2024.1.1 Energy & Environmental Advisors, Inc. GAUWCPP.pdf
PDF 877 KB Posted
- Attached to
- Master Agreement AZ|CTR067133
- Contract number
- CTR067133
- Issued by
- Arizona
About this file
This is a comprehensive insurance certificate and associated endorsement documents for Energy & Environmental Advisors, Inc., issued by Perspective Insurance with multiple insurers including Cincinnati Insurance Company, Chubb Group of Insurance Companies, and Crum & Forster Specialty Insurance Company. The primary certificate holder is the State of Arizona, specifically the Arizona Department of Environmental Quality, located in Phoenix. The insurance package covers multiple Williams & Company entities, including Williams & Company Consulting, Inc., Williams & Company Communications, Inc., and related subsidiaries.
The insurance coverage is for Contract No. CTR066266 for UST (Underground Storage Tank) Inspections, with policies effective from January 1, 2023 to January 1, 2024. The insurance includes Commercial General Liability with $1,000,000 per occurrence and $2,000,000 aggregate limits, Automobile Liability, Umbrella Liability with $3,000,000 limits, Workers' Compensation, Pollution Liability with $1,000,000 per condition, and Professional Liability with $2,000,000 per wrongful act. The State of Arizona is listed as an Additional Insured with a 30-day cancellation notice provision, and there is a Waiver of Subrogation in favor of the state and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees.
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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):
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
8/3/2023
(712) 546-7821 (712) 546-5602
10677
Energy & Environmental Advisors, Inc.
PO Box 9400 Sioux City, IA 51102
44520
A 1,000,000
X X ENP0221245 1/1/2023 1/1/2024 500,000
10,000
1,000,000 2,000,000 2,000,000
1,000,000A
X X ENP0221245 1/1/2023 1/1/2024
3,000,000A
ENP0221245 1/1/2023 1/1/2024 3,000,000
A
X EWC0413718-06 1/1/2023 1/1/2024 1,000,000
1,000,000 1,000,000
B Pollution Liability G24300006 006 7/12/2022 Each Condition 1,000,000 C Professional Liab PKC-113815 1/1/2023 1/1/2024 Each Wrongful Act 2,000,000
Named Insured includes:
Williams & Company Consulting, Inc.
Williams & Company Communications, Inc.
Williams & Company Communications Inc. DBA Willcomm Technology Services Williams & Company Consulting, Inc. DBA C&S Communications Williams & Company Consulting, Inc. DPA Petro Classroom Willico, Inc.
SEE ATTACHED ACORD 101
State of Arizona Arizona Department of Environmental Quality 1110 W Washington St Phoenix, AZ 85007
WILL&CO-01 LSTEFFEN
Perspective Insurance 200 5th Ave SW Le Mars, IA 51031
Rob Bixenman robb@perspectiveinsurance.com
Cincinnati Insurance Company Chubb Group of Insurance Companies Crum & Forster Specialty Insurance Company
X
7/12/2024
X X
X X X
X X
FORM NUMBER:
EFFECTIVE DATE:
The ACORD name and logo are registered marks of ACORD
ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE
FORM TITLE:
Page of
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
ACORD 101 (2008/01)
AGENCY CUSTOMER ID:
LOC #:
AGENCY NAMED INSURED
POLICY NUMBER
CARRIER NAIC CODE
© 2008 ACORD CORPORATION. All rights reserved.
Perspective Insurance
WILL&CO-01
SEE PAGE 1
SEE PAGE 1
ACORD 25 Certificate of Liability Insurance
SEE P 1
Energy & Environmental Advisors, Inc.
PO Box 9400 Sioux City, IA 51102
SEE PAGE 1
LSTEFFEN
Description of Operations/Locations/Vehicles:
Contract No: CTR066266 UST Inspections
The State of Arizona and its departments, agencies, boards, commissions, universities, officer, officials, agents and employees as Additional Insureds with respect to the General Liability and Automobile Liability arising out of the activities performed by or on behalf of the Contractor on a primary and non-contributory basis.
A Waiver of Subrogation is in favor of The State of Arizona, and its departments, agencies, boards, commissions, universities, officer, officials, agents and employees with respect to the General Liability, Automobile Liability and Workers Compensation.
30 Day Notice of Cancellation in favor of the certificateholder.
File details come from the government source that posted it. Updated .