2025-10-08 Watearth A.pdf
PDF 49 KB Posted
- Attached to
- Master Agreement AZ|CTR074233
- Contract number
- CTR074233
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by Paul Diaz Insurance Agency, Inc. for Watearth, Inc., with coverage provided by multiple insurers including United Financial Casualty Company, Scottsdale Insurance Company, and Hiscox Insurance Company Inc. The certificate is specifically for the Arizona Department of Environmental Quality (ADEQ), with the State of Arizona and its departments listed as additional insureds under contract number CTR074233.
The insurance certificate covers multiple types of liability, including Automobile Liability with a $2,000,000 combined single limit, Employment Practices Liability with a $500,000 per claim limit and $1,000,000 aggregate, and Cyber Liability with a $2,000,000 limit for each claim and aggregate. The policies are effective from October 8, 2024, to October 8, 2025 for Automobile Liability, November 14, 2024, to November 14, 2025 for Employment Practices Liability, and April 12, 2024, to April 12, 2025 for Cyber Liability. The certificate ensures coverage for activities performed by the contractor involving owned, hired, and non-owned automobiles.
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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
04/09/2025
Paul Diaz Insurance Agency, Inc.
9795 Cabrini Drive, Unit 105
Burbank CA 91504
Becky Cuevas
(323) 255-3700 (323) 255-0600 paul@pauldiazins.com
Watearth, Inc.
PO Box 39408
Los Angeles CA 90039
United Financial Casualty Company 11770 Scottsdale Insurance Company 41297 Hiscox Insurance Company Inc. 10200
A X X 987859451 10/08/2024 10/08/2025
2,000,000
B Employment Practices Liability EKS3550366 11/14/2024 11/14/2025 Each Claim &/or Event $500,000 Aggregate $1,000,000
C) Cyber Liability; Policy #MPL5138661.24; Effective 04/12/2024 to 04/12/2025; Each Claim &/or Event Limit: $2,000,000; Aggregate: $2,000,000
The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds with respect to liability arising out of the activities performed by, or on behalf of, the Contractor involving automobiles owned, hired and/or non-owned by the Contractor. Contract number CTR074233
Arizona Department of Environmental Quality (ADEQ) 1110 W. Washington Street Phoenix, AZ 85007
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