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�cdRo® CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY)
<br />F11/9/2011
<br />TYPE OF INSURANCE
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the p?"(ies)4nust,be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an e(hdb'r' semenf: A st jJm#nt "6rl;this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s). -
<br />PRODUCER
<br />McQueary Henry Bowles Troy LLP
<br />8144 Walnut Hill Lane, 16th FI
<br />Dallas TX 75231 - /
<br />AME: Judv Hays
<br />PHONE FAX
<br />7 -77 -1 AIC,
<br />/c No : 7 - 7 - 1 4
<br />E-MAIL
<br />ADDRESSjudy hays0mhbt.com
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />_ �lJ
<br />\
<br />INSURER A:TW*n City Fare Insurance CO, 20459
<br />EACH OCCURRENCE $1,000,000
<br />INSURED HUITTZOL
<br />INSURER B:
<br />Huitt-Zollars, Inc.
<br />1717 McKinney Ave., Ste. 1400
<br />Dallas TX 75202-1236
<br />INSURER C:
<br />INSURER D:
<br />INSURER E
<br />INSURER F:
<br />MED EXP (Any one person) $10,000
<br />COVERAGES CERTIFICATE NUMBER: 1897639679 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />IOLICY
<br />LTR
<br />TYPE OF INSURANCE
<br />IN OR DL
<br />SWVD UER
<br />POLICY NUMBER
<br />MM/DD/YPOLICY EYYF
<br />EXP
<br />PM/DD/YYYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />46UUNLJ3272
<br />/1/2011
<br />/1/2012
<br />EACH OCCURRENCE $1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE 171 OCCUR
<br />PREMISES Ea occurrence $1,000,000
<br />MED EXP (Any one person) $10,000
<br />PERSONAL & ADV INJURY $1,000,000
<br />GENERAL AGGREGATE $2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICYFX PRO- LOC
<br />PRODUCTS - COMP/OP AGG $2,000,000
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />46UENKN1126
<br />1112011
<br />!1/2012
<br />Ea accident) $1,000,000
<br />x
<br />ANY AUTO
<br />BODILY INJURY (Per person) $
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY Per accident $
<br />( )
<br />X
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />Per accident $
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />46XHURJ8271
<br />/1/2011
<br />/1/2012
<br />EACH OCCURRENCE $2,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE $2,000,000
<br />DED x IRETENTION $10,000
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECU
<br />OFFICERIMEMBER EXCLUDED? TIVE �
<br />N / A
<br />46WEZU9569
<br />/1/2011
<br />/1/2012
<br />X I WCSTATU- OTH-
<br />FR
<br />E.L. EACH ACCIDENT $1,000,000
<br />E.L. DISEASE - EA EMPLOYEE $1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />E.L. DISEASE - POLICY LIMIT $1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />Additional Insured form #HG0001 edition 06/05 applies to the General & Auto Liability policy.
<br />Certificate Holder is named as an Additional Insured per the above prm(s) including Primary and Non Contributory status but only to the
<br />extent that the limits and forms are required to satisfy the termsof 6'written contract.
<br />i, .c* j / 1 ?
<br />~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Public Works Agency M-22
<br />P.O. Box 1988 AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92702
<br />ACORD 25 (2010/05)
<br />© 1988-2010 ACORD CORPORATION. All rights reseed.,
<br />The ACORD name and logo are registered marks of ACORD
<br />
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