2024-06-07_-120Water-GAWUP.pdf
PDF 31 KB Posted
- Attached to
- Master Agreement AZ|CTR065767
- Contract number
- CTR065767
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by McGowan Insurance Group on 06/12/2023 for 120 Water Audit, Inc., with the Arizona Department of Environmental Quality as the certificate holder. The insurance coverage involves multiple insurers including Homeland Insurance Co of NY, Cincinnati Insurance Company, Lloyd's of London, and Scottsdale Indemnity Company, providing various types of liability protection.
The insurance policy covers multiple lines of coverage effective from 06/07/2023 to 06/07/2024, including Contractor's Pollution/Professional Liability with a $1,000,000 each occurrence limit, Automobile Liability, Umbrella/Excess Liability with a $5,000,000 aggregate limit, Cyber Liability with a $1,000,000 aggregate limit, and an Employment Practices Liability Policy with a $1,000,000 limit. The certificate specifically notes that the State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are additional insureds, with a waiver of subrogation and primary and non-contributory status for general liability where required by written contract.
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Text version
06/12/2023
McGowan Insurance Group 355 Indiana Avenue Suite 200 Indianapolis IN 46204
Jessica Crews
(317) 464-5000 (317) 464-5001 jessicac@mcgowaninsgrp.com
120 Water Audit, Inc.
P.O. Box 604
Zionsville IN 46077
Homeland Insurance Co of NY 34452 Cincinnati Insurance Company 10677 Lloyd's of London 32727 Scottsdale Indemnity Company 15580
CL2361259242
A Contractor's Pollution/Professional Contractual Liability 7930125970000 06/07/2023 06/07/2024
1,000,000 100,000 10,000 1,000,000 2,000,000 2,000,000
Professional/Pollution $1,000,000Each
B ENP 0499915 06/07/2023 06/07/2024
1,000,000
A
7930125980000 06/07/2023 06/07/2024 5,000,000 5,000,000
C Tech E&O Cyber Liability ESL0139677295 06/07/2023 06/07/2024
Aggregate Limit $1,000,000
Contract #CTR065767 Insurer D - Employment Practices Liability Policy EKI3433113 effective 06/07/2023 - 06/07/2024 Limit $1,000,000. State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees Additional insured, waiver of subrogation, and primary and non-contributory for general liability where required in a 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
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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