2023-03-02_Matrix_New_World_CTR055977_GAUWP.pdf

03/01/2022

United Assurance Inc 16-00 Pollitt Dr

Fair Lawn NJ 07410

Jennifer Fugate

(201) 797-6600 (201) 797-4455 j.fugate@unitedassurance.com

Matrix New World Engineering, Land Surveying and Landscape Architecture, P.C.

26 Columbia Tpke Florham Park NJ 07932

Nautilus Insurance Company 17370 Allmerica Financial Benefit 41840 Great Divide Insurance Company 25224 Twin City Fire Ins. Co. 29459 Hanover Ins. Co. 22292 Guardian Life Insurance Company of America 64246

CL223127155

A Contractual Liability Pollution Liability Y Y ECP201734116 03/02/2022 03/02/2023

2,000,000 100,000 5,000 2,000,000 2,000,000 2,000,000

Pollution Limit: Each Claim $2M

B Y Y AWY7938199 03/02/2022 03/02/2023

1,000,000

A

Y Y FFX201734216 03/02/2022 03/02/2023

10,000,000 10,000,000

C N WCA201734317 03/02/2022 03/02/2023

1,000,000 1,000,000 1,000,000

A Professional Liability

ECP201734116 03/02/2022 03/02/2023

Each Claim: $ 2,000,000

Aggregate: $ 2,000,000

As per contract with wholly Matrix New World Engineering, Land Surveying and Landscape Architecture, PC - ADEQ CTR055977.

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are listed as Additional Insured with regards to the General Liability and Automobile Liability, Waiver of Subrogation applies in favor of the additional insured, when agreed to by written contract or agreement.

Arizona Department of Environmental Quality 1110 W. Washington Street

Phoenix AZ 85007

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

Matrix New World Engineering, Land Surveying andUnited Assurance Inc

25 Certificate of Liability Insurance: Notes

EPLI and D&O Twin City Fire Ins. Co.

Policy: 13 KB 0372807-22 Effective Date: 3/1/2022 to 3/1/2023 Limit: $5,000,000

Valuable Papers - Hanover Ins. Co.

Policy : RHY5026707 Effective Date: 3/2/2022 to 3/2/2023 Blanket Limit: $1,000,000

Works Compensation Nautilus Ins. Co.

Policy: WCA201734417 (AZ) Effective Date: 3/2/2022 to 3/2/2023

NY Disability - GUARDIAN LIFE INS CO OF AMER Policy: 00932784-0000 Effective Date: 3/15/2021 to 3/15/2023 Statutory Limit

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: FORM TITLE:

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE Page of

AGENCY CUSTOMER ID:

LOC #:

AGENCY

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSURED

EFFECTIVE DATE: