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CERTIFICATE OF LIABILITY INSURANCE
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06/18/2015
THIS CERTIFl(:ATE II ISSUED AI A MATT'EA OF INfORIItATION OHl.Y AND CONFERS NO RtGHTS UPON THE C~TIACATE HOLDER. THIS
caTIFJCATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR A&.T~ THE COVERAGE AFfOROW BY THE POUCII!4
JEU)W. TH1J CERTIFICATE OF INSURANCE DO£S NOT CONITTTUTE A CONTR.\CT BE1Wf£H THE ISSUING INSURER($), AUTHORIZI!O
R£PRESENTA TM! OR PRODUCER, AND THE CERTIRCA TE HOLDER.
IIPORTANT: If tp. c:enlfk:aa. holder Ia an AOOIT10NA&.IN8UREO, the pOlicy( in) mullt be endorsed. If SUBROOATlOH II WAIVED, sulijec:t to tilt
...,.,. end condiliona ot tilt policy, ctrtllln polkiH may nqulre an en~nL A •r.tement on this ctl'tificllta don not confw rights to tilt
Ctftlflc:aa. holdtlln liN ot such endof'senwnt(a).
FLIP Program Support
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Veracity Insurance Solutions, LLC.
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260 South 2500 West, Suite 303
info@fliprogram.com
84062
Pleasant Grove
UT
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26832
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Duy Nguyen , DBAZ Catering
2 19 Wettermarl( St.
Nacogdoches
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CERTIFlCATE NUMBER·
COVERAGES
REVISION NUMBER:
THIS IS TO CemFY THAT THE POliCIES Of' INSURANCE U&TED BELOW HAV£ BE£N ISWEO TO THE INSURED NAMED NJCVE FOR THE POIJCY PERIOO
INOICATEO. HOTWITHSTANOINO AHY llt!OUIREMENT. TERM OR CONDITION OF AHY CONTRACT OR Olli!A DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE W.Y 8E ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SU8JECT TO AU 1l£ TEAMS.
EXCLUSIONS IVIC CONOmONS OF SUCH POI..IClES. UMITS SHOWN MAY HI\liE BEEN REDUCED BY PAID CLAIMS.
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Certificate holder had been added as additional insured regarding the a bove me ntioned po licy per attached
Add itional Insured- Designated Perso n or Organ ization (CG20 26 , ED. 04 13)
IIUCiiii'TIOIIOI-- I LOCAliOIIIIYEHICI.U
CERTIFICATE HOLDER
CANCELLATION
MfQU.L.O AHY 01' THE A80Vl OUC·IliNO I'QU(;IU IE ~D Hl'OIUI
THE EXJIMATIOH DATI! TIWU!OI', HOTJCI! WILL II! DE1.NEJW) IN
Stephen F. Auatln State Uni versity
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ACCORDAHCI! WITH THI! POUCY PROIIIIIOHI.
1936 North Street
Nacogdoches
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ACORD 25 (2010105)
Tht ACORO Nlmt and togo .,.. registered INI'kl of ACORD
75962
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18U-2010 ACORD CORPORATIOH. AJII'igt'a ~
CG 20 26 (Ed. 04 13)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED- DESIGNATED PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following :
COMMERCIAL GENERAL LIABilrrY CO VERAGE PART
Schedule
Name of Additional Insured Person(s) or Organization(&):
Per ind ivid ual Certificate of Coverage .
Information required to complete this Schedule . if not shown above , will be shown in the Decla rations .
A.
SECTION I!- WHO IS AN INSURED is amended to include as an Ad ditional Insured the person(s) or
organizaUon(s) .s hown in the Schedule , but only with respect to liab ility fo r "bodily injury," "property damage• or
"personal and advertising injury• caused , in whole or in part, by your acts or omissions or the acts o r omissions of
those ac·ting on your behalf:
1. in the performance of your ongoing operations ; or
2. in connection with your premises owned by or rented to you.
However:
1. the insurance afforded to such add itional insured only applies to the extent permilled by law; and
2. if c overage provided to the Add itional insured is required by a contractor agreement the insura nce afforde d to
such additional insured will not be broader lhan that which you are required by the contract or agreement to
provide for such additional insured .
B.
With respect to the insurance afforded tl these Add itional Insureds , the following is added tl SECTION IllLIMITS OF INSURANCE:
If coverage provided to the Additional Insured is required by a co ntra ct or agreement. the most we will pay on
behalf of the Additional Insured is the amountofinsurance :
1. required by the contract or agreement; or
2. available under the applicable Limits of Insurance shown in the
De cla rations ~
whichever is less.
T his endorsement shall not increase the applicable Limits of Insura nce shown in the Declarations .
CG 20 26 (Ed . 04113) PRO
Copyright, ISO Properties , Inc ., 2012
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