01-01-26_cgl_al_ul_wc.pdf

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE

INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #

NAME:

CONTACT

(A/C, No):

FAX

E-MAIL

ADDRESS:

PRODUCER

(A/C, No, Ext):

PHONE

INSURED

REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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).

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.

OTHER:

(Per accident)

(Ea accident)

N / A

SUBR

WVD

ADDL

INSD

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.

$PROPERTY DAMAGE

BODILY INJURY (Per accident)

BODILY INJURY (Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY

Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH)

DESCRIPTION OF OPERATIONS below If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE

E.L. DISEASE - POLICY LIMIT

E.L. DISEASE - EA EMPLOYEE

E.L. EACH ACCIDENT

ER

OTH-

STATUTE

PER

LIMITS(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR

INSR

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

EXCESS LIAB

UMBRELLA LIAB $EACH OCCURRENCE

$AGGREGATE

OCCUR

CLAIMS-MADE

DED RETENTION $

$PRODUCTS - COMP/OP AGG

$GENERAL AGGREGATE

$PERSONAL & ADV INJURY

$MED EXP (Any one person)

$EACH OCCURRENCE

DAMAGE TO RENTED

$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY

PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE

ACORD 25 (2016/03)

© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

12/27/2024

Commercial West Insurance Agency 2152 South Vineyard, Suite 107 Mesa AZ 85210

Lori Spelde 480-961-5400 480-961-5401

Lori@trycwi.com

Phoenix Insurance Company 25623 DBACO-1 Travelers Property Casualty Co 25674

DBA Construction, Inc.

P.O. Box 63035 Phoenix AZ 85082-3035

Travelers Casualty & Surety 31194 Continental Casualty Co. 20443 Underwriters at Lloyds, London

576640144

A X 1,000,000 X 300,000

5,000

1,000,000

2,000,000 X

DT-CO-9D586889-PHX-25 1/1/2025 1/1/2026

2,000,000

B 1,000,000

X

X X

810-2L968980-25-26-G 1/1/2025 1/1/2026

B X X 10,000,000CUP-0K482811-25-26 1/1/2025 1/1/2026

10,000,000

C X

N

UB-9J634648-25-26-G 1/1/2025 1/1/2026

1,000,000

1,000,000

1,000,000 D E

Leased & Rented Equipment Pollution Liability Blanket Installation Floater

6079982568

CPL00975001

1/1/2025 1/1/2025

1/1/2026 1/1/2026

Limit Per Occurrence Limit Limit

750,000 5,000,000 2,000,000

Work Comp applies to all states excluding monopolistic - ND, OH, WA, WY *Blanket Builder's Risk Policy #6079982568|Contienental Casualty Company| Effective 01/01/2025 to 01/01/2026 $2,000,000 Policy Limit* *Motor Truck Legal Liability #6079982568|Continenental Casualty Company| Effective 01/01/2025 to 01/01/2026 $500,000 All Vehicles-Any One Loss* RE: CTR070786- AZGFD CCH Sediment Tank Valve Repair Replacement. The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents and employees are additional insured with respect to liability arising out of the activities performed by or on behalf of the Contractor for (General Liability) and involving automobiles owned, leased hired or borrowed by the contractor (Automobile liability). Coverage is Primary & See Attached...

Arizona Game and Fish Department (AZGFD) 5000 W. Carefree Hwy Phoenix AZ 85086

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: FORM TITLE:

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE Page of

AGENCY CUSTOMER ID:

LOC #:

AGENCY

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSURED

EFFECTIVE DATE:

DBACO-1

1 1

Commercial West Insurance Agency DBA Construction, Inc.

P.O. Box 63035 Phoenix AZ 85082-3035

25 CERTIFICATE OF LIABILITY INSURANCE

Non-Contributory (General Liability). Waiver of Subrogation against losses arising from work performed by or on behalf of the contractor (General Liability, Automobile Liability & Workers Compensation) applies. This form is subject to all policy forms, terms, endorsements, conditions, definitions & exclusions.

Policy # DT-CO-9D586889-PHX-25

Policy # DT-CO-9D586889-PHX-25Policy # DT-CO-9D586889-PHX-25Policy # DT-CO-9D586889-PHX-25Policy # DT-CO-9D586889-PHX-25

Policy # DT-CO-9D586889-PHX-25 lspelde.comme53 Highlight lspelde.comme53_1 lspelde.comme53_2 lspelde.comme53_3

ENDORSEMENT WC 00 03 13 (00) -

POLICY NUMBER:

EMPLOYERS LIABILITY POLICY

AND

WORKERS COMPENSATION

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

ONE TOWER SQUARE

HARTFORD CT 06183

UB-9J634622-26-G

We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)

This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule.

SCHEDULE

DESIGNATED ORGANIZATION:

DESIGNATED PERSON:

ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED

BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS

WAIVER.

INCLUDING:

THE STATE OF ARIZONA, ARIZONA DEPARTMENT OF TRANSPORTATION,

ITS DEPARTMENTS, ITS OFFICERS, OFFICIALS, AGENTS AND

EMPLOYEES.

DATE OF ISSUE: PAGEST ASSIGN: OF01-03-22 1 101/01/2024

UB-9J634648-25-26-G

CPL AIBLKT 07 24 Page 1 of 1

ADDITIONAL INSURED - BLANKET

This endorsement, effective 12:01 a.m., 1/1/2025 forms a part of Policy No. CPL00975001 issued by Certain Underwriters at Lloyd’s, London.

THIS ENDORSEMENT CHANGES THE POLICY – PLEASE READ IT CAREFULLY

In consideration of the premium charged, the insured and the Company agree to the following Policy change(s):

It is hereby understood and agreed that Section III. WHO IS AN INSURED of the above referenced Policy is amended to include the following person(s) or entity(ies):

Any person(s) or entity(ies) for whom you are performing operations when you and such person(s) or entity(ies) have agreed in writing in a contract or agreement that such person(s) or entity(ies) be added as an additional insured on your policy; and any other person(s) or entity(ies) you are required to add as an additional insured under such contract or agreement. Such written contract or written agreement must have been executed and in effect prior to a LOSSto which this insurance applies.

But solely as respects their liability arising out of YOUR WORK performed during the policy period to which this insurance applies. The coverage provided to the additional insured(s) listed above does not apply to a CLAIM, DAMAGESor liability arising out of the sole negligence or acts, errors or omissions of the entity(ies) listed above

ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED