2-Attachment 7_-_Supplement_Insurance (1).pdf
PDF 94 KB Posted
- Solicitation number
- BPM006894
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Certificate of Liability Insurance document issued by Brown & Brown Insurance Services, Inc. for R.D. Offutt Company, certifying insurance coverage required for state and local contracting purposes. The certificate documents multiple policies effective October 31, 2024, through October 31, 2025, including commercial general liability coverage with limits of $5,000,000 per occurrence and $10,000,000 general aggregate, automobile liability coverage with $1,000,000 per accident limits, workers' compensation coverage with $4,000,000 limits, and excess liability umbrella coverage with $5,000,000 each occurrence and $5,000,000 aggregate limits. The named insurers include American Zurich Insurance Company, Zurich American Insurance Company, HDI Specialty Insurance Company, and Steadfast Insurance Company. The certificate confirms that Safeware, Inc. is designated as an additional insured with respect to the general liability policy where required by written contract, subject to policy terms and conditions.
The endorsement attached to the certificate (U-GL-1175-F) establishes automatic additional insured provisions for owners, lessees, or contractors as required by written contract or agreement. The additional insured coverage applies only to liability arising from the named insured's acts or omissions in performance of ongoing operations or work that is the subject of the written contract, but excludes professional architectural, engineering, or surveying services. The endorsement specifies that insurance afforded to additional insureds will not be broader than required by the written contract and that this coverage is primary and non-contributory where the written contract requires such designation. The certificate is issued for informational purposes only and confers no rights upon the certificate holder independent of the underlying policy terms and conditions. All policies remain in effect through October 31, 2025, with cancellation notice to be provided in accordance with policy provisions.
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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
1,000,000
5,000,000
751798149
751798149
Attn: Loren Stahl PO Box 7160
Safeware, Inc.
5,000,000
10/31/25
X
10/31/25
X
EXCESS AUTO
dawn.heinemann@bbrown.com
500,000
40142
26387
16535
1,000,000
16131
EXCESS GL
X
5,000,000
Safeware, Inc. is additional insured as respects general liability policy where required by written contract subject to
612-333-3323
X the policy terms and conditions.
10/31/25
10/31/24
USA
10/31/24
10/31/25
R.D. Offutt Company RDO Equipment Co.
CUXCD5749803S
WC929893924 (WI)
WC765079004 (AOS)
10/31/24
612-373-7270
2,000,000
10/31/25
X ddebuhr
10/31/24
4,000,000
X
Suite 1800
Lanham, MD 20706
901 Marquette Avenue
10,000
HDI SPECIALTY INS CO
ZURICH AMER INS CO
STEADFAST INS CO
4,000,000
AMERICAN ZURICH INS CO
2,000,000
D
D
10/31/24
10/31/24
BAP929893724 10/31/24
Fargo, ND 58106-7160 USA
N
Dawn Heinemann and Casey Olson
C
A
B
612-333-3323
A
LIMIT
GLO929893824
5,000,000A
03/06/2025
10/31/25
SXS007560903
X
SXS007561003
X
5,000,000
1,000,000
4403 Forbes Blvd.
Minneapolis, MN 55402 USA
10/31/25
LIMIT
Brown & Brown Insurance Services, Inc.
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add’l. Prem Return Prem.
GLO 9298938-24 10/31/2024 10/31/2025 34150000 INCL
Additional Insured – Automatic – Owners, Lessees Or Contractors
U-GL-1175-F CW (04/13)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named Insured: R.D. OFFUTT COMPANY Address (including ZIP Code):
PO BOX 7160
FARGO, ND 58106
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
A. Section II – Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations or "your work" as included in the "products-completed operations hazard", which is the subject of the written contract or written agreement.
However, the insurance afforded to such additional insured:
1. Only applies to the extent permitted by law; and
2. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured.
B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies:
This insurance does not apply to:
"Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services including:
a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or
b. Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services.
U-GL-1175-F CW (04/13)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV – Commercial General Liability Conditions:
The additional insured must see to it that:
1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim;
2. We receive written notice of a claim or "suit" as soon as practicable; and
3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non-contributory.
D. For the purposes of the coverage provided by this endorsement:
1. The following is added to the Other Insurance Condition of Section IV – Commercial General Liability
Conditions:
Primary and Noncontributory insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that:
a. The additional insured is a Named Insured under such other insurance; and
b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured.
2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV – Commercial
General Liability Conditions:
This insurance is excess over:
Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis.
E. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured.
F. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section III – Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the written contract or written agreement referenced in Paragraph A. of this endorsement; or
2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
All other terms and conditions of this policy remain unchanged.
| GL - ADDITIONAL INSURED - AUTOMATIC - OWNERS, LESSEES OR CONTRACTORS (BLANKET, PER WRITTEN CONTRACT) 2024.pdf |
| Change Endorsement - TRANSACTION 005 |
| INSURED-FULL POLICY W/OUT WKSHTS |
| COMMON & LOSS RATED GENL LIAB |
| POLICYWRITING INDEX ~ POLINDEX ~ 0000 |
| LIST OF FORMS ON POLICY INDEX ~ POLINDEX2 ~ 0000 |
| COMMON POLICY CHANGE ENDORSEMENT ~ U-GU-614-B CW ~ 1016 |
| ADDL INSD-AUTO-OWNERS LESSEES CONTRACTR ~ U-GL-1175-F CW ~ 0413 |
| Page 1 |
| Page 2 |
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