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<br /> <br /> <br /> <br /> ® DATE (MMIDD/YYYY) <br /> A ® CERTIFICATE OF LIABILITY INSURANCE 8/17/2010 <br /> PRODUCER (972) 771-4071 FAX: (972) 771-4695 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> K & S Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 2255 Ridge Road, Ste. 333 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> P. 0. Box 277 <br /> Rockwall TX 75087 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURERA:QBE Specialty Insurance Co. 11515 <br /> Josh Bray dba Sanitation Solutions INSURER R: Praetorian Insurance Company 37257 <br /> P . 0. Box 6190 INSURER C: St Paul Surplus Lines Ins Cc 30481 <br /> Texas Mutual Insurance Co. 22945 <br /> INSURER D: <br /> Paris TX 75461 INSURERE:Chartis Specialty Insurance 26883 <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ItdSR OD' POLICYNUMBER DPALEICY EFFECTI DATE( YYYN LIMITS <br /> L D E CE <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE TO RENTED <br /> X COMMERCIAL GENERAL LIABILITY PREMISE$ (Ea oautWLGv) S 100 , 000 <br /> A CLAIMS MADE F OCCUR STTX0002722 8/18/2010 8/18/2011 MED EXP (An one Person) $ 5,000 <br /> PERSONAL &ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> PRODUCTS - COMP/OP AGG $ Included <br /> GEN'LAGGREGATE LIMIT APPLIES PER: <br /> POLICY X PE 0 LOC <br /> AUTOMOBILE LIABILITY COMBINED BIdtSINGLE LIMIT $ 1,000,000 (En X ANY AUTO <br /> B ALL OWNED AUTOS 1CTXOOD1215 8/18/2010 8/18/2011 BODILY INJURY <br /> (Per person) $ <br /> SCHEDULED AUTOS <br /> X HIREDAUTOS BODILY INJURY S <br /> X NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE S <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY., AGG $ <br /> EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE S 5,000,000 <br /> X OCCUR CLAIMS MADE AGGREGATE $ 5,000,000 <br /> S <br /> C DEDUCTIBLE 209125406 8/18/2010 8/18/2011 $ <br /> Ix RETENTION $ 10,00 $ <br /> D WORKERS COMPENSATION X WC STATU- OTH- <br /> OR, AND EMPLOYERS'LIABILITY YIN <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 0001000 <br /> OFFICERIMEMBER EXCLUDED? <br /> (Mandatory In NH) 001102162 8/18/2010 8/18/2011 E.L. DISEASE - EA EMPLOYE $ 1,000,000 <br /> It yes, describe under <br /> SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 <br /> E OTHERTransportation 1,x4766550 8/18/2010 8/18/2011 $1,000,000 OCC. <br /> Pollution $2,000,000 Ago. <br /> DESCRIPTION OF OPERATIONS I LOCATIONS [VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> City of Paris is named additional insured on general liability policy (CG2033 07-04) when required by written <br /> contract. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> City of Paris <br /> P. O. BOX 9037 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> Paris, TX 75461 REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> R Daiker-1/DIANE <br /> ACORD 25 (2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. <br /> INS025 (200901).01 The ACORD name and logo are registerecl marks of ACORD <br /> 110 <br />