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.
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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
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
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