05-04-24 CTR059433 ETC_GAUWCP.pdf
PDF 178 KB Posted
- Attached to
- Master Agreement AZ|CTR059433
- Contract number
- CTR059433
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by Higginbotham Insurance Agency, Inc. for Complete Training Resources (dba ETC Compliance Solutions, Inc.), with insurance coverage provided by Mid-Continent Casualty Company and Twin City Fire Insurance Company. The certificate is for the State of Arizona, specifically covering the state's departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds with a waiver of subrogation.
The insurance policy provides comprehensive coverage including Commercial General Liability, Automobile Liability, Umbrella Liability, and Workers' Compensation. The policy is effective from 5/4/2023 to 5/4/2024, with multiple coverage limits. The Commercial General Liability has a $1,000,000 each occurrence limit and a $3,000,000 general aggregate limit. Professional Liability is also included with a $1,000,000 occurrence limit and a $3,000,000 aggregate limit. The policy covers various operational aspects, including professional services, with additional insured status for the State of Arizona per the written contract.
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Text version
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
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
5/16/2023
Higginbotham Insurance Agency, Inc.
PO Box 52534 Tulsa OK 74152-0534
David Vaughan 918-779-7880 918-779-7885 dlvjr@higginbotham.net
Mid-Continent Casualty Company 23418 COMPTRA-02 Twin City Fire Insurance Company 29459
Complete Training Resources dba ETC Compliance Solutions, Inc.
5532 E. Grant Rd Tucson AZ 85712
1309787482
A X 1,000,000 X 100,000
X Professional Excluded
1,000,000
3,000,000 X
Y Y 04-GL-001097599 5/4/2023 5/4/2024
3,000,000
A 1,000,000
X X
04-GL-001097599 5/4/2023 5/4/2024
A X 2,000,000 X
04-XS-228788 5/4/2023 5/4/2024
2,000,000
B X
N
38WECAG20BA 5/4/2023 5/4/2024
1,000,000
1,000,000
1,000,000 A Professional Liability Y Y 04-GL-001097599 5/4/2023 5/4/2024 Occurrence
Aggregate 1,000,000 3,000,000
The State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, agents and employees are included as Additional Insureds with Waiver of Subrogation on the policy referenced above per written contract.
State of Arizona 100 N. 15th Ave., Ste. 201 Phoenix AZ 85007
File details come from the government source that posted it. Updated .