ACCEPTED_ANY_ALL_GL_AL_WC_Pollution_10.28.23-02.14.24.pdf
PDF 1 MB Posted
- Attached to
- Master Agreement AZ|CTR063620
- Contract number
- CTR063620
- Issued by
- Arizona
About this file
This document is a comprehensive insurance certificate and associated endorsements for Chase Sports Specialist, LLC, issued by The Mahoney Group in Tucson, Arizona. The primary insurers are Auto-Owners Insurance Company and Westchester Surplus Lines Insurance Company. The certificate involves multiple additional insured parties, including the Arizona Department of Transportation Procurement Group, City of Scottsdale, City of Surprise, City of Goodyear, Arizona, Cleveland Indians Baseball Company, Cincinnati Reds LLC, Willmeng Construction Inc, and other related organizations.
The insurance coverage includes Commercial General Liability, Automobile Liability, Umbrella Liability, Workers' Compensation, and Pollution Liability, with policy periods ranging from 10/12/2023 to 10/28/2024 and 2/14/2023 to 2/14/2024. The policies provide various coverage limits, with general liability set at $1,000,000 per occurrence and $2,000,000 aggregate, and pollution liability at $2,000,000. The endorsements specify additional insured provisions, primary and noncontributory insurance conditions, and waivers of subrogation for ongoing operations and completed work. The coverage is designed to protect the named parties during construction, maintenance, and related operations, with specific provisions for different types of potential liability and damage.
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ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
PRODUCER CONTACT
NAME:
FAXPHONE
(A/C, No):(A/C, No, Ext):
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $
DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT
OTHER: $
COMBINED SINGLE LIMIT
$(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED
BODILY INJURY (Per accident) $AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
$AUTOS ONLY AUTOS ONLY (Per accident)
OCCUR EACH OCCURRENCE
CLAIMS-MADE AGGREGATE $
DED RETENTION $
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below
INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N N / A
(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
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.
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 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).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
The ACORD name and logo are registered marks of ACORD
11/13/2023
(520) 795-8511 (520) 795-8542
18988
Chase Sports Specialist, LLC 7650 S. McClintock Dr. Ste 103 Tempe, AZ 85284
10172
A 1,000,000
X X 45017512 10/28/2023 10/28/2024 300,000 10,000
1,000,000 2,000,000 2,000,000
1,000,000A
X X 45017512 10/28/2023 10/28/2024
2,000,000A X 5141404600 10/28/2023 10/28/2024 2,000,000
10,000 A
X A106543742 10/12/2023 10/12/2024 1,000,000 1,000,000 1,000,000
B Pollution Liability X X G71664600 001 2/14/2023 $2,000,000 1,000,000
Arizona Dept of Transportation Procurement Group, State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees: General Liability Additional Insured, Waiver of Subrogation and Primary & Noncontributory per written contract, per attached.
Auto Additional Insured, Waiver of Subrogation per written contract, per attached.
Worker’s Compensation Waiver of Subrogation per written contract, per attached.
Pollution Additional Insured, per written contract, per attached.
Umbrella follow form.
Arizona Dept of Transportation Procurement Group 1739 W Jackson St #A, MD 100P Phoenix, AZ 85007
CHASSPO-01 PHAWTHORNE
The Mahoney Group - Tucson 5330 N. La Cholla Blvd Tucson, AZ 85741
AUTO-OWNERS INSURANCE COMPANY
Westchester Surplus Lines Ins. Co
X
2/14/2024
X X
X
X X
X
X
X
F0950 Accepted
Agency Code 25-0189-00 Policy Number 084625-45017512
COMMERCIAL GENERAL LIABILITY
CG 20 37 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations
CITY OF SCOTTSDALE
CITY OF SURPRISE
ARIZONA DEPARTMENT OF TRANSPORTATION
THE CITY OF GOODYEAR & ITS ELECTED & APPOINTED BOARDS
OFFICERS
OFFICIALS AGENTS EMPLOYEES & VOLUNTEERS GOODYEAR
BALLPARK
RECREATIONAL COMPLEX CLEVELAND GUARDIANS BASEBALL
COMPANY & THE
CINCINNATI REDS LLC
WILLMENG CONSTRUCTION INC SEE SUPP DEC
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or orga-nization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard".
However:
1. The insurance afforded to such additional insured only applies to the extent permitted by law; and
2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
B.With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance:
If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits of Insur-ance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1
CG 20 10 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations
CITY OF SCOTTSDALE
CITY OF SURPRISE
ARIZONA DEPARTMENT OF TRANSPORTATION
THE CITY OF GOODYEAR & ITS ELECTED & APPOINTED BOARDS
OFFICERS
OFFICIALS AGENTS EMPLOYEES & VOLUNTEERS GOODYEAR
BALLPARK
RECREATIONAL COMPLEX CLEVELAND GUARDIANS BASEBALL
COMPANY & THE
CINCINNATI REDS LLC
MARICOPA COMMUNITY COLLEGES
PARADISE VALLEY COMMUNITY COLLEGE
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or or-ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above.
However:
1. The insurance afforded to such additional insured only applies to the extent permitted by law; and
2. If coverage provided to the additional insured is required by a contract or agreement, the
CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
B.With respect to the insurance afforded to these addi-tional insureds, the following additional exclusions apply:
This insurance does not apply to "bodily injury" or "property damage" occurring after:
1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or
2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.
C.With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance:
If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits of Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable
CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2
CG 20 38 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - AUTOMATIC STATUS FOR OTHER
PARTIES WHEN REQUIRED IN WRITTEN
CONSTRUCTION AGREEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II — Who Is An Insured is amended to include as an additional insured:
1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy; and
2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above.
Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by:
a. Your acts or omissions; or
b. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured.
However, the insurance afforded to such additional insured described above:
a. Only applies to the extent permitted by law;
and
b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph 1. above are completed.
B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to:
1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:
a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or
b. Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services.
2. "Bodily injury" or "property damage" occurring after:
a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or
b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or
CG 20 38 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2
Agency Code 25-0189-00 subcontractor engaged in performing operations for a principal as a part of the same project.
C. With respect to the insurance afforded to these additional insureds, the following is added to Section III Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
Policy Number 084625-45017512
1. Required by the contract or agreement described in Paragraph A.1.; or
2. Available under the applicable Limits of Insur-ance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable
CG 20 38 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2
CG 20 01 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance Condition and supersedes any provision to the contrary:
Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that:
(1) The additional insured is a Named Insured under such other insurance; and
(2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured.
CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1
CG 20 38 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - AUTOMATIC STATUS FOR OTHER
PARTIES WHEN REQUIRED IN WRITTEN
CONSTRUCTION AGREEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II — Who Is An Insured is amended to include as an additional insured:
1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy; and
2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above.
Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by:
a. Your acts or omissions; or
b. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured.
However, the insurance afforded to such additional insured described above:
a. Only applies to the extent permitted by law;
and
b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph 1. above are completed.
B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to:
1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:
a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or
b. Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services.
2. "Bodily injury" or "property damage" occurring after:
a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or
b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or
CG 20 38 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2
Agency Code 25-0189-00 subcontractor engaged in performing operations for a principal as a part of the same project.
C. With respect to the insurance afforded to these additional insureds, the following is added to Section III Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
Policy Number 084625-45017512
1. Required by the contract or agreement described in Paragraph A.1.; or
2. Available under the applicable Limits of Insur-ance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable
CG 20 38 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2
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