ACCEPTED_CTR069472_GL_AL_WC_03.01.25-03.01.26.pdf
PDF 652 KB Posted
- Attached to
- Master Agreement AZ|CTR069472
- Contract number
- CTR069472
- Issued by
- Arizona
About this file
This is a Certificate of Garage Insurance issued by Shepherd Insurance, LLC for VVG Holdings, LLC, Freightliner of Arizona, LLC, and Los Angeles Truck Centers, LLC. The certificate covers multiple insurance carriers including The Travelers Indemnity Co of Connecticut, The Travelers Prop Cas Ins Co of America, Starstone National Ins Co, and Liberty Mutual Ins Corp. The certificate holder is the Arizona Department of Transportation, located in Phoenix, AZ, and the policy is effective from 03/01/2025 to 03/01/2026.
The insurance provides comprehensive coverage including auto liability, garage keepers liability, commercial general liability, umbrella liability, and workers' compensation. Coverage limits include $1,000,000 for auto liability, $2,000,000 aggregate, $10,000,000 for umbrella liability, and $1,000,000 for workers' compensation. The policy includes additional insured provisions, primary and non-contributory status, and a waiver of subrogation for general and auto liability when agreed in a contract. The policy covers a wide range of entities listed in the document, including various truck centers, dealerships, and automotive-related businesses operating under different doing-business-as (DBA) names across multiple states.
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Text version
05/16/2025
Shepherd Insurance, LLC.
111 Congressional Boulevard Suite 200 Carmel IN 46032
Certificate Processing Department (317)846-5554 (317)846-5444 trkdlrcerts@shepherdins.com
VVG Holdings, LLC, Freightliner of Arizona, LLC Los Angeles Truck Centers, LLC 2429 South Peck Road Whittier CA 90601
The Travelers Indemnity Co of Connecticut 25682 The Travelers Prop Cas Ins Co of America 25674 Starstone National Ins Co 44776 Liberty Mutual Ins Corp 33600
00017518 CL253458507
A AD4W927323/AD4W92474A 03/01/2025 03/01/2026
1,000,000
1,000,000
2,000,000
A AD4W927323/AD4W92474A 03/01/2025 03/01/2026
5,000
ACV
5,000
ACV
A
AD4W927323/AD4W92474A 03/01/2025 03/01/2026
1,000,000 100,000
1,000,000 2,000,000 2,000,000
BC
-0-
CUP4W970835/77553L231ALI 03/01/2025 03/01/2026
10,000,000 10,000,000
D N
WA5-64D-446354-015 03/01/2025 03/01/2026
1,000,000 1,000,000 1,000,000
Customers are included as an insured for Covered Auto Liability. Automatic additional insured status when agreed in writing in a contract or agreement for general liability "your operations" (including ongoing and completed ops liability). Insurance is on a primary and noncontributory basis for general/auto liability. A waiver of subrogation for general/auto liability and Workers' Compensation is automatic when agreed in writing in a contract or agreement. All in accordance with the attached forms and policy terms, conditions, and exclusions
Arizona Department of Transportation
MD 100P
1655 W Jackson St Phoenix AZ 85007
PROD / CUSTOMER ID:
OTHER:
ER
OTH-
STATUTE
PER
LOC
LOC
LOC
OTC LOC $
AUTO ONLY (Ea accident)
$AGGREGATE
ONLY
HIRED AUTOS
AUTOS ONLY
IN GARAGE
AUTOS USED
JECT
COLLISION
EXCESS
PERILS
SPECIFIED
PRIMARY
COMP /
DIRECT BASIS
LEGAL LIABILITY
GARAGE KEEPERS LIABILITY
$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- LOC
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.
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
REMARKS below If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
LIMITS(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
POLICY NUMBERTYPE OF INSURANCELTR
INSR
REMARKS (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 $
OTHER THAN
AUTO ONLY
$EA ACCIDENT
GARAGE LIABILITY
OWNED
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 #:CERTIFICATE #:COVERAGES
The ACORD name and logo are registered marks of ACORD
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.
CERTIFICATE OF GARAGE INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 30 (2016/03)
© 2010-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
NON-OWNED
BUSINESS
ANY AUTO
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).
Cindy Lewis Accepted
VVG Holdings, LLC
00017518
Shepherd Insurance, LLC.
30 Certificate of Garage Insurance: Notes
RE: Contract #CTR069472
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:
Cindy Lewis Highlight
D o no t a tta ch th is fo rm to a p ol ic y.
I t i s f or in fo rm at io na l u se o nl y.
COMMERCIAL AUTO
POLICY NUMBER: ISSUE DATE:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED FOR GENERAL LIABILITY
COVERAGES – PRIMARY AND NON-CONTRIBUTORY
WITH OTHER INSURANCE
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
SCHEDULE OF ADDITIONAL INSURED PERSONS OR ORGANIZATIONS
PROVISIONS
b. In connection with your premises owned by or1. The following is added to Paragraph D., Who Is rented to you.An Insured, of SECTION II – GENERAL
LIABILITY COVERAGES: 2. The following is added to Paragraph 5., Other
Insurance, in B., General Conditions, ofAny person or organization designated in the SECTION IV –CONDITIONS, but only for GeneralSchedule Of Additional Insured Persons Or Liability Coverages:Organizations who you are required under a written contract or agreement between you and Regardless of the provisions of paragraphs d.
that person or organization, that is signed by you and f. of this part 5. Other Insurance, this insurance is primary to and non-contributory withbefore:
applicable other insurance under which the
a. The "bodily injury" or "property damage" person or organization designated in the occurs; or Schedule Of Additional Insured Persons Or
b. The "personal injury" or "advertising injury" Organizations is the first named insured when the offense is committed; written contract or agreement between you and that designated person or organization, that isand that is in effect during the policy period, to signed by you before:name as an additional insured for general liability
(1) The "bodily injury" or "property damage"coverage, but only for damages because of occurs; or"bodily injury", "property damage", "personal injury" or "advertising injury" caused, in whole or (2) The "personal injury" or "advertising injury" in part, by your acts or omissions or the acts or offense is committed;
omissions of those acting on your behalf:
and that is in effect during the policy period,
a. In the performance of your ongoing "auto requires this insurance to be primary and non-dealer operations"; or contributory.
CA T6 21 01 18 ú 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
AD4W92732323/AD4W92474A
1. "Any person or organization with whom you have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy, any any other person or organization you are required to add as an additional insured under the contract or agreement."
AD4W927323/AD4W92474A
no t a tta ch th is fo rm to a p ol ic y.
I t i s f or in fo rm at io na l u se o nl y.
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED FOR COVERED AUTOS
COVERAGES – PRIMARY AND NON-CONTRIBUTORY
WITH OTHER INSURANCE
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
2. The following is added to Paragraph 5., OtherPROVISIONS
Insurance, in B., General Conditions, of
1. The following is added to Paragraph c. in D.2., SECTION IV –CONDITIONS, but only for Who Is An Insured, of SECTION I – COVERED
Covered Autos Liability Coverage:
AUTOS COVERAGES:
Regardless of the provisions of paragraphs a. and This includes any person or organization who you
f. of this part 5. Other Insurance, this insurance are required under a written contract or is primary to and non- contributory with applicableagreement between you and that person or other insurance under which an additional insuredorganization, that is signed by you before the person or organization is the first named insured"bodily injury" or "property damage" occurs and when a written contract or agreement betweenthat is in effect during the policy period, to name you and that person or organization, that isas an additional insured for auto liability signed by you before the "bodily injury" orcoverage, but only for damages to which this "property damage" occurs and that is in effectinsurance applies and only to the extentof that during the policy period, requires this insurance toperson's or organization's liability for the conduct be primary and non-contributory.of another "insured".
CA T6 18 01 18 ú 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission
AD4W92732323/AD4W92474AAD4W927323/AD4W92474A
no t a dd th is fo rm to a p ol ic y.
It is fo r i nf or m at io na l p ur po se s o nl y.
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF SUBROGATION
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
The following replaces Paragraph A.5., Transfer of required of you by a written contract executed Rights Of Recovery Against Others To Us, of the prior to any "accident" or "loss", provided that the CONDITIONS Section: "accident" or "loss" arises out of the operations
5. Transfer Of Rights Of Recovery Against Oth- contemplated by such contract. The waiver ap-ers To Us plies only to the person or organization desig-nated in such contract.We waive any right of recovery we may have against any person or organization to the extent
CA T3 40 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
AD4W92732323/AD4W92474AAD4W927323/AD4W92474A
WC 00 03 13 © 1983 National Council on Compensation Insurance, Inc. Page 1 of 1 Ed. 4/1/1984
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
Where required by contract or written agreement prior to loss and allowed by law.
Effective Date 03/01/2025 Premium $ Included
Issued by: LM Insurance Corporation
For attachment to Policy No.: WA5-64D-446354-015
Issued to: VVG Holdings, LLC
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