ACORD_Form_20250506-104114.pdf

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Attached to
Master Agreement AZ|CTR071841
Contract number
CTR071841
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance for Atlas Trap Company, LLC, based in Benton, Kansas, issued by Insurance Services Group LLC in Wichita, Kansas. The certificate involves multiple insurers, including EMCASCO Insurance Company and EMC Insurance, and is specifically designated for the State of Arizona and the Arizona Game & Fish Department as the certificate holder.

The insurance coverage spans multiple areas including commercial general liability, automobile liability, workers' compensation, and commercial cyber and privacy liability. The policies are effective from 07/10/2024 to 07/10/2025, with various coverage limits. Notably, the general liability policy has a $1,000,000 each occurrence limit and a $2,000,000 general aggregate limit. The automobile liability provides a $1,000,000 combined single limit, and the cyber liability includes specific sublimits for data compromise response expenses, legal review, and named malware. The certificate includes a waiver of subrogation in favor of the certificate holder and considers the State of Arizona and Arizona Game & Fish Department as additional insureds via written contract.

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Text version

05/06/2025

Insurance Services Group LLC 1720 N Webb Rd Suite 110 Wichita KS 67206

Steven Jones

(316) 928-0044 steven@isgkansas.com

ATLAS TRAP COMPANY, LLC

14200 SW 50TH ST

BENTON KS 67017-9165

EMCASCO Insurance Company 21407 Employers Mutual Casualty Company 21415 EMC Insurance

CL255602842

A 6D46431 07/10/2024 07/10/2025

1,000,000 300,000 10,000 1,000,000 2,000,000 2,000,000

B 6E46431 07/10/2024 07/10/2025

1,000,000

Uninsured motorist combined single limit

1,000,000

A Y 6H46431 07/10/2024 07/10/2025 1,000,000 1,000,000 1,000,000

C Commercial Cyber and Privacy Liability

6Q46431 07/10/2024 07/10/2025

DATA COMPROMISE -

RESPONSE EXPENSE

$50,000

LEGAL REVIEW

SUBLIMIT

$25,000

NAMED MALWARE

SUBLIMIT

$50,000

Certificate Holder: State of Arizona and the Arizona Game & Fish Department are considered Additional Insureds via written contract. Waivor of Subrogation in favor of Certificate Holder.

Arizona Game and Fish Department 5000 W. Carefree Highway

Phoenix AZ 85086

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

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