2023-03-06COI.pdf

PDF 26 KB Posted

Attached to
Master Agreement AZ|CTR063500
Contract number
CTR063500
Issued by
Arizona

About this file

This document is an ACORD Certificate of Liability Insurance for Wildlife Acoustics, Inc., issued by New England Insurance Group on 12/13/2022. The certificate involves multiple insurance providers, including Hartford Fire Insurance Company, Sentinel Insurance Co., LTD, and Great American E&S Insurance Company. The certificate holder is the Arizona Game and Fish Department, with the State of Arizona and its various departments, agencies, boards, commissions, universities, officers, officials, agents, and employees listed as additional insureds.

The insurance coverage includes Commercial General Liability with a $1,000,000 per occurrence limit, Automobile Liability, Umbrella Liability with a $10,000,000 limit, and Workers' Compensation. The policies are effective from 3/6/2022 to 3/6/2023, with an additional Excess Liability policy extending coverage. The certificate provides comprehensive insurance protection for Wildlife Acoustics, Inc. across multiple areas of potential liability, ensuring coverage for the company's operations in relation to its contract with the Arizona Game and Fish Department.

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Text version

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

INSR ADDL SUBR

LTR INSD WVD

PRODUCER CONTACT

NAME:

FAXPHONE

(A/C, No):(A/C, No, Ext):

E-MAIL

ADDRESS:

INSURER A :

INSURED INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)

AUTOMOBILE LIABILITY

UMBRELLA LIAB

EXCESS LIAB

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

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

AUTHORIZED REPRESENTATIVE

EACH OCCURRENCE $

DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT

OTHER: $

COMBINED SINGLE LIMIT

$(Ea accident)

ANY AUTO BODILY INJURY (Per person) $

OWNED SCHEDULED

BODILY INJURY (Per accident) $AUTOS ONLY AUTOS

HIRED NON-OWNED PROPERTY DAMAGE

$AUTOS ONLY AUTOS ONLY (Per accident)

OCCUR EACH OCCURRENCE

CLAIMS-MADE AGGREGATE $

DED RETENTION $

PER OTH-

STATUTE ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE $

If yes, describe under

E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below

INSURER(S) AFFORDING COVERAGE NAIC #

COMMERCIAL GENERAL LIABILITY

Y / N N / A

(Mandatory in NH)

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

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.

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 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).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

CERTIFICATE HOLDER CANCELLATION

© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)

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

The ACORD name and logo are registered marks of ACORD

12/13/2022

(617) 928-9222 (617) 928-9298

Wildlife Acoustics, Inc.

3 Mill & Main Place, Suite 210 Maynard, MA 01754

11000

A 1,000,000

X 08HISWL1319 3/6/2022 3/6/2023 1,000,000

10,000

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

EBLI AGGREGATE 1,000,000

1,000,000A

08HISWL1319 3/6/2022 3/6/2023

10,000,000B

X 08SBANN3235 3/6/2022 3/6/2023

10,000 10,000,000 A

08HISWL1319 3/6/2022 3/6/2023 1,000,000

1,000,000 1,000,000

C Exces Liability XS E879475 8/22/2022 Excess Liability 9,000,000

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds when required by written contract.

Arizona Game and Fish Department 5000 W Carefree Hwy Phoenix, AZ 85086

WILDACO-01 AHARTLEY

New England Insurance Group 1101 Worcester Rd Framingham, MA 01701 audrey@newenglandins.com

Hartford Fire Ins Co Sentinel Insurance Co., LTD Great American E&S Insurance Company

3/6/2023

X X

X X X

X

X

X

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