DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1/31/2015 3/18/2014 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 endorsement(s). PRODUCER INSURED CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS: A-Lockton Companies, LLC 3280 Peachtree Rd NE, Suite #250, Atlanta, GA 30305 B-AON Risk Services West Inc. 199 Fremont St, Ste 1500 San Francisco CA 94105 FAX (A/C, No): INSURER(S) AFFORDING COVERAGE Crane Cartage, LLC 1376331 dba: Crane Cartage Freight Services 1500 Rankin Road Suite 400 Houston TX 77073 INSURER A : Liberty Mutual Fire Insurance Company INSURER B : INSURER C : Farmington Casualty Company Lexington Insurance Company INSURER D : Starr Indemnity & Liability Company NAIC # 23035 41483 19437 38318 INSURER E : INSURER F : COVERAGES A CERTIFICATE NUMBER: 12112551 REVISION NUMBER: XXXXXXX 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 A ADDL SUBR INSR WVD TYPE OF INSURANCE GENERAL LIABILITY X N N POLICY NUMBER TB2-651-291017-034 POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY) 1/31/2014 1/31/2015 COMMERCIAL GENERAL LIABILITY CLAIMS-MADE X OCCUR X Annual Agg Cap $10M GEN'L AGGREGATE LIMIT APPLIES PER: PROPOLICY JECT LOC AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS HIRED AUTOS C X UMBRELLA LIAB EXCESS LIAB N N AI2-655-291017-014 1/31/2014 1/31/2015 SCHEDULED AUTOS NON-OWNED AUTOS X MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ $ COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ N 048883267 1/31/2014 1/31/2015 CLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ X B DED RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below D Y Motor Truck Cargo $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) $ N OCCUR $ PRODUCTS - COMP/OP AGG $ X A LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) $ N PF-UB-0D635362-14 3/31/2014 1/31/2015 N/A N N MASICSF0088US14 1/31/2014 1/31/2015 X WC STATUTORY LIMITS 1,000,000 1,000,000 10,000 1,000,000 2,000,000 1,000,000 1,000,000 XXXXXXX XXXXXXX XXXXXXX XXXXXXX 3,000,000 3,000,000 XXXXXXX OTHER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ 1,000,000 1,000,000 1,000,000 Any One Vehicle - $250,000 Deductible - $10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required) Broker A listed above represents broker for General Liability, Auto, Umbrella and Workers Compensation coverages. Broker B listed above represents broker for Motor Truck Cargo coverage. If Applicable: Trailer Interchange Coverage $50,000 Limit Per Trailer - Liberty Mutual Fire Ins. Co. Policy #AI2-655-291017-014; Effective: 1/31/2014 to 1/31/2015. Jose Sanchez/Jose A Sanchez Trucking LLC, ELP351866, 2005 International 9400 Eagle, vin#3HSCNAPR45N051866 CERTIFICATE HOLDER 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. 12112551 AUTHORIZED REPRESENTATIVE EVIDENCE OF INSURANCE 1500 RANKLIN ROAD, SUITE #400 HOUSTON TX 77073 ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD
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