directors , employees, repre
1936 North St.
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Nacogdoches , TX 75962
AUTHORIZED REPRESENTATIVE
9(~-
I
The ACORD name and logo are reg1stered marks of ACORD
ACORD 25 (2014/01)
(This certificate replaces c:eni11catY 10209663 issued on 31112016)
© 1988-2014 ACORD CORPORATION . All r1ghts reserved.