2023-02-09_COI.pdf

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Attached to
Master Agreement AZ|CTR060942
Contract number
CTR060942
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by Christensen Group on February 8, 2022, for Advanced Telemetry Systems, Inc. located in Isanti, Minnesota. The certificate lists multiple insurers, including Great Northern Insurance, Federal Insurance Company, Travelers Casualty & Surety Company, and Ace American Insurance Company. The certificate holder is the Arizona Game and Fish Department, representing the State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees.

The insurance coverage includes Commercial General Liability, Automobile Liability, Umbrella/Excess Liability, Workers' Compensation, and Professional Liability. The policies are effective from February 9, 2022, to February 9, 2023, with various coverage limits. For example, the Commercial General Liability has a $1,000,000 each occurrence limit and a $2,000,000 general aggregate limit. The Professional Liability coverage has an aggregate limit of $1,000,000 with a $25,000 deductible. The certificate includes provisions for additional insured status and a waiver of subrogation in favor of the Arizona Game and Fish Department when required by written contract.

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Text version

02/08/2022

Christensen Group 9855 West 78th Street, Ste 100

Eden Prairie MN 55344

Ginny Mosier

(952) 653-1000 (952) 653-1100 gmosier@christensengroup.com

ADVANCED TELEMETRY SYSTEMS, INC.

470 - 1st Avenue NW

Isanti MN 55040

Great Northern Ins. 20303 Federal Ins. Co. 20281 Travelers Casualty & Surety Co 19038 Ace American Insurance Co.

22-23 Liability

A 99470928 02/09/2022 02/09/2023

1,000,000 1,000,000 10,000 1,000,000 2,000,000 1,000,000

B 73583122 02/09/2022 02/09/2023

1,000,000

B

79888132 02/09/2022 02/09/2023 5,000,000 5,000,000

C N UB3K07238A 02/09/2022 02/09/2023

500,000 500,000 500,000

D Professional Liability

95881932 02/09/2022 02/09/2023 Aggregate 1,000,000 Deductible 25,000

Arizona Game and Fish Department, the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees is included as an Additional Insured under the General Liability when required by written contract. A Waiver of Subrogation in favor of the Arizona Game and Fish Department, the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees applies to the General Liability when required by written contract.

Arizona Game and Fish Department 5000 West Carefree Hwy

Phoenix AZ 85086

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

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