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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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):
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.
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