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ACORD"
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CERTIFICATE OF LIABILITY INSURANCE
n: fUUJr\r\Nvv",
.A.
6/1/2015
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(SI, 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 endorsementfs-).
CONTACT
NAME:
PRODUCER
BancorpSouth Insurance Services, Inc.-NAC
Joe Max Greenllnsurance Concepts
3310 N. University Drive
Nacogdoches TX 75965-
~D
Lorene Pless
•..Ext}.
936-564-0221
~
....Na).
J.:DAJ~5S.lorene.pless@bxsi.com
INSURERISIAFFOROING
NAIC It
COVERAGE
INSURERA:America First Lloyds Insurance Co
NACOSHE-01
Nacogdoches Sheet Metal & Plumbing, LTD
dba Nacogdoches AlC & Heating; Attn: Jason Bradfor
P.O. Box 631277
Nacogdoches TX 75963-1277
INSURED
INSURER
B
,Netherlands
INSURER
C
:America
11526
Insurance Comoanv
First Insurance
24171
Company
12696
INSURER 0:
INSURER
E:
INSURER F:
CERTIFtCATE NUMBER' 216103552
COVERAGES
REVISION NUMBER'
THIS 1$ TO CERTIFY THAT THE POLICIES OF INSURANCE
LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO~_
INDICATED.
NOTWITHSTANDING
ANY REQUIREMENT,
TERM OR CONDITION
OF ANY CONTRACT
OR OTHER DOCUMENT
WITH RESPECT TO V\t-iICH 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 SHOVVN MAY HAVE BEEN REDUCED BY PAID CLAiMS
INSR
LTR
A
IADDt SUBR
INSD WVD
TYPE OF INSURANCE
X
COMMERCIAL GENERAL LIABILITY
I CLAIMS-MADE
W
POLICY NUMBER
CBP8442683
POLICY EF,~\
MMIDDIYVYY
POLICY EX\.\
MMIDOIYVYY
/512015
15/2016
LIMITS
EACH OCCURRENCE
DAMAG!']9:ENTED
OCCUR
$1,000,000
'"'
PREMISES Ea occurrence
$300,000
f-
MED EXP (Anyone person)
$15,000
f-
PERSONAL & AOV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMPlOP AGG
$2,000,000
R'"
o
AGGREGATE
POLICY
D
LIMIT APPLIES
PRO.
JECT
PER
LOC
$
OTHER
B ~TOMOBILE
~
f-
LIABILITY
ANY AUTO
ALL OWNED
AUTOS
~
HIRED AUTOS
~
UMBRELLA L1AB
/5/2015
BA8445383
-
15/2016
SCHEDULED
AUTOS
NON-QVVNEO
AUTOS
-
.!:..-
I
(E~~~6~d;~I~INtjLt: L1MI
$1,000,000
BODILY INJURY (Per person)
,
,
,
BODILY INJURY (Per aCCident)
I
;P~~~;c~~~t?AMAGE
$
C
EXCESS L1AB
I
B
~
CU8449083
OCCUR
15/2016
CLAIMS-MADE
EACH OCCURRENCE
$3,000,000
AGGREGATE
$3,000,000
I
OED X
RETENTION S 10,000
WORKERS COMPENSATION
AND EMPLOYERS' L1ABILlTY
YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFlCERfMEMBEREXCLUDED?
IMandatory in NHJ
If yes describe under
DESCRIPTION OF OPERATIONS below
D
::;.:
/5/2015
$
WC8447183
15/2016
NIA
=
-
/512015
-
I
I
X
1STATUTE I
PER
10TH.
ER
E L EACH ACCIDENT
$1,000.000
E L DISEASE - EA EMPLOYE
$1,000,000
E L DISEASE - POLICY LIMIT
$1,000,000
I
DESCRIPTION OF OPERATIONS I LOCATIONS (VEHICLES (ACORD 101, Additional Remarlts S';hedule, may be attached If more space Is required)
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE
IN
EXPIRATION
DATE
THEREOF,
NOTICE
WILL
BE DELIVERED
ACCORDANCE
WITH THE POLICY PROVISIONS.
THE
SFA
P.O. Box 13030
Nacogdoches TX 75962-0000
,
AUTHORIZED REPRESENTATIVE
-.<J~r~.~
@1988-2014ACORD
ACORD 25 (2014/01)
The ACORD name and logo are registered
marks of ACORD
CORPORATION.
All rights reserved.