ACCEPTED CTR060480 GL,AL,WC 01.01.25-01.01.26.pdf
PDF 230 KB Posted
- Attached to
- Master Agreement AZ|CTR060480
- Contract number
- CTR060480
- Issued by
- Arizona
About this file
This document is a comprehensive insurance certificate and associated endorsements for Stanley Consultants, Inc., primarily covering commercial general liability, automobile liability, workers' compensation, and excess liability insurance. The insurance policies are issued by multiple carriers including Charter Oak Fire Insurance Company, Travelers Property Casualty Co of America, and Navigators Insurance Company, with Arthur J. Gallagher Risk Management Services, LLC serving as the producer. The primary certificate holder is the State of Arizona, Arizona Department of Transportation (ADOT), specifically for a Multi Modal Planning contract (ADOT CTR060480).
The insurance coverage is effective from January 1, 2025 to January 1, 2026, with various policy limits. The commercial general liability policy has a $1,000,000 per occurrence limit and a $2,000,000 aggregate limit. The automobile liability coverage includes a $1,000,000 combined single limit, and the workers' compensation policy provides statutory coverage with $1,000,000 limits. An excess liability policy provides an additional $5,000,000 per occurrence and in the aggregate. The policies include provisions for additional insured status for the State of Arizona or ADOT, with waiver of subrogation and primary insurance clauses. The insurance specifically relates to liability arising from activities performed by or on behalf of the contractor for the ADOT Multi Modal Planning project.
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Text version
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
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
1/7/2025
Arthur J. Gallagher Risk Management Services, LLC 220 Emerson Place Suite 200 Davenport IA 52801
Julie Brockert 563-316-3418 563-322-1046 julie_brockert@ajg.com
Charter Oak Fire Insurance Company 25615 Travelers Property Casualty Co of America 25674
Stanley Consultants, Inc.
225 Iowa Avenue Muscatine IA 52761
Navigators Insurance Company 42307
1419090673
A X 1,000,000 X 1,000,000
5,000
1,000,000
2,000,000 X
Y Y P-630-4885B479-COF-25 1/1/2025 1/1/2026
2,000,000
B 1,000,000
X
X X
Y Y 810-2L649784-25-43-G 1/1/2025 1/1/2026
B X X 15,000,000CUP-9S313559-25-NF 1/1/2025 1/1/2026
15,000,000
A X
N
Y UB-8J736329-25-43-G 1/1/2025 1/1/2026
1,000,000
1,000,000
1,000,000 C Excess Liability CH25EXRZ0G0YAIV 1/1/2025 1/1/2026 Each Occ
Aggregate $5,000,000 $5,000,000
RE: ADOT Multi Modal Planning ADOT CTR060480 The State of Arizona or ADOT, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are Additional Insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor, as respects general liability and auto policies, pursuant to and subject to the policy’s terms, definitions, conditions and exclusions. The insurance provided in the general liability and auto policies is primary and any other insurance shall be excess only, and not contributing. Waiver of Subrogation applies to The State of Arizona or ADOT, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contract, as respects general liability, auto, and workers compensation policies, pursuant to and subject to the policy’s terms, definitions, conditions, and exclusions. 30 day cancellation notice applies.
STATE OF ARIZONA
ARIZONA DEPARTMENT OF TRANSPORTATION
1739 W. Jackson St., Ste. A Phoenix AZ 85007
Cindy Lewis Accepted
COMMERC GENERAL L LIAL IABI ITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED WRITTEN
CONTRACTS (ARCHITECTS, ENGINEERS AND
SURVEYORS)
This endorsement i ies insurance pro ided under t folmod f v he lowing:
COMMERC GENERAL L ITY VERA AIAL IABIL CO GE P RT
1. SECT II WHO ISThe fo lowing is added to plies only to such "bodily injury or "propertyl "ION AN INSURED: damage" tha fore the end o the pe-t occurs be f riod o t me f which the "writ contrac re-f i or ten tAny person or organization that you agree in a quiring insurance" requires you to pro idev"written contrac ring " tot requi insurance include as such coverage or the end of the pol eriod,icy pan additiona insured on this Co Part,l verage but:
whichever is earlier.
a. Only with respect to liab li f "bod y injur ",i ty or il y
2. 4.a. SEC-The fol is added to Paragraph olowing f"property da " or "personal y";mage injur and
T ON IV COMMERCIAL GENERAL LIABILI YI T
b. I and only to the e tent that the in orf, x , jury CONDI IONST :
damage is caused by acts or omissions of The insurance prov to the additional insuredidedyou or your subcontractor in the performance is excess over any va id and collec le "other in-l tibof "your work" to which the "written contract surance", whether primary e contingent or, xcess,requiring insurance" applies. The person or on any other basis, that is ava lable to the addi-iorganization does not quali as an additionalfy tional we cover. However finsured for a loss , i youinsured with respect to the independent acts specif ll agree in the "writ contract requ ingica y ten iror o .missions of such person or organization insurance" that this insurance prov to the ad-ided
The insurance prov additionalided to such insured dit insured under this Co Part mional verage ust is l m fo lows:i ited as l apply on a pr mary basis or a pr mary and non-i i
c. In the e ent that the Li i of Insurance of contributory basis, this insurance is pri y tov m ts mar this Co Part shown in the Declarations "other insurance" a i to the addit in-verage va lable ional exceed the l m ts of l li required by the sured which co or organization asi i iabi ty vers that person "written contract requir insurance", the in- a named insured for such loss, and we wil noting l surance prov to the addit insured share with that "other insurance". But this insur-ided ional shall be li i li i l li requi ance pro ided to the addi ional insured stil is ex-m ted to the m ts of iabi ty red v t l by that "written contract requir insurance". cess o any v l and col ib "other insur-ing ver a id lect le This endorsement shall not increase the li its ance", whether pri e contingent or onm mary, xcess, of insurance described in Section Li its any other basis, that is a ai le to the additIII m v lab ional O Insurance.f insured when that person or organization is an additiona insured under any "other insurance".ld. This insurance does not apply to the render-ing o or fa lure to render any "pro l The fol is added tof i fessiona lowing3. SEC ION IV C M-T O
MERCIAL GEN I COND TERAL LIABIL TY I IONS:serv " or construction manage errorsices ment or omissions. Duties iti l IOf An Add ona nsured
e. This insurance does not apply to "bodi in-ly As a condition o co erage pro ided to the addi-f v v jury" or "property damage" caused by "your tional insured:
work" and included in the "products-
a. The additional insured must gi us writtenvecomp operations hazard" unless theleted notice as soon as practicable o an "occur-f"written contract requir insurance" specifing i-rence" or an of which may result in afensecall requ you to pro i such co eragey ires v de v clai . To the ex possible, such noticem tentfor that addit and then the insur-ional insured, should include:ance pro ided to the addi l insured ap-v tiona
CG D4 14 04 08 Page 1 o 22008 The Travelers Companies, Inc. f
P-630-4885B479-COF-25 Policy Period 1/01/2025-1/01/2026
COMMERC GENERAL L LIAL IABI ITY
i. How, when and where the "occurrence" any pro ider o other insurance which wouldv f or o fense took placef ; co the addit insured for a loss wever ional co . However th condition does not af ectver , is fii. The names and addresses of any injured whether this insurance prov to the addi-idedpersons and witnesses; and tional insured is pri to that o insur-mary theriii. The nature and locat o any in orion f jury ance ava lable to the addit insured whichi ionaldamage arising out o the "occurrence" orf co that person or organization as aversof ense.f named insured.
b. I a c m is made or "suit is brought againstf lai "
4. DE I IONSThe fo is added to the Sec-llowing FIN Tthe additional insured, the additional insured tion:must:
" r ten contract requir insurance" means thatW it ingi. I media record the speci ics of them tely f part of any written contract or agreement underclai or "suit" recei ed;m and the date v and which you are required to inc a person or or-lude
ii. Noti y us as soon as practicable.f ganization as an additional insured on this Cover- The addit insured must see to it that weional age Part, pro i that the "bodi in " andv ded ly jury recei e written notice o the cla m or "suit" asv f i "property damage" occurs and the "personal in-soon as practicable. jury" f m itted:is caused by an o fense co m
c. The addit insured must i m telyional m edia send a. A the signing and e ion o contractfter xecut f the us copies of al legal papers recei in con-l ved or agreement by you;
nection with the c i "sui ", cooperate withla m or t b. W i f t or agreementh le that part o the contrac is us in the in igation or sett ment o thevest le f in e f ; andf ect clai or de against the "suit", and oth-m fense
c. Before f li iod.the end o the po cy pererwise comply l icy ions.with al pol condit
d. The addit insured must tender the de-ional fense and inde ty o any c m or "suit tomni f lai "
Page 2 o 2f 2008 The Travelers Companies, Inc. CG D4 14 04 08
COMMERCIAL GENERAL LIABILITY
occupational therapist or occupational that is available to any of your "employees" for "bodily injury" that arises out of providingtherapy assistant, physical therapist or or failing to provide "incidental medicalspeech-language pathologist; or services" to any person to the extent not(b) First aid or "Good Samaritan services"
2.a.(1) IIsubject to Paragraph of Section –by any of your "employees" or "volunteer Who Is An Insured.workers", other than an employed or
K. MEDICAL PAYMENTS – INCREASED LIMITvolunteer doctor. Any such "employees" or "volunteer workers" providing or failing
7.The following replaces Paragraph of to provide first aid or "Good Samaritan
SECTION III – LIMITS OF INSURANCE:
services" during their work hours for you
7. 5.Subject to Paragraph above, the Medicalwill be deemed to be acting within the scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct CCoverage for all medical expenses of your business. because of "bodily injury" sustained by any
3. one person, and will be the higher of:The following replaces the last sentence of
5. SECTION III – LIMITS OFParagraph of a. $10,000; or
INSURANCE:
b. The amount shown in the Declarations of
For the purposes of determining the this Coverage Part for Medical Expenseapplicable Each Occurrence Limit, all related Limit.acts or omissions committed in providing or failing to provide "incidental medical L. AMENDMENT OF EXCESS INSURANCE services", first aid or "Good Samaritan CONDITION – PROFESSIONAL LIABILITY services" to any one person will be deemed
4.b.The following is added to Paragraph ,to be one "occurrence".
Excess Insurance SECTION IV –, of
4. The following exclusion is added to COMMERCIAL GENERAL LIABILITY
2. Exclusions SECTION I –Paragraph , , of CONDITIONS:
COVERAGES – COVERAGE A – BODILY
This insurance is excess over any of the otherINJURY AND PROPERTY DAMAGE insurance, whether primary, excess, contingentLIABILITY:
or on any other basis, that is Professional
Sale Of Pharmaceuticals Liability or similar coverage, to the extent the
"Bodily injury" or "property damage" arising loss is not subject to the professional services out of the violation of a penal statute or A Bexclusion of Coverage or Coverage .
ordinance relating to the sale of
M. BLANKET WAIVER OF SUBROGATION –pharmaceuticals committed by, or with the WHEN REQUIRED BY WRITTEN CONTRACTknowledge or consent of the insured.
OR AGREEMENT
5. DEFINITIONSThe following is added to the
8. TransferThe following is added to Paragraph ,Section:
Of Rights Of Recovery Against Others To Us, "Incidental medical services" means:
SECTION IV – COMMERCIAL GENERALof
a. Medical, surgical, dental, laboratory, x- LIABILITY CONDITIONS:
ray or nursing service or treatment, If the insured has agreed in a written contract or advice or instruction, or the related agreement to waive that insured's right offurnishing of food or beverages; or recovery against any person or organization, we
b. The furnishing or dispensing of drugs or waive our right of recovery against such person medical, dental, or surgical supplies or or organization, but only for payments we make appliances. because of:
6. 4.b.The following is added to Paragraph , a. "Bodily injury" or "property damage" that Excess Insurance SECTION IV –, of occurs; or
COMMERCIAL GENERAL LIABILITY
b. "Personal and advertising injury" caused byCONDITIONS:
an offense that is committed;This insurance is excess over any valid and collectible other insurance, whether primary, subsequent to the signing of that contract or excess, contingent or on any other basis, agreement.
CG D3 79 02 19 Page 5 of 6© 2017 The Travelers Indemnity Company. All rights reserved.
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
cmharless Highlight cmharless_1 Highlight cmharless_2 Highlight cmharless_3 Highlight cmharless_4 Highlight
COMMERCIAL AUTO
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
CA T3 53 02 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO EXTENSION ENDORSEMENT
Page 1 of 4© 2015 The Travelers Indemnity Company. All rights reserved.
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
GENERAL DESCRIPTION OF COVERAGE – This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover-age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en-dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.
A. BROAD FORM NAMED INSURED
B. BLANKET ADDITIONAL INSURED
C. EMPLOYEE HIRED AUTO
D. EMPLOYEES AS INSURED
E. SUPPLEMENTARY PAYMENTS – INCREASED
LIMITS
F. HIRED AUTO – LIMITED WORLDWIDE COV-
ERAGE – INDEMNITY BASIS
G. WAIVER OF DEDUCTIBLE – GLASS
PROVISIONS
A. BROAD FORM NAMED INSURED
The following is added to Paragraph A.1., Who Is An Insured, of SECTION II – COVERED AUTOS
LIABILITY COVERAGE:
Any organization you newly acquire or form dur-ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage.
Coverage under this provision is afforded only un-til the 180th day after you acquire or form the or-ganization or the end of the policy period, which-ever is earlier.
B. BLANKET ADDITIONAL INSURED
The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II – COVERED
AUTOS LIABILITY COVERAGE:
Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi-tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which
H. HIRED AUTO PHYSICAL DAMAGE – LOSS OF
USE – INCREASED LIMIT
I. PHYSICAL DAMAGE – TRANSPORTATION
EXPENSES – INCREASED LIMIT
J. PERSONAL PROPERTY
K. AIRBAGS
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
M. BLANKET WAIVER OF SUBROGATION
N. UNINTENTIONAL ERRORS OR OMISSIONS
this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II.
C. EMPLOYEE HIRED AUTO
1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II – COV-
ERED AUTOS LIABILITY COVERAGE:
An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi-ness.
2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV – BUSI-
NESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage Cover-age, the following are deemed to be cov-ered "autos" you own:
(1) Any covered "auto" you lease, hire, rent or borrow; and
(2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your
810-2L649784-25-43-G Policy Period 1/01/2025-1/01/2026
CA T3 53 02 15Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved.
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
permission, while performing duties related to the conduct of your busi-ness.
However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto".
D. EMPLOYEES AS INSURED
The following is added to Paragraph A.1., Who Is An Insured, of SECTION II – COVERED AUTOS
LIABILITY COVERAGE:
Any "employee" of yours is an "insured" while us-ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs.
E. SUPPLEMENTARY PAYMENTS – INCREASED
LIMITS
1. The following replaces Paragraph A.2.a.(2), of SECTION II – COVERED AUTOS LIABIL-
ITY COVERAGE:
(2) Up to $3,000 for cost of bail bonds (in-cluding bonds for related traffic law viola-tions) required because of an "accident" we cover. We do not have to furnish these bonds.
2. The following replaces Paragraph A.2.a.(4), of SECTION II – COVERED AUTOS LIABIL-
ITY COVERAGE:
(4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be-cause of time off from work.
F. HIRED AUTO – LIMITED WORLDWIDE COV-
ERAGE – INDEMNITY BASIS
The following replaces Subparagraph (5) in Para-graph B.7., Policy Period, Coverage Territory, of SECTION IV – BUSINESS AUTO CONDI-
TIONS:
(5) Anywhere in the world, except any country or jurisdiction while any trade sanction, em-bargo, or similar regulation imposed by the United States of America applies to and pro-hibits the transaction of business with or within such country or jurisdiction, for Cov-ered Autos Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their households.
(a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada:
(i) You must arrange to defend the "in-sured" against, and investigate or set-tle any such claim or "suit" and keep us advised of all proceedings and ac-tions.
(ii) Neither you nor any other involved "insured" will make any settlement without our consent.
(iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit".
(iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in-sured" pays with our consent, but only up to the limit described in Para-graph C., Limits Of Insurance, of
SECTION II – COVERED AUTOS
LIABILITY COVERAGE.
(v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga-tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para-graph C., Limits Of Insurance, of
SECTION II – COVERED AUTOS
LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses.
(b) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess, contingent or on any other basis.
(c) This insurance is not a substitute for re-quired or compulsory insurance in any country outside the United States, its ter-ritories and possessions, Puerto Rico and Canada.
CA T3 53 02 15 Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
© 2015 The Travelers Indemnity Company. All rights reserved.
You agree to maintain all required or compulsory insurance in any such coun-try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in-surance requirements.
(d) It is understood that we are not an admit-ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can-ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance.
G. WAIVER OF DEDUCTIBLE – GLASS
The following is added to Paragraph D., Deducti-ble, of SECTION III – PHYSICAL DAMAGE
COVERAGE:
No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced.
H. HIRED AUTO PHYSICAL DAMAGE – LOSS OF
USE – INCREASED LIMIT
The following replaces the last sentence of Para-graph A.4.b., Loss Of Use Expenses, of SEC-
TION III – PHYSICAL DAMAGE COVERAGE:
However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident".
I. PHYSICAL DAMAGE – TRANSPORTATION
EXPENSES – INCREASED LIMIT
The following replaces the first sentence in Para-graph A.4.a., Transportation Expenses, of
SECTION III – PHYSICAL DAMAGE COVER-
AGE:
We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in-curred by you because of the total theft of a cov-ered "auto" of the private passenger type.
J. PERSONAL PROPERTY
The following is added to Paragraph A.4., Cover-age Extensions, of SECTION III – PHYSICAL
DAMAGE COVERAGE:
Personal Property
We will pay up to $400 for "loss" to wearing ap-parel and other personal property which is:
(1) Owned by an "insured"; and
(2) In or on your covered "auto".
This coverage applies only in the event of a total theft of your covered "auto".
No deductibles apply to this Personal Property coverage.
K. AIRBAGS
The following is added to Paragraph B.3., Exclu-sions, of SECTION III – PHYSICAL DAMAGE
COVERAGE:
Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in-flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only:
a. If that "auto" is a covered "auto" for Compre-hensive Coverage under this policy;
b. The airbags are not covered under any war-ranty; and
c. The airbags were not intentionally inflated.
We will pay up to a maximum of $1,000 for any one "loss".
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
The following is added to Paragraph A.2.a., of
SECTION IV – BUSINESS AUTO CONDITIONS:
Your duty to give us or our authorized representa-tive prompt notice of the "accident" or "loss" ap-plies only when the "accident" or "loss" is known to:
(a) You (if you are an individual);
(b) A partner (if you are a partnership);
(c) A member (if you are a limited liability com-pany);
(d) An executive officer, director or insurance manager (if you are a corporation or other or-ganization); or
(e) Any "employee" authorized by you to give no-tice of the "accident" or "loss".
M. BLANKET WAIVER OF SUBROGATION
The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV – BUSINESS AUTO CONDI-
TIONS :
5. Transfer Of Rights Of Recovery Against Others To Us
We waive any right of recovery we may have against any person or organization to the ex-tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by
CA T3 53 02 15Page 4 of 4 © 2015 The Travelers Indemnity Compa ny. All rights reserved .
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
such contract. The waiver applies only to the person or organization designated in such contract.
N. UNINTENTIONAL ERRORS OR OMISSIONS
The following is added to Paragraph B.2., Con-cealment, Misrepresentation, Or Fraud, of
SECTION IV – BUSINESS AUTO CONDITIONS:
The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How-ever this provision does not affect our right to col-lect additional premium or exercise our right of cancellation or non-renewal.
WORKERS COMPENSATION
AND
EMPLOYERS LIABILITY POLICY
ENDORSEMENT WC 00 03 13 (00)-
POLICY NUMBER:
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 any one not named in the Schedule.
SCHEDULE
DESIGNATED PERSON:
DESIGNATED ORGANIZATION:
DATE OF ISSUE: 1/01/2025 ST ASSIGN:
UB-8J736329-25-43-G
IA
STATE OF ARIZONA
ARIZONA DEPARTMENT OF TRANSPORTATION
1739 W. Jackson St., Ste. A Phoenix, AZ 85007
File details come from the government source that posted it. Updated .