6
ACOR0 3 CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIOONYVY) ~ 06/09/2015 THIS CERTIFICATE IS ISSUED AS A MAnER 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 endorsement(s}. PRODUCER CONTACT NAME: Andrea Uspi(040855F) r~g.N:O>-f);t1. 913-441.1800 [r~LNO): 816-452.9399 22233 W 66th St E-MAIL ~OBE_S~spj@farme[sagenLcon-. INSURERfSIAFFOROING COVERAGE NAIC# Shawnee KS 66226.3522 INSURER A: Truck Insurance ExchanQe 21709 INSURED cc,$ P('~91'\ ~ l~U~ER B: Farmers Insurance Exchange 21652 MIDWEST PRESENTATIONS INC INSURER c: Mid Century Insurance Company 21687 7820 BARTON ST INSURER 0: INSURERE: LENEXA KS 66214 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. I~MI IADO SUB t~MErv~ I f~~~ri%~V~ I TYPE OF INSURANCE POLICY NUMBER LIMITS ~NERAL LIABILITY EACH OCCURRENCE S 1,000.000 X COMMERCIAL GENERAL liABILITY 15AMAG~llJRmrED 1,000.000 ~lISES lEa occurrence' S -] CLAIMS-MADE [8J OCCUR MED EXP (Anyone person) S 5,000 B - 604712319 06/14/2014 06/14/2015 PERSONAL & ADV INJURY S 1.000.000 - I GENERAl AGGREGATE S 2.000.000 ~L AGG~nE LIMIT APPLIES PER: I PRODUCTS - COMPIOP AGG S 2.000.000 X POLICY J;l£<:.ft nlOC I s ~O_" __ See ~ 3pf~ ~~~~~~t~INGlE LIMIT S ANY AUTO _ BODilY INJURY (Per person) S ALL OWNED SCHEDULED BODilY INJURY (Per accidanll S AUTOS _ AUTOS NON-QWNED ;pROPERTY DAMAGE S HIRED AUTOS _ AUTOS ~.90dent S >--- UMBRELLA LIAB f -i OCCUR EACH OCCURRENCE S EXCESS LIAS CLAIMS. MADE AGGREGATE S OED II RETENTION S S WORKERS COMPENSATION I ~VJ..ySTAT~-:: I IOJ!;,- AND EMPLOYERS' LIABILITY YIN 1,000.000.00 MY PROPRIETORIPARTNERlEXECUTrVE CD A2172792 6/14/2014 6/14/2015 E.l. EACH ACCIDENT S OFFlCERrMEMBER EXCLUDED? NI' (Mandatory In NH) E,L. DISEASE. EA EMPLOYE S 1.000.000.00 II yell. desc;nbe under EL DISEASE. POLICY LIMIT S 1.000,000.00 DESCRIPTION OF OPERATIONS below I I OESCRIPTION OF OPERATlONS! LOCATIONS! VEHICLES (Altach ACORD 101, Additional Remarh Schedule, if more space is n,qulrodJ CERTIFICATE HOLDER Stephen F. Auslin Stale University 1936 North SI. Nacogdoches, TX 75962 CANCELLATION 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 ACORD 25 (2010/05) @1988-2010 ACORD CORPORATION. All ri9hts reserved. The ACORD name and logo are registered marks of ACORD

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Page 1: New CERTIFICATE OFLIABILITY INSURANCE Isfasu.edu/purchasing/documents/insurance-certificates/... · 2016. 2. 17. · acor03 certificate ofliability insurance i date (mmioonyvy) ~

ACOR03 CERTIFICATE OF LIABILITY INSURANCE IDATE (MMIOONYVY)

~ 06/09/2015THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE 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 tothe terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to thecertificate holder in lieu of such endorsement(s}.

PRODUCER CONTACTNAME:

Andrea Uspi(040855F) r~g.N:O>-f);t1. 913-441.1800 [r~LNO): 816-452.939922233 W 66th St E-MAIL

~OBE_S~spj@farme[sagenLcon-.INSURERfSIAFFOROING COVERAGE NAIC#

Shawnee KS 66226.3522 INSURER A: Truck Insurance ExchanQe 21709INSURED cc,$ P('~91'\ ~ l~U~ER B: Farmers Insurance Exchange 21652

MIDWEST PRESENTATIONS INC INSURER c: Mid Century Insurance Company 216877820 BARTON ST INSURER 0:

INSURERE:

LENEXA KS 66214 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 PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE 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.

I~MI IADO SUB t~MErv~If~~~ri%~V~ITYPE OF INSURANCE POLICY NUMBER LIMITS

~NERAL LIABILITY EACH OCCURRENCE S 1,000.000X COMMERCIAL GENERAL liABILITY

15AMAG~llJRmrED1,000.000~lISES lEa occurrence' S

-] CLAIMS-MADE [8J OCCUR MED EXP (Anyone person) S 5,000B - 604712319 06/14/2014 06/14/2015 PERSONAL & ADV INJURY S 1.000.000

- I GENERAl AGGREGATE S 2.000.000

~L AGG~nE LIMIT APPLIES PER: I PRODUCTS - COMPIOP AGG S 2.000.000X POLICY J;l£<:.ft nlOC I s

~O_" __ See ~ 3pf~ ~~~~~~t~INGlE LIMIT SANY AUTO _ BODilY INJURY (Per person) SALL OWNED SCHEDULED BODilY INJURY (Per accidanll SAUTOS _ AUTOS

NON-QWNED ;pROPERTY DAMAGE SHIRED AUTOS _ AUTOS ~.90dent

S

>--- UMBRELLA LIAB

f-i OCCUR EACH OCCURRENCE S

EXCESS LIAS CLAIMS. MADE AGGREGATE S

OED I I RETENTION S SWORKERS COMPENSATION I ~VJ..ySTAT~-:: I IOJ!;,-AND EMPLOYERS' LIABILITY YIN 1,000.000.00MY PROPRIETORIPARTNERlEXECUTrVE CD A2172792 6/14/2014 6/14/2015 E.l. EACH ACCIDENT SOFFlCERrMEMBER EXCLUDED? NI'(Mandatory In NH) E,L. DISEASE. EA EMPLOYE S 1.000.000.00II yell. desc;nbe under

EL DISEASE. POLICY LIMIT S 1.000,000.00DESCRIPTION OF OPERATIONS below

I IOESCRIPTION OF OPERATlONS! LOCATIONS! VEHICLES (Altach ACORD 101, Additional Remarh Schedule, if more space is n,qulrodJ

CERTIFICATE HOLDER

Stephen F. Auslin Stale University1936 North SI.Nacogdoches, TX 75962

CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE

ACORD 25 (2010/05) @1988-2010 ACORD CORPORATION. All ri9hts reserved.The ACORD name and logo are registered marks of ACORD

Page 2: New CERTIFICATE OFLIABILITY INSURANCE Isfasu.edu/purchasing/documents/insurance-certificates/... · 2016. 2. 17. · acor03 certificate ofliability insurance i date (mmioonyvy) ~

ProgressiveP.O.Box94739Cleveland,OH44101'.800-895-2886

Certificate of Insurance

PROGRESSIVE'

Policy number: 01451213-1Underwritten by:PROGRESSIVECOUNTYMUTUALINSCOApril 28, 2015Page1 of 2

Certificate Holder...................... . .EDERAGUIRRE2006 PINERIVERDRKINGWOOD, TX 77339

Insured....................... .....

EDERAGUIRREITECHSOLUTIONS2006 PINERIVERDRKINGWOOD, TX 77339

Agent...................... . .

PROGCOMMERCIALPOBOX 94739CLEVELANO,OH 44101

This document certifies that insurance policies identified below have been issued by the designated insurer to the insurednamed above for the period(5) indicated. This Certificate is issued for information purposes only. It confers no rights uponthe certificate holder and does not change, alter, modify, or extend the coverages afforded by the policies listed below.The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations, endorsements, andconditions of these policies................................................. . ' .Policy Effective Date: Mar 25, 2015 Policy Expiration Date: Mar 25, 2016

~~~.~~~.~~~.~~.~~~.~~~~) .BODILYINJURY/PROPERTYDAMAGE........ , , ,

UNINSURED/UNDERINSUREDMOTORIST...................... .UNINSUREDMOTORISTPROPERTYDAMAGE

Limits

S50,000/S 1DD,DOD/S25,DOO................................... , '........ . .S50,00D/5100,000............. .. .m,ooo W/5250 DED

Description of LocationNehicies/Specialltems~~~~~~_I.e.d__<I~t_o_s.~_~.Iy' __.._ _..__.__ .2012 CHEVROLETEXPRESSGI500 I GCSGAFX8Cli 08976PERSONALINJURYPROTEGION S2,SOOCOMPREHENSIVE S500 DEDCOLLISION S500 DEDROADSIDEASSISTANCE SELEaED..... , , , .2008 GMC SAVANA G25DO I GTGG29C281913125PERSONALINJURYPROTEGION 52,500COMPREHENSIVE 5500 DEDCOLLISION 5500 DEDROADSIDEASSISTANCE SELEaED....................................... , .2012 FORDTRANSITCONNEG NMDLS7BN3G08064SPERSONALINJURYPROTEGION 52,500COMPREHENSIVE 5500 DEDCOLLISION 5500 DEDROADSIDEASSISTANCE SELEaED

II(ontJrluea

Page 3: New CERTIFICATE OFLIABILITY INSURANCE Isfasu.edu/purchasing/documents/insurance-certificates/... · 2016. 2. 17. · acor03 certificate ofliability insurance i date (mmioonyvy) ~

Certificate number11815NET213

Form 5241 (10/02)

Policy number: 01451213-1

Page 2 of 2

Page 4: New CERTIFICATE OFLIABILITY INSURANCE Isfasu.edu/purchasing/documents/insurance-certificates/... · 2016. 2. 17. · acor03 certificate ofliability insurance i date (mmioonyvy) ~

Texas Liability Insurance CardPROGRESSIVECOUNTYMUTUAL INSCO1.800.895.2886(se habla espanol)

PROGRE.f.fIVE'Policy period: Mar 25, 2015 to Mar 25, 2016Policy number: 01451213.1

Agent ~~9fJf M~RCIAL

I~'1 8nO.89'S;Z886~!l!lt I jTh. ~~\ll' '";j - 'll'~ll"~'~l' t~ijl ll, !]~

Name of Insured ~I~111!1~1j! ,II' j lill: \,EOERAGUIRRE , l!p~~111'1~1 i: ' j, l~ 1 !~j,I' ,DBA" ITECHSOLUTIONSII,i"" 1111'~' i II ~CilL ,; '.2006 PINERIVERDR II I 1,1'" IIKINGWOOD, TX 77339 ,;1

VehicleYear2012

MakeCHEVROLET

ModelEXPRESSG1500

Vehicle Identification No,1GCSGAFX8C1108976

This policy prov;des at least the minimum amounts of liability insurance ~equired by the Texas Motor Vehicle Sa1ely Responsibility Act for tnespecified vehicles and named insuleds and may provide coverage for other persons and other vehicles as provided by the insurance policy.

Texas Liability Insurance Card Tarjeta de Segura de Responsabilidad de TexasKeep this card. Guarde esta tarjeta.

IMPORTANT: This card or a copy of your insurance policy must IMPORTANTE: Esta tarjeta a una copia de su poliza de segura debebe 'shown when you apply for or renew your: ser mostrada cuando usted solicite a renueve SUI

motor vehicle registratIOn • registra de vehicul'Md~'moiJr

",~~l , 'llf"~• dnver's license IcenCia~r co~:ur ~~~

motor vehICle safety mspectlon sticker 'Ie' :ei~ueta',~&. SPeCf'i6(jde segundad para su vehiculo, .• "lIfo ~' .~~ ,'I~~ 1 141 ,It ',' .,

You may also be asked to show thiS card or X,~ur~,j!'Y' YO\!. L ~ I ig~iiijs,q e usled tenga tamb,en que mostrar esta tafJeta a su pollZa dehave an aCCIdentor a peace.~!!;\;~£.a~~s'fu~~~iJ~I ,1 if ~lfli • S~9ura si tlene un accidente 0 Sl un oflCiaI de la paz se la pide.All dnvers In Texas must carry11lj~llltya~sUlan'l q tn,)r <'h,cles Todos los conductares en Texas deben de tener seguro deor otherwise meet legal requlfenw£ts f9liman ral responsibility. responsabilidad para sus vehieulos, a de otra manera lIenar losFailure to do so could result in flftes up to $1,000, suspension of requlsltos legales de responsabilldad CIVIl. Falla en lIenar este reqUlsltoyour drivers license and motor vehicle registration, and pudiera resultar en multas de hasta $1,000, suspension de su licenciaimpoundment of your vehicle for up to 180 days (at a cost of $15 para conducir y su registro de vehiculo de motor. y la retencion de super day), vehieulo par un periodo de hasta 180 dias (a un costa de $15 par dial.

Our claims service number is '.800-895-2886. We are available 24 hours a day, 7 days a week to begin working to resolve your claim,

Page 5: New CERTIFICATE OFLIABILITY INSURANCE Isfasu.edu/purchasing/documents/insurance-certificates/... · 2016. 2. 17. · acor03 certificate ofliability insurance i date (mmioonyvy) ~

Texas Liability Insurance CardPROGRESSIVECOUNTYMUTUAL INSCO1.800.895-2886(se habla espanol)

PROGRESSIVE'Policy period: Mar 25, 2015 10 Mar 25, 2016Policy number: 01451213-1Agent: pa9:G;coM~lRCIAl

'ti ~ill.~~a9~9~'2886r I'll~~\~jl"jf !~]11'11'11:1>. I'll

Name of Insured ,. 1~111~1'~~~, l~d~l',I~, ~,EDERAGUIRRE '11"1'" l'II'li 'II !Il'I!' tll'lll j,'DBA ITECHSOlUTION~ lljl~"l,iH "lll!1 : 1 \ 1il,20D6 PINERIVERDR II \ :tWil 1MKINGWOOD, TX 77339 I,

VehicleYear2008

MakeGMC

ModelSAVANA G2500

Vehicle Identification No.IGTGG29C281913125

This policy provides at ieast the minimum amounts of liability insurar,ce required by the Texas Motor Vehicle Safety Responsibility Act for thespecified vehicles and named insureds and may provide (overage for other persons and other vehicles as provided by the insurance policy.

Texas Liability Insurance Card Tarjeta de Seguro de Responsabilidad de TexasKeep this card. Guarde esta tarjeta.

IMPORTANT: This card or a copy of your insurance policy must IMPORTANTE: Esta tarjeta 0 una copia de su p61izade seguro debebe 'shown when you apply for or renew your: ser mostrada cuando usted solicite 0 renueve su:

• motor vehicle registration • reglstro de vehicul'ld~~o['dr.1:I*t t ~~• dnvers license IlCenCia ra candu I, ~I

l~....n I "!tf trtill' •motor vehicle safety inspection stICker l~~)..~liquet~ e"l'lspea ~ ~e guridad para su vehiculo

•. tJt~, iH' !d" 'j~,111 IYou may also be asked to show this card or ¥~ur RRI!.",:i1~YO 'lit if~e<jj,que usted tenga tambien que mostrar esta ta'leta 0 su p6liza dehave an accident or a peace ~l1ii;ila~!~lto ~~~\1.ill ,I, I:~ ,lhf segura si Ilene un accidente 0Slun oflCial de la paz se la p,de.All dflvers In Texasmust carr1l1~bllily Insmanl:!> th lr i!hlcles Todos los conductores en Texas deben de tener seguro de

:ll:1i f~ !!if. HI 'or otherWise meet legal requlfe~iWs fW:c!lOancialresponsibility. responsabilldad para sus vehiculos, 0 de otra manera lIenar losfailure to do so could result In fines up to $1,000, suspension of requisitos legales de responsabilidad civil. fallo en Ilenar este requ',sitoyour driver's license and motor vehicle registration, and pudiera resultar en multas de hasta $1,000, suspension de su licenciaimpoundment of your vehicle for up to 180 days (at a cost of $15 para conducir y su registro de vehiculo de motor, y la retenci6n de super day). vehiculo por un periodo de hasta 180 dias (a un costo de $15 por dial.

Our claims service number is '.800.895-2886. We are available 24 hours a day, 7 days a week to begin working to resolve your claim.

Page 6: New CERTIFICATE OFLIABILITY INSURANCE Isfasu.edu/purchasing/documents/insurance-certificates/... · 2016. 2. 17. · acor03 certificate ofliability insurance i date (mmioonyvy) ~

-------------------------~

Texas Liability Insurance CardPROGRESSIVECOUNTYMUTUAL INSCO1-800-895-2886(se habla espanol)

VehicleYear2012

MakeFORD

ModelTRANSITCONNECT

Vehicle Identification No.NMOLS7BN3CT080645

This policy provides at least the minimum amounts of liability insurance required by the Texas Motor Vehicle Safety Responsibility Act for thespecified vehicles and named ir,sureds and may provide coverage fo~other persons and other vehicles as provided by t~e insurance policy.

Texas Liability Insurance Card Tarjeta de Segura de Responsabilidad de TexasKeepthis card. Guardeestatarjeta.

IMPORTANT: This card or a copy of your insurance policy must IMPORTANTE: Esta tarjeta 0 una copia de su poliza de se9uro debebe 'shown when you apply for or renew your: ser mostrada cuando usted solicite 0 renueve su:

motor vehicle registration • registro de vehicula de molOrdriver's license • licenCia oai<' cd~HJ1rr "III~"

I~'l' ~,,~t ""'1,,, 'I• motor vehicle safety InspectIOn sticker 'I!~iilli:et g~et<!c.~IPf,P<lj~ru~~de's'eguridad para su vehiculo

You may also be asked to show this card or vQur DOllcy1il"i~u Ii I 11'lli~~~MIt,J~~"~~t~~'l~ng~ !amblen que mostrar esta ta'leta 0 su poliza de,,' I' ~" B Il: 10' 'I j "J' " 't1"have an accident or a peace offlce\ aSKS:00s~e1tt I' 'il lj';" ,I,,~ eguro si tlene un accidente 0 Sl un oflCial de la paz se la p,de,

All drivers In Texas must carrti~hil:t~lhsVtaMdl!> theIr U~hlcles' Todos los conductores en Texas deben de tener segura de~tn !', ~ ,.or otherWise meet legal requifemeDts Q!"nnanclal responsibility, responsabilidad para sus vehiculos, 0 de otra manera lIenar los

l B ~ 'Failure to do so could result In firres up to $1,000, suspension of requisitos legales de responsabilidad civil. Fallo en Ilenar este requisitoyour driver's license and motor vehicle registration, and pudiera resultar en multas de hasta $1,000, suspension de su licenciaimpoundment of your vehicle for up to 180 days (at a cost of $15 para conducir y su registro de vehiculo de motor, y la retencion de super day). vehiculo por un periodo de hasta 180 dias (a un costo de $15 por dial,

Our claims service number is t .800.895.2886, We are available 24 hours a day, 7 days a week to begin working to resolve your claim,