2022-12-31_GDAT_GAUW.pdf

PDF 4 MB Posted

Attached to
Master Agreement AZ|CTR049354
Contract number
CTR049354
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by Arthur J. Gallagher Risk Management Services, Inc. on behalf of multiple insurance companies, including National Fire Insurance Co of Hartford, Valley Forge Insurance Company, Transportation Insurance Company, Continental Insurance Company, Continental Casualty Company, and Federal Insurance Company. The primary insured is Gordon Darby Arizona Testing, Inc., located in Louisville, Kentucky. The certificate is issued for the benefit of the Arizona Department of Environmental Quality, covering various Opus Inspection, Inc. affiliated companies and their subsidiaries.

The insurance provides comprehensive coverage including commercial general liability, automobile liability, umbrella liability, workers' compensation, and employers' liability. The policy period is from 12/31/2021 to 12/31/2022, with substantial coverage limits including $1,000,000 per occurrence for general liability, $10,000,000 aggregate for umbrella liability, and $1,000,000 for workers' compensation. The State of Arizona and its departments, agencies, boards, commissions, and universities are included as additional insureds. The policy includes a waiver of subrogation in favor of the certificate holder and covers a broad range of named insureds across multiple related corporate entities engaged in inspection, testing, and diagnostic services.

View the file

Other files

Show all 15

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

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

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

12/30/2021

Arthur J. Gallagher Risk Management Services, Inc.

200 Glastonbury Boulevard Suite 300 Glastonbury CT 06033

Monique Normandy 860-251-6310 860-616-2764 monique_normandy@ajg.com

National Fire Insurance Co of Hartford 20478 OPUSINS-02 Valley Forge Insurance Company 20508

Gordon Darby Arizona Testing, Inc.

2410 Ampere Drive Louisville, KY 40299

Transportation Insurance Company 20494 Continental Insurance Company 35289 Continental Casualty Company 20443 Federal Insurance Company 20281

1902560035

A X 1,000,000 X 1,000,000

15,000

1,000,000

2,000,000 X X X

Y Y 7011637024 12/31/2021 12/31/2022

2,000,000

B 1,000,000

X

X X

7011637055 12/31/2021 12/31/2022

D X X 10,000,0007011637069 12/31/2021 12/31/2022

10,000,000 X 10,000

C E

X

N

7011637038 7011637041

12/31/2021 12/31/2021

12/31/2022 12/31/2022

1,000,000

1,000,000

1,000,000 F Excess Liability 7819-54-33 12/31/2021 12/31/2022 Per Occurrence

Per Aggregate 25,000,000 25,000,000

Named Insured's Include: Opus Inspection, Inc., Envirotest Systems Corp., Environmental Systems Products, Inc.; Drew Technologies, Inc., Systech International, LLC; Autologic Diagnostics, Inc.;Gordon-Darby, Inc.; Gordon-Darby Arizona Testing, Inc.; Gordon-Darby NHost Services, Inc.; Opus VTR, Inc., AutoEnginuity, LLC, Opus IVS, Inc.

The State of Arizona, Its departments , agencies, boards, commissions, universities and its officers, officials, agents and employees are included as additional insureds per blanket General Liability form CNA74879. Waiver of subrogation applies in favor of the certificate holder per General Liability form CGD467, Auto Liability Form CA 73530215 and Workers Compensation form no. WC 00 03 13. Policy Forms attached.

Arizona Dept of Environmental Quality Contracts & Procurement Unit: 1110 W Washington St Phoenix AZ 85007-2935

USA

12/31/2021

7011637038

File details come from the government source that posted it. Updated .