2022-08-01_COI.pdf

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Attached to
Master Agreement AZ|CTR060939
Contract number
CTR060939
Issued by
Arizona

About this file

This document is an ACORD Certificate of Liability Insurance issued on 6/6/2022 by AssuredPartners of Arizona, LLC for Sonotronics Inc., with coverage involving the State of Arizona and the Arizona Game & Fish Department. The insurance is provided by Travelers Indemnity and Travelers Casualty Insurance Company, covering commercial general liability, automobile liability, and workers' compensation for the period from 8/1/2021 to 8/1/2022 and 1/1/2022 to 1/1/2023.

The certificate is associated with Contract #AGFD12-015032 and provides multiple insurance coverages with specific limits, including $1,000,000 per occurrence for commercial general liability, $1,000,000 combined single limit for automobile liability, and workers' compensation coverage. The State of Arizona and the Arizona Game & Fish Department are listed as additional insureds, with a waiver of subrogation applicable per the contract terms. The insurance policies cover various aspects of potential liability, with policy periods spanning from August 2021 to August 2022 and January 2022 to January 2023.

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Text version

6/6/2022

AssuredPartners of Arizona, LLC 4544 E Camp Lowell Dr Ste 110

Tucson AZ 85712-1282

Frani Schmidt (520)571-7737 (520)571-9115

Frani.Schmidt@AssuredPartners.com

Sonotronics Inc.

3169 S. Chrysler

Tucson AZ 85713

Travelers Indemnity 25658 Travelers Casualty Insurance Company of America19046

21-22 GL AU 22-23 WC

A

X

X

X

X 6803H150727 8/1/2021 8/1/2022

1,000,000

300,000

5,000

1,000,000

2,000,000

2,000,000

B X X X

BA3N212840 8/1/2021 8/1/2022

1,000,000

Medical payments 5,000

A UB8R0524992142G 1/1/2022 1/1/2023

1,000,000

1,000,000

1,000,000

Contract #AGFD12-015032

The State of Arizona and the Arizona Game & Fish Dept are Additional Insureds as regards general libility, if required by contract, waiver of subrogation applies - per form CG D4 17 01 12 subject to all policy terms, conditions, definitions and exclusions.

Arizona Game and Fish Dept 5000 W Carefree Highway Phoenix, AZ 85085 jscherbing@azgfd.gove

Frani Schmidt/FRANI

The ACORD name and logo are registered marks of ACORD

CERTIFICATE HOLDER

© 1988-2014 ACORD CORPORATION. All rights reserved.

ACORD 25 (2014/01)

AUTHORIZED REPRESENTATIVE

CANCELLATION

DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE

LOCJECT

PRO-

POLICY

GEN'L AGGREGATE LIMIT APPLIES PER:

OCCURCLAIMS-MADE

COMMERCIAL GENERAL LIABILITY

PREMISES (Ea occurrence) $

DAMAGE TO RENTED

EACH OCCURRENCE $

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GENERAL AGGREGATE $

PRODUCTS - COMP/OP AGG $

$RETENTIONDED

CLAIMS-MADE

OCCUR

AGGREGATE $

EACH OCCURRENCE $UMBRELLA LIAB

EXCESS LIAB

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

INSR

LTR TYPE OF INSURANCE POLICY NUMBER

POLICY EFF

(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY) LIMITS

PER

STATUTE

OTH-

ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE

E.L. DISEASE - POLICY LIMIT

ANY PROPRIETOR/PARTNER/EXECUTIVE

If yes, describe under DESCRIPTION OF OPERATIONS below

(Mandatory in NH)

OFFICER/MEMBER EXCLUDED?

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY Y / N

AUTOMOBILE LIABILITY

ANY AUTO

ALL OWNED SCHEDULED

HIRED AUTOS

NON-OWNED

AUTOS AUTOS

AUTOS

COMBINED SINGLE LIMIT

BODILY INJURY (Per person)

BODILY INJURY (Per accident)

PROPERTY DAMAGE $

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.

INSD

ADDL

WVD

SUBR

N / A

(Ea accident)

(Per accident)

OTHER:

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).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

INSURED

PHONE

(A/C, No, Ext):

PRODUCER

ADDRESS:

E-MAIL

FAX

(A/C, No):

CONTACT

NAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

INSURER(S) AFFORDING COVERAGE

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

INS025 (201401)

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