ACCEPTED ANY_ALL GL,AL,WC 06.27.24-06.27.25 (1).pdf
PDF 3 MB Posted
- Attached to
- Master Agreement AZ|CTR056729
- Contract number
- CTR056729
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by multiple insurance companies, including Federal Insurance Company, National Union Fire Insurance Co. Pittsburgh PA, Chubb Indemnity Insurance Co, and Certain Underwriters at Lloyds, London, for Econolite Control Products, Inc. The certificate is for the State of Arizona, specifically the Arizona Department of Transportation, located at 1739 West Jackson in Phoenix, AZ, with the insurance broker being Marsh Risk & Insurance Services in Irvine, CA.
The insurance policy covers multiple liability types, including Commercial General Liability, Automobile Liability, Umbrella Liability, and Workers' Compensation, with policy periods running from 06/27/2024 to 06/27/2025. The coverage includes limits ranging from $1,000,000 to $4,000,000 across different categories, with a professional liability policy having a $2,000,000 limit and a $25,000 deductible. The contract number is IV0000004125, and the policy includes additional insured provisions for the State of Arizona and its departments, with a waiver of subrogation where required by written contract. The insurance is primary and non-contributory over existing insurance, with contractual liability included in the General Liability coverage.
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Text version
06/27/2025
10,000
X
4,000,000
20281
PECON001024
1,000,000
A
X
B
$2,000,000
06/27/2025 X
Chubb Indemnity Insurance Co
Professional Liability
06/27/2024
CN119180939-Econo-Cyber-24-25
1,000,000
19445
12/31/2024
LOS-002427025-17
06/27/2024
X
4,000,000
11/22/2024
Phoenix, AZ 85009
2,000,000
X
1,000,000
1,000,000
A
06/27/2025
06/27/2024
06/27/2024
X
12777
73628715
Limit
10,000
71836843
X
020407806
Deductible: $25,000
2,000,000 existing insurance and limited to liability arising out of the operations of the named insured subject to policy terms and conditions. Contractual Liability is included in General Liability subject to policy terms and conditions.
Contract # IV0000004125
The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as additional insured where required by written contract with respect to General Liability and Auto Liability. Waiver of subrogation is applicable where required by written contract and subject to policy terms and conditions. This insurance is primary and non-contributory over any
Certain Underwriters at Lloyds, London
1250 N. Tustin Avenue Econolite Control Products, Inc.
Anaheim, CA 92807
2,000,000
Federal Insurance Company
X
17901 Von Karman Avenue, Suite 1100 Marsh Risk & Insurance Services
Irvine, CA 92614
(949) 399-5800; License #0437153
36075748
National Union Fire Ins Co Pittsburgh PA
N
1739 West Jackson Mod D
State of Arizona Arizona Dept. Of Transportation
06/27/2024
C
2,000,000
X
X
D
1,000,000
06/27/2025
Cindy Lewis Accepted
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective 06-27-24 Policy No. 71836843 Endorsement No. 003 Insured ECONOLITE GROUP INC. Premium $ Incl.
Insurance Company Chubb Indemnity Insurance Company
Countersigned By
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
WC 00 03 13
(Ed. 4-84)
1983 National Council on Compensation Insurance.
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
For policies or exposure in Missouri:
Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual.
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