_______,
ACORD®
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I1D;T;1~;7~·~{l5
CERTIFICATE OF LIABILITY INSURANCE
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THIS CERTIFICATEIS 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 SUBROGATIONIS WAIVED, subject to the
terms and conditions of the policy, certain polic ies may require an endorsemenl A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT
HIGGIN BOT!Lll,M INS AGENCY INC / P HS
PHONE.
f.AJC . tfo. &t)
5042 21 p : (8 66 ) 467 - 8730 F : ( 888 ) 4 -13 - 6112
PO BOX 33015
Sl\N ANTONIO TX 782 5 5
E-MAIL
rJAME..
INSURED
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(866 ) 467 - 873 0
(888 ) 443-6112
(ACC. rJo)
ADoqess
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INSURER B
INSURER C
GREG WILLIP-..MS DBA WILL I AMS ELE CTRIC INC
156 PINE CO lE LN
LUFKIN TX 75 901
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COVERAGES
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REVISION NUMBER:
THIS IS TO CERTIFY T HAT THE POLICIES OF INSURANCE LISTED BELO W HAVE BEEN ISSUED T O T HE INSURED NAMED ABOVE FOR THE POLIC Y PERIO D
IND ICATED. NOTWITHSTANDING ANY REQUIREMENT . TERM OR CON DITION OF ANY CONTRACT OR OTH ER DOC UMENT WITH RESPECT TO WHIC H THIS
AFFORDED BY THE POLIC IES DESCRIB ED HERE IN IS SU BJECT TO ALL THE
CERT IFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE
TERM S.EXCLUS IONS AND COND ITIONS O F SUCH POLICIES . LIMIT S SHOWN M AY HAVE BEEN REDUCED BY PA ID CLAIMS .
J.'\'SH.
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EACH OCCURRENCE
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GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
BODILY INJURY (Per person)
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PERSONAL & ADV INJURY
COMB INED SINGLE LI MIT
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COMMERCIAL GENERAL LIAB ILITY
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DESCRJPTION OF OPERATIONS I UXATIC»IS I VEH/c::Jlllf!CRD 101, Additi onal Remar1(s Sch edula, may be attached if more s pace is requ i red)
!Those usual to the Insur.::d ' s Operati.ons _ RE: Stephen L Austin State
!univei sit:-, it.s o fficials , directors , employee s , representative and vol unteers ,
I
I
I
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE T HE EXPIRATION DATE THEREOF . NOT ICE WILL BE
DELIVERED IN ACCORDANC E WITH THE POLIC Y PROVISIONS.
CERTIFICATE HOLDER
I' Stephen
F . Austin State University
1936 NORTH Sm
! NACOGDOCHES , TX 75 965
'
ACORD 25 {2014/01)
AUTHORIZED REPRESENTATIVE
© 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registe red marks of ACORD
- - I
~
ACORD®
_,.,
I..
I ;;TJ1~~~17;~v~1 5
CERTIFICATE OF LIABILITY INSURANCE
THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVEL'i 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 SUBROGATIONIS WAIVED, subject to the
terms and conditions of the policy, certain polic ies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
Pnoaucrn
COrlT.\CT
rn
NORTHE!>-. ST P..Gt:NCIE
tJ AME
PHONE
tA!C No, !;.I)
/ Pfi S
214608 p : (8 66 ) 4 6 7 - 8 730 F : ( 88 8)
44 3- 6112
301 NOODS PARK DRIVE
CLINTON NY 13323
( 866 )
IF
A.<
(A'C . rlo)
(888)
467 - 8 73 0
A0011ESS
1'l3UREtt(_5} AFFORO!tlG COVEHAGE
INSURER A
IN.SURED
443-6112
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INSURER B
IUSVRER C
GREG WILLIAMS DBA \\!I LL I.!l.MS ELECTRIC INC
1S6 PINE CONE LN
LU FKIN TX 75 901
lt~SUREH
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lrlSlJRER E
l tJSURER F
CERTIFICATE NUMBER:
COVERAGES
REVISION NUMBER:
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TH IS IS l 0 CERT IF Y THA I THE PO LIC IES OF INSURANCE LISTED BELOW HAVE BEEN ISSUE D TO fHE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICAT ED . NOTWITHSTANDING AN Y REQUIREMENT . TERM OR CONDITIO N OF ANY CONTRACT OR OTH ER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE
AFFORDED BY THE POLICIES DE SC Hf BED H EREIN IS SUBJECT T O ALL THE
fERMS.EXCLUS IO NS AN D CO N Oil 1\.!NS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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LIMI TS
/ l/ lf/1)/l/1"1T1.
ICOMMERCIAL GENERAL LIABILITY
ICLAIMS-MADE DOCCUR
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EACH OCCURRENCE
DAMAGETO RENTED
PREMISES (Ea occurrence)
s
MED EXP (Any one person)
3
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PERSONAL & MJV INJURY
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GENERAL AGGREGATE
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NON-OWNED
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RODILY INJURY (Por person)
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ANY PROPRIETORIPARTNERIEXECuTIVEYIN
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DESCRIPTION OF OPERA TlONS I LOCATIONS / VEHJqtt:&:S) RD 1D1 , Additional Remarks Schodulu, may be attached if more spaca ls
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E.L EACH ACCIDENT
'' l , 000 , 0 0 0
E.L DISEASE· EA EMPLOYEE
'' l , 000 , 000
sl , 000 , 000
E.L DISEASE - POLICY LIMIT
I
DESCRIPTION OF OPERAllQNS tr..low
x IPER
5TATVTE.
r&1qu l r~d}
Those usual to the InsuLed ' s Oper.at i ons . RE : Stephen F . Austin State
University its offic i als , dir.ectors , employees , representative and volunteers .
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EX PIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN AC CORDANC E WITH THE POLICY PROVISIONS.
Stephen F . Austin State Uni versi::::y
AUTHORIZED REPRESENrATNE
1936 NORTH ST
1 NACOGDOCHES ,
ACORD 25 (2014/01)
TX 75965
© 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD