2026-04-10_Water_Finance_Assistance_GAWP.pdf

PDF 240 KB Posted

Attached to
Master Agreement AZ|CTR074234
Contract number
CTR074234
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by The Hartford for Water Finance Assistance LLC, with the State of Arizona's Department of Environmental Quality as the certificate holder. The insurance is produced by Nutmeg Insurance Agency and covers multiple insurance carriers, including Twin City Fire Insurance Company, Hartford Fire and Its P&C Affiliates, and Landmark American Insurance Company.

The insurance policy provides comprehensive coverage including Commercial General Liability, Automobile Liability, Workers Compensation, and Professional Liability. The policy periods are effective from April 10, 2025 to August 29, 2026, with various coverage limits. Notable limits include $1,000,000 per occurrence for General Liability, $2,000,000 aggregate, $1,000,000 for Automobile Liability, and $2,000,000 for Professional Liability (each claim and aggregate). The policy is associated with Contract #CTR074234 and includes additional insured status and waiver of subrogation for the certificate holder, the State of Arizona's Department of Environmental Quality.

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CTR074234_Pricing.pdf PDF
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Text version

WLTR005

THE HARTFORD

BUSINESS SERVICE CENTER

3600 WISEMAN BLVD

SAN ANTONIO TX 78251 September 22, 2025

State of Arizona AZ Department of Environmental Quality

1110 W WASHINGTON ST

PHOENIX AZ 85007-2952

Account Information:

Policy Holder Details : Water Finance Assistance LLC Contact Us

Need Help?

Chat online or call us at

(866) 467-8730.

We're here Monday - Friday.

Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any questions or concerns.

Sincerely, Your Hartford Service Team

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

09/22/2025 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 SUBROGATIONIS 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).

PRODUCER

NUTMEG INS AGENCY INC/PHS

76210775 The Hartford Business Service Center 3600 Wiseman Blvd San Antonio, TX 78251

CONTACT

NAME:

PHONE

(A/C, No, Ext):

(866) 467-8730 FAX

(A/C, No):

E-MAIL

ADDRESS:

INSURER(S) AFFORDING COVERAGE NAIC#

INSURED

Water Finance Assistance LLC

209 FOREST DR

GRAHAM NC 27253-4403

INSURER A : Twin City Fire Insurance Company 29459 INSURER B : Hartford Fire and Its P&C Affiliates 00914 INSURER C : Landmark American Insurance Company 33138

INSURER D :

INSURER E :

INSURER F :

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

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

LTR

TYPE OF INSURANCE ADDL

INSR

SUBR

WVD

POLICY NUMBER POLICY EFF

(MM/DD/YYYY)

POLICY EXP

(MM/DD/Y YYY)

LIMITS

A

COMMERCIAL GENERAL LIABILITY

X X 76 SBU BE6426 04/10/2025 04/10/2026

EACH OCCURRENCE $1,000,000

CLAIMS-MADE X OCCUR DAMAGE TO RENTED

PREMISES (Ea occurrence) $1,000,000

X General Liability MED EXP (Any one person) $10,000

PERSONAL & ADV INJURY $1,000,000

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000

POLICY PRO-

JECT X LOC PRODUCTS - COMP/OP AGG $2,000,000

OTHER:

A

AUTOMOBILE LIABILITY

X 76 SBU BE6426 04/10/2025 04/10/2026

COMBINED SINGLE LIMIT

(Ea accident)

$1,000,000 ANY AUTO BODILY INJURY (Per person)

ALL OWNED

AUTOS

SCHEDULED

AUTOS BODILY INJURY (Per accident)

X HIRED

AUTOS X NON-OWNED

AUTOS

PROPERTY DAMAGE

(Per accident)

UMBRELLA LIAB

EXCESS LIAB

OCCUR

CLAIMS-

MADE

EACH OCCURRENCE

AGGREGATE

DED RETENTION $

B

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

ANY

PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below

N/ A 76 WBG AD8J5A 08/20/2025 08/20/2026

X PER

STATUTE

OTH-

ER

Y/N E.L. EACH ACCIDENT $1,000,000

E.L. DISEASE -EA EMPLOYEE $1,000,000

E.L. DISEASE - POLICY LIMIT $1,000,000

C Professional Liability LHR860539 08/29/2025 08/29/2026 Each Claim Limit Aggregate Limit

$2,000,000 $2,000,000

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

Those usual to the Insured's Operations. Contract # CTR074234

CERTIFICATE HOLDER CANCELLATION

State of Arizona AZ Department of Environmental Quality

1110 W WASHINGTON ST

PHOENIX AZ 85007-2952

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED

BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED

IN ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE

© 1988-2015 ACORD CORPORATION. All rights reserved.

ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD

ACORD 101 (2014/01) © 2014 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

AGENCY CUSTOMER ID:

LOC# :

ADDITIONAL REMARKS SCHEDULE Page 2 of 2

AGENCY

NUTMEG INS AGENCY INC/PHS

NAMED INSURED

WATER FINANCE ASSISTANCE LLC

209 FOREST DR

GRAHAM NC 27253-4403

POLICY NUMBER

SEE ACORD 25

CARRIER

SEE ACORD 25

NAIC CODE

EFFECTIVE DATE: SEE ACORD 25

ADDITIONAL REMARKS

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM

FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE

Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008, attached to this policy.

Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 and the Hired Auto and Non Owned Auto Endorsement SS0438, attached to this policy.

File details come from the government source that posted it. Updated .