2024-06-1-GAUWPro-Native_Env.pdf

CERTIFICATE HOLDER

© 1988-2010 ACORD CORPORATION. All rights reserved.

ACORD 25 (2010/05)

AUTHORIZED REPRESENTATIVE

CANCELLATION

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

LOCJECT

PRO-

POLICY

GEN'L AGGREGATE LIMIT APPLIES PER:

OCCURCLAIMS-MADE

COMMERCIAL GENERAL LIABILITY

GENERAL LIABILITY

PREMISES (Ea occurrence) $

DAMAGE TO RENTED

EACH OCCURRENCE $

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GENERAL AGGREGATE $

PRODUCTS - COMP/OP AGG $

$RETENTIONDED

CLAIMS-MADE

OCCUR

AGGREGATE $

EACH OCCURRENCE $UMBRELLA LIAB

EXCESS LIAB

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

INSR

LTR TYPE OF INSURANCE POLICY NUMBER

POLICY EFF

(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY) LIMITS

WC STATU-

TORY LIMITS

OTH-

ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE

E.L. DISEASE - POLICY LIMIT

ANY PROPRIETOR/PARTNER/EXECUTIVE

If yes, describe under DESCRIPTION OF OPERATIONS below

(Mandatory in NH)

OFFICER/MEMBER EXCLUDED?

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY Y / N

AUTOMOBILE LIABILITY

ANY AUTO

ALL OWNED SCHEDULED

HIRED AUTOS

NON-OWNED

AUTOS AUTOS

AUTOS

COMBINED SINGLE LIMIT

BODILY INJURY (Per person)

BODILY INJURY (Per accident)

PROPERTY DAMAGE $

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.

INSR

ADDL

WVD

SUBR

N / A

(Ea accident)

(Per accident)

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 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).

The ACORD name and logo are registered marks of ACORD

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

INSURED

PHONE

(A/C, No, Ext):

PRODUCER

ADDRESS:

E-MAIL

FAX

(A/C, No):

CONTACT

NAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

INSURER(S) AFFORDING COVERAGE

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

17370

17370

25445

25445

10885

10885

25224

25224

06/01/24

X

2435 E University Dr

2435 E University Dr

XSCUW0015197900

WCA1510776-24

06/01/2023

06/01/2023

X

X

Native Environmental, LLC

Native Environmental, LLC

1,000,000

X

C

1,000,000 mtyson

ECPO1511066-24

X agreement. A waiver of subrogation is added to the Commercial General Liability, Contractors Pollution Liability, insurance available to those person(s) or organization(s) with which the Insured has so agreed in a written contract or Environmental. The coverage provided the additional insured shall be primary and not contributing with any other

100,000

Liability and Auto Liability for liability arising out of the activities performed by or on behalf of Native employees are added as additional insureds with respect to the Commercial General Liability, Contractors Pollution The State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and Re: Contract No. ADEQ18-202760 / Asbestos and Lead Consultant and Abatement Services

Melanie C. Tyson

Melanie C. Tyson

X

1110 W. Washington Street

UCW Insurance Agency, Inc.

UCW Insurance Agency, Inc.

4,000,000

1-866-829-4368

1-866-829-4368

5,000

X

PO Box 31644

PO Box 31644

Professional Liability

1,000,000

Contractors Pollution

D

Nautilus Ins Co (AM Best Rating: A+)

Nautilus Ins Co (AM Best Rating: A+)

Ironshore Specialty Ins Co (AM Best

Ironshore Specialty Ins Co (AM Best

USA

06/01/23 X

Key Risk Ins Co (AM Best Rating: A+)

Key Risk Ins Co (AM Best Rating: A+)

Great Divide Ins Co (AM Best Rating: A+)

Great Divide Ins Co (AM Best Rating: A+)

BAP2014907-18

Contract No. ADEQ18-202760

X

1,000,000

LIC #124221

LIC #124221

2,000,000

Phoenix, AZ 85034

Phoenix, AZ 85034

X

A

4,000,000

06/01/24

X

(866) 829-4369

(866) 829-4369

X

(866) 829-4368

(866) 829-4368

Contracts and Procurement Arizona Department of Environmental Quality

06/01/23

Y

1,000,000

B

Mesa, AZ 85275-1644

Mesa, AZ 85275-1644

Phoenix, AZ 85007-2935

2,000,000

X

06/01/24

X

Melanie Tyson

Melanie Tyson mtyson@ucwinsurance.com mtyson@ucwinsurance.com

X

06/01/24

06/01/23

1,000,000

X

68871864

68871864

06/01/23

SUPP (05/04)

SUPPLEMENT TO CERTIFICATE OF INSURANCE

DATE

NAME OF INSURED:

Additional Description of Operations/Remarks from Page 1:

Additional Information:

Native Environmental, LLC

Holder.

Native Environmental or Broker will provide 30 days notice of such cancellation or non-renewal to the Certificate

If the insurance company elects to cancel or non-renew coverage for any reason other than nonpayment of premium, Auto Liability and Workers Compensation in favor of the additional insureds.

06/01/2023