ACORd"
I
CERTIFICATE OF LIABILITY INSURANCE
~
OA TE (1ol•••.!OOiYYYYJ
6/9/2015
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 policies may requIre an endorsement.
A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
~2~~~CTBrandy
PRODUCER
Agency,
Morgan Insurance
3708 S. Medford
Ltd.
Dunkin
tA~g.NNEQ._E2\1)'(936) 634
-77
I FAX
{A!!l::
•.N91: (936)612-3862
55
_AoMDA~~ss:bdunkin@morganins.com
INSURERISI AFfORDING
Lufkin
TX
75901-5700
INSURER
A:The Cine innati
INSURED
Russell
15286
Co.
Drilling
US
Hwy
259
Inc_
N
NAIC#
COVERAGE
Insurance
INSURERB ;TEXAS
MUTUAL
INSURANCE
INSURERC ;Great
American
Insurance
Co~p~r;ie_s
22945
CO
Co
INSURERD;
INSURERE;
TX
Nacogdoches
75961
INSURER F ;
CERTIFICATE NUMBER:CL1552703130
REVISION NUMBER:
COVERAGES
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 I/v'HICH 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
POLICY EXP
I/!:OUCY EFF
LIMITS
TYPE OF INSURANCE
POLICY NUMBER
MMIDDfYYVY MMIDDIYYYY
I~~~I
X
~
A
i~~~nC~~
COMMERCIAL GENERAL LIABiliTY
W
CLAIMS.MADE
,
,•
,•
,
,
EACH OCCURRENCE
DAMAGE-r01rENTEl5
£R_I;Ml~~HEa .9c_c.urre!lce'
OCCUR
X
Y
6/1/2015
EPP0144065
6/1/2016
MED EXP (Anyone person)
-
PERSONAL & ADV INJURY
~:
o
AGGREGATE
POLICY
LIMIT APPLIES
C
PRO.
JECT
PER
PRODUCTS- COMPIOPAGG
LOC
I
OTHER
AUTOMOBILE LIABILITY
l~
A
-
All
O\'~ED
AUTOS
HIRED AUTOS
~
~MBREllA
L::
-
'--
LIAS
I OED I
COMBINED SINGLE LIMIT
l~a'pcc:ide[l!l
BODILY INJURY(per person)
I
SCHEDULED
X
~~1~gWNED
AUTOS
Y
6/1/2015
EBA0144065
6/1/2016
I
1RETENTIONS
I
EPP0144065
l WORKERS COMPEN5AnON
AND EMPLOYERS'LIABILITY
Y'N
ANY PROPRIETOR/PARTNER,eXECUTiVE
OFF1CER,MEMBER
EXCLUDED?
B
[Mandatory
0
In NH)
TSF-0001l19752
If yes, descnbe under
DESCRIPTIONOF OPERATIONSbelow
C
Rented/Leased
I
I S
6/1/2015
6/1/2016
6/1/2015
6/1/2016
TBD
,
1,000,000
I
5,000,000
5,000,000
SUo-lUlL j~PTH- ER
1,OOO,.QQQ.
I
,
,
EL DISEASE. EA EMPLOYE
E,L DISEASE . POLICY LIMIT
I
Equipment
S
$
EL. EACH ACCIDENT
I
Y
2,000,000
1,000,000
PlJ5~fc~e~t?AMAGE
~ER
I X
N'A
2,000,000
S
Uninsured motonst combined
6/1/2016
!
5,000
1,000,000
BODILY INJURY (Per accldenl) S
~~5..GATE
6/1/2015
100,000
I '
I
EACH OCCURRENCE
MOCCUR
CLAIMS.MADE
EXCESSLIAS
A
GENERAL AGGREGATE
I
1,000,000
l!OOO,OOO
1,000,000
$1,000
limit $50,000
dad
I
DESCRIPTIONOF OPERATIONSI LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be atlached If more !opaceIs required)
directors,
employees.
representatives
Stephen
F.
Austin
State
University,
its
officials,
shall
be
CERTIFICATE
named
as
additional
insured
when
required
HOLDER
by
written
contracto
with
waiver
and
of
volunteers
subrogation.
CANCELLATION
purchase@sfasu.edu
Stephen F. Austin State University
its officials, directors, employees,
and Volunteers
1936 North St.
Nacogdoches, TX 75962
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
EXPIRATION
DATE THEREOF. NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
THE
repr
AUTHORIZED REPRESENTATIVE
Terry Morgan/BRANDY
-~-
@1988.2014ACORDCORPORATION.
ACORD 25(2014/01)
INS025l?Ol<ln1\
The ACORD name and logo are registered
marks of ACORD
,o..-=--,?
All rights
reserved.