DATE(MM/DD/YYYY)
CERTIFICATE OF LiABILITY INSURANCE
10/6/2015
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 ah ADDITIONAL INSURED, the policy([es) 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).
NAM&^ Jo Aim Brovm
PRODUCER
Bartlett Baggett & Shands
p.„: (936)632-4496
<536,«,-ll2S
a'ddress- 3oahhb@bbsins.com
pp Box 9
1204 S First Street
INSURERfS)AFFORDING COVERAGE
Lufkih
TX
75902
.NAIC#
INSURER A:Westerh Hefitacre Xns Co
INSURED
INSURER a:AmTrust Xns Co of Kansas
Southland Fence Company
INSURER C:Torus National Insurance Co
Alvin Settle dba
INSURER D;Texas. Mutual Insurance Co
P O Box 2202
INSURER E:
Lufkin
TX
75902-2202
15954
0013
INSURER F:
CERTIFICATE NUMBER:CL1510600?16
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 WHICH,THIS
CERTIFICATE MAY-BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES.OESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OFSUCH POLICIES,.LIMITS SHOWN MAY-HAVE BEEN REDUCED BY PAID CLAIMS.
addCsubK
INSR
ryPE OP INSURANCE
.LTR'i
POLICY NUMBER
POUCYEFF
POLICY EXP
fMMmPfYYYYl fMMfPDWYYYi
COMMERCIAL GENERAL LIABILITY
1/000,000
DAMAGE TO'RMTED
1
I CLAIMS-MADE
A
UMUS
EACH OCCURRENCE
X I .OCCUR
PREMISES lEa oceufreneei
SCP1036£8a
8/11/2015
8/11/2016
GENIAGGREGATE UMIT APPLIES PER:
POLICY[Zl jec-F lZ],log
100,000
MED EXP (Any one person)
5,000
PERSONAL & ADV INJURY
1,000,000
GENEFIAL AGGREGATE
2,000,000
PRODUCTS - COMP/OP A6G
2,000,000
COMBINED SINGLE UMIT
1,000,000
OTHER:
AUTOMOBILE LIABIUTY
(Ea acddent).
BODILY INJURY (Per person)
-ANY AUTO
ALL OWNED'
AUTOS
X
HIRED AUTOS
X
SCHEDULED
KPP102956701
AUTOS
NON-OWNED
8/11/2016
UMBRELUUAB
BODILY INJURY,(Per acddenl)
^OMRTY bAMAGE'"*
(Per accidenO
AUTOS
EXCESS UAB
OCCUR
EACH OCCURRENCE
1^000,000
CLAIMS-MADE
AGGREGATE
1,000,000
82237K152ALX
RETENTIONS'
DED
8/11/201S
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
[Mandatory In NH)
8/11/2015
8/11/2016
TPER
! STATUTE
OTHER
YIN
□
E.L. EACH ACCIDENT
1,000,000
E.L DISEASE • EA EMPLOYEE
1,000.000
E.L DISEASE - POLICY LIMIT
1.000.000
N/A
SBP0001000162
10/10/2015 10/10/2016
If yes. describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCADONS/VEHICLES (ACORD101, Additional Remarks Schedule, may be attached if more space Is required)-
E mail:
purchase@8fasu.edu^
CANCELLATION
CERTIFICATE HOLDER
(.936)468-4282
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Stephen F'Austin State University
its officials/ directors, en^loyees
representatives and volunteers
1936 North Street
NacogdocheS/ TX
75962
THE EXPIRATION DATE THEREOF, NOtlCE WILL BE DELIVERED IN
ACCORDANCE WITH thE POLICY PROVISIONS.,
AUTHORIZED REPRESENTATIVE
Ben 'Bartlett/JAB
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ACORD 25 (2014/01)
NS025 (201401)
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