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Home My WebLink AboutGL InsHEATH-5 OP ID: CJ "40 R" CERTIFICATE OF LIABILITY INSURANCE DATE D/VYYV) 02120113 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 endorsements . PRODUCER 979-776-2626 Anco Insurance B/CS P. O. Box 3889 979-774-5372 Bryan, TX 77805 Grant Graham CONTACT NAME: PHONE —FAX-- AIC 0o Ext)+ ......_ No); ........_.._LAIC, ..._ E-MAIL ADDRESS INSURERS) AFFORDING_ COVERAGE NAICp INSURERA: Mid-COntment Casualty CO. INSURED Heath Phillips Investments,LLC Heath Phillips P.O. BOX 262 INSURER B: Federal Insurance Company "--—_�---- INSURER C INSURERD. Wellborn, TX77881-0262 INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMRFR- 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 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. " INSR LTR TYPE OF INSURANCE ADDL SUBR " POUCY NUMBER POLICY EFF POLICY EXP MMIDDIYYY MMIDDNYYYl _ LIMITS A GENERAL LIABILITYi tXCOMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR __„_,,,_"_ 04GL000860047 10I03112 10/03/13 l EACH OCCURRENCE $ 1,000,000 DAMAGE TO RYEO PREMISES Ea occurrence $ 100,000 MED EXP (Any ena person) $ Exclude PERSONAL SADV INJURY $ 1,000,00 _ G�NERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: r POLICY PRO- LOC "', PRODUCTS - COMPIOP AGG $ 2,000,000 _"$ AUTOMOBILE LIABILITY ANY AUTO 1SCHEDULEDALL AUTOS OWNED I AUTOS HIRED AUTOS AUTOSWNEO ( 1 Ee COMBINED BtSINGLE LIMIT $ BODILY INJURY (Per person),$ BODILY INJURY Per ecadent�$ 1 )' PROPERTY pAMAGE $ _(Peraocident) UMBRELLA DAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMSER EXCLUDED? (MantlatoryinNH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA j '�, I WC STATU- I IOTH- Y41 ITS ER E.L.EACH ACCIDENT $ - — E.L. DISEASE - EA EMPLOYEE $ E. L. DISEASE -POLICY LIMIT $ B Equipment Floater 45465997 10/12112 li 10112/13 Equipment 2,650 Rented Eq 250,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) City of College Station P.O. Box 9960 College Station„ TX 77842 CITYCOL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE V�'1►�THJ7�INNa n 1988-2n1n rinhfe rnenrund ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD MID-CONTINENT CASUALTY COMPANY P.O. BOX 1409 TULSA, OK 74101.1409 GENERAL LIABILITY GENERAL CHANGE ENDORSEMENT POLICY NO: 04-GL-000860047 NAMED INSUKEU ANU MAILING AUUKESS AGENCY ANU MAILING AUUl,i HEATH PHILLIPS INVESTMENTS LLC ANCO INSURANCE SERVICE INC 42-0218 PO BOX 262 P O BOX 3889 WELLBORN TX 77881-0262 1111 BRIARCREST DRIVE BRYAN TX 77802 POLICY PERIOD: FROM 10/03/2012 TO 10/03/2013 at 12:01 A.M. Standard Time at your mailing address shown above Nothing herein contained shall be held to vary, waive, alter, or extend any of the terms, conditions, agreements, or declarations of the undermentioned Policy otherthan as stated below. ENDORSEMENT NO: 004 EFFECTIVE OZ/19/2013 THIS POLICY IS AMENDED AS SHOWN Adding: Class Code: 049950 Description: SEE ENDORSEMENT ML1214 Per Each (Fully Earned) Exposure: 1 Premium Basis: T) Adding Form: ML 1214 06 08 Addl Insd-O/L/C Schad Person Adding Additional Insured, under form # ML 1214, in favor of: Name of Person or Organization - CITY OF COLLEGE STATION I ADDITIONAL PREMIUM: $100.00 1 FORMS AND ENDORSEMENTS APPLYING TO THIS COVERAGE PART AND MADE PART OF THIS POLICY AT THIS TIME: M19065(02/07) ML1214(06/08) COUNTERSIGNEDAT: BRYAN TX DATE: OW21/2013 BY; MI 90 00 (08 99) INSURED COPY PAGE 001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: CITY OF COLLEGE STATION (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability caused, in whole or in pan, by your performance of ongoing operations for that insured. This amendment applies only when you have agreed by written "insured contract" to designate the person or organization listed above as an additional insured subject to all provisions and limitations of this policy. ML 12 14 (06 08) Page 1 of 1 HEATH-5 OP ID: CJ A16. � CERTIFICATE OF LIABILITY INSURANCE DAT02/20 D/YYYV) 2/20113 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(les) 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 endorsements . PRODUCER ARInsurance B/CS 979-776-2626 P. O. Box 3889 979-774-5372 Bryan, TX 77806 Grant Graham CONTACT NAME acPHONE Eal : FAX Np)?,,, ADDRESS: --- INSURERS AFFORDING COVERAGE NAICN INSURER A: Mid -Continent Casualty Co. INSURED Heath Phillips Investments,LLC INSURER B: Federal Insurance Company Heath Phillips P.O. BOX 262 — INSURERC: INSURER D: Wellborn, TX 77881-0262 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL INSR SUB MD POLICY NUMBER MMIDDNYCY YY MM DD VYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR 04GL000860047 10/03112 10103/13 DAMAGE TO RENTED PREMISES Ea occurrence MED EXP(Any one person) $ 100,000 $ Excluded PERSONALS ADV INJURY _ $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PRO)FG- LOG $ _ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT BODILY INJURY (Par person) $ ANYAUTO AOSCHEDULED AUTOS AUTOS BODILY INJURY IPeraaitlenl) $ NON -OWNED HIREDAUTOS AUTOS _......._.____ PROPERTY nEen( AGE $ - - - S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ $ DED RETENTION$ WORKERS COMPENSATION WCSTATU- OTH- ANDEMPLOYERS' LIABILITY YIN ANY PROPRIETOREARTNEWEXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA""--'-- T Y-LIMLTSER E.L. EACH ACCIDENT _- $ E.L. DISEASEEAEMPLOYEE - $ (MandalerylnNH) Ifyes,describeunder DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ B Equipment Floater 45465997 10112112 10/12/13 Equipment 2,650 Rented Eq 250,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CITYCOL City of College Station P.O. Box 9960 College Station„ TX 77842 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 6r'It+ riohfe rcecrvcd ACORD 25 (2010106) The ACORD name and logo are registered marks of ACORD „1 ..i�ai MID-CONTINENT CASUALTY COMPANY P.O. BOX 1409 TULSA, OK 74101.1409 GENERAL LIABILITY GENERAL CHANGE ENDORSEMENT POLICY NO: 04-GL-00086OD47 NAMED INSURED AND MAILING ADDRESS AGENCY AND MAILING ADDRESS HEATH PHILLIPS INVESTMENTS LLC ANCO INSURANCE SERVICE INC 42-0218 PO BOX 262 P O BOX 3889 WELLBORN TX 77881-0262 1111 BRIARCREST DRIVE BRYAN TX 77802 POLICY PERIOD: FROM 10/03/2012 TO 10/03/2013 at 12:01 A.M. Standard Time at your mailing address shorn above Nothing herein contained shall be held to vary, waive, alter, or extend any of the terms, conditions, agreements, or declarations of the undermentioned Policy other than as stated below. ENDORSEMENT NO: 004 EFFECTIVE 02119/2013 THIS POLICY IS AMENDED AS SHOWN Adding: Class Code: 049950 Description: SEE ENDORSEMENT ML1214 Per Each (Fully Earned) Exposure:1 Premium Basis: T) Adding Form: ML 1214 06 08 Addl Insd-O/L/C Schad Person Adding Additional Insured, under form 8 ML 1214, in favor of: Name of Person or Organization - CITY OF COLLEGE STATION Pro -Rats: .619178 ADDITIONAL PREMIUM: $100.00 FORMS AND ENDORSEMENTS APPLYING TO THIS COVERAGE PART AND MADE PART OF THIS POLICY AT THIS TIME: M19065(02107) ML1214(06/08) COUNTERSIGNEDAT: BRYAN TX DATE: 02/21/2013 BY: MI 90 00 (08 99) INSURED COPY PAGE 001 Isar THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: CITY OF COLLEGE STATION (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability caused, in whole or in part, by your performance of ongoing operations for that insured. This amendment applies only when you have agreed by written "insured contract" to designate the person or organization '.. listed above as an additional insured subject to all provisions and limitations of this policy. '.. ML 12 14 (06 08) Page 1 of 1