ACCEPTED_ANY_ALL_07.01.23-07.01.24.pdf

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

11/14/2023

IBTX Risk Services 32335 US Hwy 281 N., Suite #102 Bulverde TX 78163

Daphne L Watkins 214-989-7100 210-696-8414 service@ib-tx.com

Zurich American Insurance Company 16535 URETUSA-01 RSUI Indemnity Company 22314

URETEK USA, Inc.

13900 Humble Road Tomball TX 77375

Endurance American Insurance Company 10641 Allied World Assurance Company (U.S.) Inc. 19489

371152410

A X 2,000,000 X 1,000,000

X Contractual Liab 10,000

X XCU 2,000,000

4,000,000 X X

GLO 0187947-07 7/1/2023 7/1/2024

4,000,000

A 2,000,000

X

X X

BAP 0187948-07 7/1/2023 7/1/2024

B C

X 5,000,000 X

NHA103342

EXC30001800403

7/1/2023 7/1/2023

7/1/2024 7/1/2024

5,000,000 X 0 2nd Lyr XS Occ/Agg 4,000,000

A X

N

WC 0187946-07 7/1/2023 7/1/2024

1,000,000

1,000,000

1,000,000 D D

Pollution Liability Professional Liability Retention $25,000

0310-1771 0310-1771

7/1/2023 7/1/2023

7/1/2024 7/1/2024

Poll Per Occurr Prof Per Claim Prof/Poll Aggregate

$2,000,000 $2,000,000 $4,000,000

The General Liability and Auto policies include blanket additional insured endorsements [U-GL-2162-A CW 02/19, UGL1345BTX 4/13 with Ongoing/Completed Ops included, CG2007 04/13, UUMANB & UCA424FCW 04/14] as required in a written contract with the Named Insured. The General Liability, Auto & Work Comp policies include a blanket waiver of subrogation endorsement [UGL1345BTX 4/13, UCA424FCW 4/14,EXL6092 08/13, UUMANB, WC000313 4/84, & WC420304B 6/14] as required in a written contract with the Named Insured. Primary Noncontributory wording per attached endorsements [UGL1345BTX 4/13, UCA424FCW 4/14, UUMANB, RSG36111 10/13 & EXL3038 08/17]. Cancellation provisions-see attached [UGL1521BCW 01/19, UCA832ACW 1/13, WC990643 1/13 & RSG94118 02/14]. Umbrella is follow form of the General Liability, Auto and Work Compensation, Employers Liability policies subject to policy terms and conditions. Per Project Aggregate [CG2503 05/09]

RE: Any and All work performed for or on behalf of the State of Arizona/ADOT.

The State of Arizona/ADOT 206 S. 17th Ave.

Phoenix, AZ 85007 a8812 Accepted

GLO 0187947-07

BAP 0187948-07

WC 0187946-07

BAP 0187948-07