2023-12-31_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 for Gordon Darby Arizona Testing, Inc., issued by Arthur J. Gallagher Risk Management Services, LLC. The insurance policy involves multiple insurers, including National Fire Insurance Co of Hartford, Valley Forge Insurance Company, Continental Insurance Company, American Casualty Company of Reading, PA, and Travelers Property Casualty Co of America. The certificate lists the Arizona Department of Environmental Quality as the certificate holder, and covers multiple named insureds including Opus Inspection, Inc. and various affiliated companies.
The insurance provides comprehensive coverage including commercial general liability, automobile liability, umbrella liability, workers' compensation, and excess liability. The policy periods are from 12/31/2022 to 12/31/2023, with significant coverage limits: $1,000,000 for general liability per occurrence, $1,000,000 for automobile liability, $10,000,000 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. A notable feature is the waiver of subrogation in favor of the certificate holder across multiple policy types, providing broad protection for the state and its entities.
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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
1/13/2023
Arthur J. Gallagher Risk Management Services, LLC 200 Glastonbury Boulevard Suite 300 Glastonbury CT 06033
Helen Romeo 212-994-7096 helen_romeo@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
Continental Insurance Company 35289 American Casualty Company of Reading, PA 20427 Travelers Property Casualty Co of America 25674
1272576904
A X 1,000,000 X 1,000,000
15,000
1,000,000
2,000,000 X
Y Y PMT7011637024 12/31/2022 12/31/2023
2,000,000
B 1,000,000
X
X X
BUA7011637055 12/31/2022 12/31/2023
C X X 10,000,000CUE7011637069 12/31/2022 12/31/2023
10,000,000 X 10,000
D D
XWC711637038
WC711637041
12/31/2022 12/31/2022
12/31/2023 12/31/2023
1,000,000
1,000,000
1,000,000 E Excess Liability EX-3W183461-22-NF 12/31/2022 12/31/2023 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 akshiraiwa Typewriter
PMT7011637024
akshiraiwa_1 Typewriter 12/31/2022 akshiraiwa_2 Typewriter
PMT7011637024
akshiraiwa_3 akshiraiwa_4 Typewriter
PMT7011637024
akshiraiwa_5 akshiraiwa_6 Typewriter
PMT7011637024
akshiraiwa_7 akshiraiwa_8 Typewriter
PMT7011637024
akshiraiwa_9 akshiraiwa_10 Typewriter
PMT7011637024
akshiraiwa_11 akshiraiwa_12 Typewriter
PMT7011637024
akshiraiwa_13 akshiraiwa_14 Typewriter
PMT7011637024
akshiraiwa_15 akshiraiwa_16 Typewriter
PMT7011637024
akshiraiwa_17 akshiraiwa_18 Typewriter
PMT7011637024
akshiraiwa_19 akshiraiwa_20 Typewriter
PMT7011637024
akshiraiwa_21 akshiraiwa_22 Typewriter
PMT7011637024
akshiraiwa_23 akshiraiwa_24 Typewriter
PMT7011637024
akshiraiwa_25 akshiraiwa_26 akshiraiwa_27 Typewriter 12/31/2022 akshiraiwa_28
7011637038 akshiraiwa_29 Typewriter
WC711637041
akshiraiwa_30
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