ACCEPTED ANY_ALL GL,AL,WC 06.27.24-06.27.25.pdf

PDF 2 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 and associated endorsements for Econolite Group, Inc., covering multiple insurance policies issued by various insurers including Federal Insurance Company, National Union Fire Insurance Company, Chubb Indemnity Insurance Company, and Certain Underwriters at Lloyds, London. The primary certificate holder is the State of Arizona, specifically the Arizona Department of Transportation, located in Phoenix, AZ. The insurance policies provide coverage across multiple liability categories including commercial general liability, automobile liability, umbrella liability, workers' compensation, and professional liability.

The insurance policies provide comprehensive coverage with varying limits, including $2,000,000 for commercial general liability, $1,000,000 for automobile liability, $1,000,000 for umbrella liability, and $2,000,000 for professional liability. The policies are effective from June 27, 2024 to June 27, 2025, with a professional liability policy deductible of $25,000. The coverage extends to the State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds where required by written contract. The policies include provisions for contractual liability, waiver of subrogation, and primary non-contributory insurance status.

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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.

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 Group, 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

G0171 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.

Producer Copy

File details come from the government source that posted it. Updated .