2025-04-04 Watearth GUP.pdf

PDF 1 MB Posted

Attached to
Master Agreement AZ|CTR074233
Contract number
CTR074233
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance for Watearth, Inc., issued by AssuredPartners of WA, LLC, with Admiral Insurance Company as the primary insurer. The certificate is associated with Contract No. CTR074233 and is issued for the Arizona Department of Environmental Quality (ADEQ), located in Phoenix, Arizona. The insurance policy provides comprehensive coverage including Commercial General Liability, Contractors Pollution Liability, and Professional Liability for Watearth, Inc., with an effective period from 04/04/2024 to 04/04/2025.

The insurance policy includes multiple coverage limits, with a general aggregate of $2,000,000, each occurrence limit of $1,000,000, and personal and advertising injury limit of $1,000,000. Additional coverage includes a Pollution Liability policy with a $1,000,000 limit per occurrence. The policy contains several endorsements, including Additional Insured provisions, Automatic Primary and Non-Contributory Insurance, Automatic Waiver of Subrogation, and notifications for cancellation. The insurance covers all operations of the insured subject to policy terms, and includes blanket additional insured and blanket waiver of subrogation provisions as required under written contracts or agreements.

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Text version

09/03/2024

AssuredPartners of WA, LLC 1325 Fourth Ave, Suite 2100

Seattle WA 98101

Joann Pfeifer

(206) 343-2323 (206) 508-5910 joann.pfeifer@assuredpartners.com

Watearth, Inc.

PO Box 39408

Los Angeles CA 90039

Admiral Insurance Company

CL245802893

A Y Y FEIECC3588100 04/04/2024 04/04/2025

1,000,000 100,000 10,000 1,000,000 2,000,000 2,000,000

A Y Y FEIEXS4548400 04/04/2024 04/04/2025

5,000,000 5,000,000

A Professoinal Liab

FEIECC3588100 04/04/2024 04/04/2025 Each Claim/Aggregate 2,000,000

Re: Contract No. CTR074233 All operations of insured subject to policy terms and conditions.

Includes Blanket Additional Insured and Blanket Waiver of Subrogation if required under written contract or agreement per attached.

Pollution Liab: Policy #FEIEC3588100, 4/4/24 - 4/4/25, Limit $1,000,000 Each Occurrence

Arizona Department of Environmental Quality (ADEQ) 1110 W Washington St

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

E-MAIL

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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