ACCEPTED_ANY_ALL_GL_AL_WC_10.01.23-10.01.24.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)

© 1988-2016 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

Chemical Drift Coverage

10/01/2024

X

19445

5,000,000

19399

ISPILLSCEQO4001

5,000,000

10/01/2024

D

C

25,000,000

10/01/2024 X

American Guarantee & Liability Ins Co

Pollution

10/01/2021

CN102359568-HELEN-#3A-23-25

2,000,000

25445

Amber Roetker

01/24/2025

ATL-005701311-02

10/01/2023

X

EXCLUDED

01/31/2024

10/01/2023

50,000,000Legal Liability

2,000,000

X

Aggregate

2,000,000 2,000,000

D amber.roetker@marsh.com

10/01/2024

11/17/2021

INCLUDED

10/01/2023

X

26247

4594415 (AOS)

Each Incident

5,000

049154371 (AOS)

IPR379234004

Ded:$1,000,000 each occurrence

500,000 required by written contract with respect to general liability, workers compensation and auto liability.

The State of Arizona/ADOT are listed as Additional Insured on the Automobile and General Liability if and to the extent required by written contract. This insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract with respect to general liability and auto liability. Waiver of subrogation is applicable where

National Union Fire Ins Co. of Pittsburgh PA 225 Schilling Boulevard

Helena Agri-Enterprises, LLC

Collierville, TN 38017 Suite #300

2,000,000

AIU Insurance Co

X

6410 Poplar Avenue, Suite 540

MARSH USA, LLC.

Attn: amber.roetker@marsh.com Memphis, TN 38119

D

GL1728981

Ironshore Specialty Insurance Co.

N

Phoenix, AZ 85007

The State of Arizona

206 S 17th Ave

10/01/2023

4594416 (MA)

A

1,000,000X

615 340 2462

X

B

5,000,000

10/01/2024

X

F0950 Accepted

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:

MARSH USA, LLC.�

Carrier: AIU Insurance Co.�

Effective Date: 10/01/2023� Policy No.: 049154371 �

Expiration Date: 10/01/2024�

Workers Compensation Continued:�

Carrier: AIU Insurance Company (AL, AR, AZ, CO, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MA, MD, MI, MN, MO, MS, MT, NC, NE,NJ, NM, NV, NY, OK, OR, PA, SC, SD, TX, VA, Effective Date: 10/01/2023�

Policy No.: 049154372 (California)�

EL limits are $2,000,000 except $1,000,000. Employers Liability for states of GA, MI, MN and VA, which is the maximum Employers Liability limit allowed in those states. �

Deductible is BI by accident $1,000,000 / by disease $1,000,000 / All covered BI aggregate $20,000,000. �

Memphis

Certificate of Liability Insurance

Expiration Date: 10/01/2024�

Carrier: AIU Insurance Co.�

Effective Date: 10/01/2023� and Monopolistic States)�

Policy No. 049154373 (Wisconsin)�

Expiration Date: 10/01/2024�

225 Schilling Boulevard� Helena Agri-Enterprises, LLC�

Suite #300�

CN102359568

Collierville, TN 38017