ACORD_Form_20251020-113901.pdf
PDF 21 KB Posted
- Attached to
- Master Agreement AZ|CTR074696
- Contract number
- CTR074696
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance issued on 10/20/2025 for Arizona Brush Management LLC, located in Flagstaff, Arizona. The insurance is provided by BITCO Insurance Companies through Hancock-Leavitt Insurance, with the certificate holder being the Arizona Game and Fish Department in Phoenix, Arizona. The contract number is CTR048464, and the additional insured parties include the State of Arizona and Arizona Game and Fish Department.
The insurance certificate covers multiple liability types with various policy limits, including commercial general liability ($1,000,000 per occurrence), automobile liability, umbrella liability ($2,000,000), workers' compensation, and physical damage coverage. The policies are effective from 2/17/2025 to 2/17/2026, with specific coverage details such as a $1,000 comprehensive/collision deductible and inland marine coverage. The insurance provides protection for potential incidents and meets the state contract requirements, with all coverages subject to the terms, conditions, and exclusions of the underlying policies.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 2025-02-17_COI_AZ_Brush_Management.pdf | ||
| CTR074696_Contractor_Bid_Arizona_Brush_Mgmt.pdf | ||
| CTR074696_YR2_Contract_Renewal.pdf | ||
| CTR074696_Contract_Docs_Arizona_Brush_Management_LLC.pdf | ||
| CTR074696_PRICING__AZ_Brush.xlsx | XLSX spreadsheet | |
| Contract_Summary_Document.pdf |
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Text version
10/20/2025
Hancock-Leavitt Insurance PO Box 830
Taylor AZ 85939
Monti Hancock (928)536-4237 (866)821-4287 monti-hancock@leavitt.com
Arizona Brush Management LLC Colombini, Robert Paul 3227 S. Gila Dr Flagstaff AZ 86005
BITCO Insurance Companies 020095
CL2522007826
A
X
X
X
X Y CLP 3 754 597 2/17/2025 2/17/2026
1,000,000
50,000
10,000
1,000,000
2,000,000
2,000,000
Loggers Broadform 1,000,000
A
X X X
CAP 3 754 598 2/17/2025 2/17/2026
1,000,000
A
X
X
X 10,000
CUP 3 754 602 2/17/2025 2/17/2026 2,000,000
2,000,000
A WC 3 754 596 2/17/2025 2/17/2026
X X
1,000,000
1,000,000
1,000,000
A Physical Damage CAP 3 754 598 2/17/2025 2/17/2026 Comp/Collision Deductible $1,000
A Inland Marine CLP 3 754 597 2/17/2025 2/17/2026 Limits & Deductible See Below
Contract No. CTR048464 Additional Insured: State of Arizona & Arizona Game and Fish Department.
All coverages and limits are subject to the terms, conditions, insuring agreement, and exclusions provided in the policy.
Arizona Game and Fish Department 5000 W. Carefree Highway Phoenix, AZ 85086
Monti Hancock/TAMATT
The ACORD name and logo are registered marks of ACORD
CERTIFICATE HOLDER
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
AUTHORIZED REPRESENTATIVE
CANCELLATION
DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE
LOCJECT
PRO-
POLICY
GEN'L AGGREGATE LIMIT APPLIES PER:
OCCURCLAIMS-MADE
COMMERCIAL GENERAL LIABILITY
PREMISES (Ea occurrence) $
DAMAGE TO RENTED
EACH OCCURRENCE $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
$RETENTIONDED
CLAIMS-MADE
OCCUR
AGGREGATE $
EACH OCCURRENCE $UMBRELLA LIAB
EXCESS LIAB
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
INSR
LTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY) LIMITS
PER
STATUTE
OTH-
ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
ANY PROPRIETOR/PARTNER/EXECUTIVE
If yes, describe under DESCRIPTION OF OPERATIONS below
(Mandatory in NH)
OFFICER/MEMBER EXCLUDED?
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
HIRED AUTOS
NON-OWNED
AUTOS AUTOS
AUTOS
COMBINED SINGLE LIMIT
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE $
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.
INSD
ADDL
WVD
SUBR
N / A
(Ea accident)
(Per accident)
OTHER:
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.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSURED
PHONE
(A/C, No, Ext):
PRODUCER
ADDRESS:
FAX
(A/C, No):
CONTACT
NAME:
NAIC #
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
INSURER(S) AFFORDING COVERAGE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
INS025 (201401)
File details come from the government source that posted it. Updated .