2026-08-17 UST Training Inc GA.pdf
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- Attached to
- Master Agreement AZ|CTR051078
- Contract number
- CTR051078
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance for UST Training, Inc., a Washington state S-Corporation, issued by Elliott Powell Baden and Baker Inc. through Beazley Syndicates insurance. The certificate covers UST Operator Training and Training Course License services, with the State of Arizona, Arizona Department of Environmental Quality listed as the primary certificate holder. The insurance policy is effective from 08/17/2025 to 08/17/2026 and includes multiple liability coverages such as commercial general liability, automobile liability, and pollution liability.
The contract (Contract # CTR051078) appears to be for UST Operator Training and Training Course License services, with a policy providing comprehensive insurance coverage. The liability limits include $1,000,000 for each occurrence, $2,000,000 general aggregate, $1,000,000 for products-completed operations, and $1,000,000 for pollution liability. The policy includes additional insured provisions for the State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees. The insurance is primary and non-contributory, meaning it will not seek contribution from other available insurance and will be the first line of coverage for any claims related to the contracted services.
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Text version
08/18/2025
Elliott Powell Baden and Baker Inc.
An ISU Network Member 1521 SW Salmon Street Portland OR 97205-1783
Joanne Taylor
(503) 227-1771 (503) 274-7644 jtaylor@epbb.com
UST Training, Inc., a WA S-Corp PO Box 1591
Langley WA 98260
Beazley Syndicates
25-26 GL/E&O/H&NO
AUTO
A
Professional Liability
Y Y ENC0004946-06 08/17/2025 08/17/2026
1,000,000 100,000 10,000 1,000,000 2,000,000 2,000,000
Pollution Liability 1,000,000
A Y Y ENC0004946-06 08/17/2025 08/17/2026
0/17/2025
Contract # CTR051078 UST Operator Training and Training Course License.
Per attached forms CG2010 07/04; CG2037 07/04; CG2001 04/13; CG2404 10/93; CPP2781216; EVA124 12/2016.
State of Arizona, Arizona Dept of Environmental Quality * 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
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
UST Training, Inc., a WA S-Corp
00108083
Elliott Powell Baden and Baker Inc.
25 Certificate of Liability Insurance: Notes
*Certificate holer includes: State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees
ACORD 101 (2008/01)
The ACORD name and logo are registered marks of ACORD
© 2008 ACORD CORPORATION. All rights reserved.
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: FORM TITLE:
ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY CUSTOMER ID:
LOC #:
AGENCY
CARRIER NAIC CODE
POLICY NUMBER
NAMED INSURED
EFFECTIVE DATE:
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