ACCEPTED CTR075513 GL,AL,PROF LIAB 04.01.24-04.01.25 .pdf

PDF 897 KB Posted

Attached to
Master Agreement AZ|CTR075513
Contract number
CTR075513
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance for Kimley-Horn and Associates, Inc., covering multiple insurance policies issued by various insurers including National Union Fire Insurance Company of Pittsburgh, New Hampshire Insurance Company, and Lloyd's of London. The certificate is issued for the benefit of the State of Arizona, specifically the Arizona Department of Transportation, and is related to Contract #CTR075513 for On-Call Consultant services for Communications.

The insurance coverage includes Commercial General Liability with a $2,000,000 per occurrence limit, Automobile Liability, Umbrella Liability with a $5,000,000 limit, Workers' Compensation, and Professional Liability with a $2,000,000 per claim and aggregate limit. The policies are effective from 4/1/2024 to 4/1/2025 and provide additional insured status to the State of Arizona, its departments, agencies, boards, commissions, universities, and employees. The contract specifically references Joseph Cuffari as the consultant, and includes provisions for waiver of subrogation and primary non-contributory insurance where required by written contract.

View the file

Other files

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

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

E-MAIL

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

2/6/2025

Edgewood Partners Insurance Agency 3780 Mansell Rd. Suite 370 Alpharetta GA 30022

Jerry Noyola 7702207699 greylingcerts@greyling.com

National Union Fire Ins Co of Pittsburg 19445 KIMLASS Allied World Assurance Co (U.S.) Inc. 19489

Kimley-Horn and Associates, Inc.

421 Fayetteville Street, Suite 600 Raleigh, NC 27601

New Hampshire Insurance Company 23841 Lloyd's of London 85202

509664998

A X 2,000,000 X 1,000,000

X Contractual Liab 25,000

2,000,000

4,000,000 X X

GL5268169 4/1/2024 4/1/2025

4,000,000

A A

2,000,000

X

X X

CA4489663 (AOS)

CA2970071 (MA)

4/1/2024 4/1/2024

4/1/2025 4/1/2025

B X X 5,000,000 X

03127930 4/1/2024 4/1/2025

5,000,000 X 10,000

C C

X

N

WC015893685 (AOS)

WC015893686 (CA)

4/1/2024 4/1/2024

4/1/2025 4/1/2025

2,000,000

2,000,000

2,000,000 D Professional Liability B0146LDUSA2404949 4/1/2024 4/1/2025 Per Claim

Aggregate $2,000,000 $2,000,000

Re: Contract #CTR075513 On-Call Consultant for Communications; Joseph Cuffari. The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents and employees are named as Additional Insureds with respects to General & Automobile Liability where required by written contract. Waiver of Subrogation in favor of Additional Insured(s) where required by written contract & allowed by law. The above referenced liability policies with the exception of workers compensation and professional liability are primary & non-contributory where required by written contract. Multimedia Coverage is included under the Professional Liability Policy.

The State of Arizona Arizona Department of Transportation 1655 W. Jackson Street, MD 100P Phoenix AZ 85007

THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE

Cindy Lewis GL-AL Only

Cindy Lewis Professional Only

Cindy Lewis Highlight

Cindy Lewis Highlight

POLICY NUMBER:

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

COMMERCIAL GENERAL LIABILITY

CG 20 10 12 19

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

526-81-69

ANY PERSON OR ORGANIZATION WHOM YOU

BECOME OBLIGATED TO INCLUDE AS AN

ADDITIONAL INSURED AS A RESULT OF ANY

CONTRACT OR AGREEMENT YOU HAVE ENTERED

INTO.

PER THE CONTRACT OR AGREEMENT.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Insurance Services Office, Inc., 2018CG 20 10 12 19 Page of1 2

GL5268169

A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(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 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 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;

whichever is less.

This endorsement shall not increase the applicable limits of insurance.

Insurance Services Office, Inc., 2018 CG 20 10 12 19Page of2 2

ADDITIONAL INSURED - OWNERS, LESSEES OR

CONTRACTORS - COMPLETED OPERATIONS

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations

COMMERCIAL GENERAL LIABILITY

CG 20 37 12 19

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

POLICY NUMBER: 526-81-69

ANY PERSON OR ORGANIZATION WHOM YOU

BECOME OBLIGATED TO INCLUDE AS AN

ADDITIONAL INSURED AS A RESULT OF ANY

CONTRACT OR AGREEMENT YOU HAVE ENTERED

INTO.

PER THE CONTRACT OR AGREEMENT.

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 organization(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 insurance;

whichever is less.

This endorsement shall not increase the applicable limits of insurance.

CG 20 37 12 19 Page ofInsurance Services Office, Inc., 2018 1 1

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US (WAIVER OF SUBROGATION)

COMMERCIAL GENERAL LIABILITY

CG 24 04 12 19

This endorsement modifies insurance provided under the following:

SCHEDULE

Name Of Person(s) Or Organization(s):

COMMERCIAL GENERAL LIABILITY COVERAGE PART

ELECTRONIC DATA LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES

POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

RAILROAD PROTECTIVE LIABILITY COVERAGE PART

UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS

526-81-69

PURSUANT TO APPLICABLE WRITTEN CONTRACT OR AGREEMENT YOU ENTER INTO.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions:

We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above.

The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions:

We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above.

CG 24 04 12 19 Insurance Services Office, Inc., 2018 Page 1 of 1

PRIMARY AND NONCONTRIBUTORY -

COMMERCIAL GENERAL LIABILITY

CG 20 01 12 19

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 20 01 12 19 Insurance Services Office, Inc., 2018 Page 1 of 1

OTHER INSURANCE CONDITION

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.

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

526-81-69GL5268169

04/01/2024

CA4489663

CA4489663

���������������)�$$����%�*+,-*./ $����� ����$0�!��"1�(

2��&����

3"

4���%���������������%���&� �"�����$�����"���!��'!�$������5&�"��%����'"���� �!��"(4�#�!!�����$����

�&���������������� �������������6���������������7����&!�(�������������� !�����!"������8��������"�&

��$���#��9&�����#��������������������:&����"�&���'�����������������$���&�(

����������������!!���� �����������!"����������!"��'���$����"����������������7����&!�(

AAABCB

D?EF=GHIJE=>KL

M�>NAOPQOR

�?F<DGIS=>�=TG=H=EFUFIV=

����W$���W��W���W� !���'!�W��WX�����W$��W ��%���W������&�����W���������W��W��$����W��WX(7(.(W*YZ*[-*W����&��WX(7(.W

*YZ*[-\W��W &'!��W������&�����W���������W��W��$����W��WX(7(.(W*YZ*]-*W����&��W*YZ*]-[)W�8�� �W#����W ��������W'"W

����&��W��W�����W� !���'!�W!�#)W�&��W��W$��W&��W��W#�� Z& W���&�����W �������(

.�"W �����W��W������6�����W$��W#����W���W�� !�"��W���W������W'"W#������W��������)W�8��&���W ����W��W!���)W��"W�8��&��W

�W#��%��W�$W�&'��������(Ŵ �#�%��)W$��W &� ����W�$W#��9W ��$�����W'"W���W�� !�"��W��W/����&��)W����W#��%��W�$W

�&'��������W����W���W� !"W��W��"W������&�����W���& W�$W�!����$��������W��W����������W'"W���W#��%��W�$W�����W��W����%��W

$���W������W_�&'��������̀W�&!�W��W�&�W���&�!(

����W$���W��W���W� !���'!�W��Wa�!�$�����)WX���&�9")W1�#Ŵ�� �����)W1�#Wb����")W��8��)W��Wc���( defWghijkeWkiWkildemndomkeWokWpqkrWfksWthukrhWWWWWW ktvmldohwWokWpdmxhWfksiWimlqojWkyWihukxhifWWWWWWWWW dldmejozWsewhiWdefWpimooheWukeoiduoWkiWdlihhrheoWWW fksWheohiWmeokWgimkiWokWoqhWkuusiiheuhWkyWvkjj{

|}~|�~�|�� puWWW|����������

�mrvhf�qkieWdewWdjjkumdohjzWmeu{ ehpWqdrgjqmihWmejsideuhWukrgdef

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