AKD_COI_11-8-2024.pdf

PDF 24 KB Posted

Attached to
Master Agreement AZ|CTR074627
Contract number
CTR074627
Issued by
Arizona

About this file

This Certificate of Liability Insurance, issued November 8, 2024, certifies insurance coverage for AKD Advanced Services LLC, a contractor located in Washington, Utah. The certificate is issued by Landmark Risk Management on behalf of multiple insurers and lists the State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds. The Arizona Game and Fish Department, Purchasing Division, is identified as the certificate holder.

The insurance coverage includes four active policies with the following insurers and limits: Risk Placement Services (CPS8008367) providing Commercial General Liability with $1,000,000 each occurrence and $2,000,000 general aggregate limits, effective August 11, 2024 through August 11, 2025; Progressive (972755540) providing Automobile Liability with $1,000,000 combined single limit, effective September 1, 2024 through September 1, 2025; Work Comp of Utah Group (4102529) providing Workers Compensation and Employers' Liability with $1,000,000 per statute limits, effective November 1, 2024 through November 1, 2025; and Cincinnati Insurance Company (ENP 0694383) providing Scheduled Equipment coverage with $320,000 limits, effective September 1, 2024 through September 1, 2025. All policies include provisions naming the State of Arizona as an additional insured.

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Other files

File Type Posted
CTR074627_YR2_Contract_Renewal_AZGFD_Signed.pdf PDF
Cert_of_Ins_-_Arizona_Game_and_Fish_Dept..PDF PDF
CTR074627_Contract_documents.pdf PDF
2025-08-11__COI_AKD.pdf PDF
CTR074627_Contractor_Bid_AKD.pdf PDF
CTR074627_PRICING.xlsx XLSX spreadsheet
Contract_Summary_Document.pdf PDF

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Text version

11/08/2024

Landmark Risk Management 107 S 1470 East #302 Saint George, UT 84790

TierraShort

(435)656-4586 (435)673-3621 tierra@lmx180.com

00009470-129353 6

AKD Advanced Services LLC 935 E Crooked Creek Dr Washington, UT 84780

Risk Placement Services

A Y CPS8008367 08/11/2024 08/11/2025X

X

X

1,000,000 100,000

5,000 1,000,000 2,000,000 2,000,000

Progressive 11770

B Y 972755540 09/01/2024 09/01/2025

X X X

1,000,000

Work Comp of Utah Group

C 4102529 11/01/2024 11/01/2025 X 1,000,000 1,000,000 1,000,000

Cincinnati Insurance Company 10677

D ENP 0694383 09/01/2024 09/01/2025Scheduled Equipment 320,000

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are listed as additional insureds.

Arizona Game and Fish Dept.

Attn: Purchasing 5000 W Carefree Hwy Phoenix, AZ 85086

(TRS)

Printed by TRS on 11/08/2024 at 10:49AM

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

INSR ADDL SUBR

LTR INSD WVD

DATE (MM/DD/YYYY)

PRODUCER CONTACT

NAME:

FAXPHONE

(A/C, No):(A/C, No, Ext):

E-MAIL

ADDRESS:

INSURER A :

INSURED INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

POLICY NUMBER

POLICY EFF POLICY EXP

TYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)

AUTOMOBILE LIABILITY

UMBRELLA LIAB

EXCESS LIAB

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

AUTHORIZED REPRESENTATIVE

EACH OCCURRENCE $

DAMAGE TO RENTED

CLAIMS-MADE OCCUR $PREMISES (Ea occurrence)

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

PRO-

POLICY LOC PRODUCTS - COMP/OP AGG $JECT

OTHER: $

COMBINED SINGLE LIMIT $(Ea accident)

ANY AUTO BODILY INJURY (Per person) $

OWNED SCHEDULED BODILY INJURY (Per accident) $

AUTOS ONLY AUTOS

HIRED NON-OWNED PROPERTY DAMAGE $

AUTOS ONLY AUTOS ONLY (Per accident)

OCCUR EACH OCCURRENCE $

CLAIMS-MADE AGGREGATE $

DED RETENTION $ $

PER OTH-

STATUTE ER

E.L. EACH ACCIDENT $

E.L. DISEASE - EA EMPLOYEE $

If yes, describe under

E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below

INSURER(S) AFFORDING COVERAGE NAIC #

COMMERCIAL GENERAL LIABILITY

Y / N

N / A (Mandatory in NH)

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

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.

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 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).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

CERTIFICATE HOLDER CANCELLATION

© 1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03)

CERTIFICATE OF LIABILITY INSURANCE

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