APPROVED CTR062472 01.01.23-01.01.24.pdf
PDF 1 MB Posted
- Attached to
- Master Agreement AZ|CTR062472
- Contract number
- CTR062472
- Issued by
- Arizona
About this file
This document is a comprehensive insurance certificate and associated endorsements for Parsons Transportation Group Inc., issued by multiple insurance carriers including National Union Fire Insurance Company of Pittsburgh and Lexington Insurance Company. The primary certificate holder is the State of Arizona, specifically for a Transportation Systems Management and Operations (TSMO) On-Call Consultants contract (Contract No. CTR062472) with Parsons Corporation. The insurance covers multiple policy types including commercial general liability, automobile liability, workers' compensation, and professional liability across various operational jurisdictions.
The contract appears to be an on-call consulting services agreement for transportation systems management, with a contract end date of 09/30/2023. The insurance policies provide extensive coverage with significant liability limits, including $2,000,000 for commercial general liability, $1,000,000 for automobile liability, and $5,000,000 for professional liability. The professional liability policy has a retroactive date of 06/19/1986. The policies include additional insured provisions for the State of Arizona and its departments, agencies, boards, commissions, universities, officers, and employees. The coverage is effective from 01/01/2023 to 01/01/2024, with various endorsements ensuring comprehensive protection for the contracted services.
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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
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
X
19399
X
19445
X
X
X
A
A
C
1,000,000
X
LIC #CA 0C19812
X
1,000,000
10,000
XX
The State of Arizona
67426377
67426377
Washington, DC 20003-3515
CA134-1447(NJ)
11665420
1324 N. 22nd Ave.
X
USA
2,000,000
12/21/2022
X
X 2,000,000
LEXINGTON INS CO
GL17587105
AIU INS CO
NATIONAL UNION FIRE INS CO OF PITTS
Lockton-HA2
01/01/24
01/01/24
AUTO LIABILITY
PROFESSIONAL LIABILITY
ARCHITECTS & ENGINEERS
CSL (EA ACCIDENT)
POLICY AGG
PER CLAIM
01/01/24
1,000,000
X
Phoenix, AZ 85009
Lockton Companies, LLC-1 Kansas City
X
A
4,000,000
X
1,000,00001/01/23
444 W. 47th Street, Suite 900
01/01/23
01/01/23
100 M Street SE, Suite 1200
01/01/24
N B
2,000,000
CA134-1446(AOS)
B
B
Parsons Transportation Group Inc.
2,000,000
5,000,000
01/01/23
5,000,000
X
Kansas City, MO 64112-1906
WC013-75-1721(WI)
WC013-75-1719(CA)
WC013-75-1720(AOS)
01/01/23
01/01/23
01/01/23
1-816-960-9000
4,000,000
01/01/24 01/01/24
01/01/24
See attached endorsements and special clauses.
RiskManagement.Parsons@parsons.com
Contract End Date: 09/30/2023 Professional Liability Retroactive Date: 06/19/1986 officials, agents, and employees.
Additional Insureds: State of Arizona, and its departments, agencies, boards, commissions, universities, officers, RE: Contract No. CTR062472 - TSMO On-Call Consultants - ADOT CTR062472.
19437 a8812 Accepted
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POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
CG 20 10 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2
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
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", "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.
WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT. WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT.
GL17587105
Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13
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 shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
CG 20 37 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1
ADDITIONAL INSURED – OWNERS, LESSEES OR
CONTRACTORS – COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations
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 shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT. WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT.
CG 24 04 05 09
CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 �
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization:
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 we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above.
WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
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
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective Policy No. Endorsement No.
Insured: Premium $ Company: Countersigned By
WC 00 03 13
(Ed. 4-84)
Copyright 198:1 National Council on Compensation Insurance. AGENT COPY
AIU INS CO
The State of Arizona
WC013-75-1720(AOS)
USA
01/01/23
Phoenix, AZ 85009
1324 N. 22nd Ave.
Parsons Transportation Group Inc.
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA
This endorsement changes the policy to which it is attached effective on inception date of the policy unless a different date is indicated below.
(The following “attaching clause” need be completed only when this endorsement is issued subsequent to preparation of the policy.)
This endorsement, effective 12:01 AM forms a part of Policy No.
Issued to:
By:
Premium: INCL
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).
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
The additional premium for this endorsement shall be 5% of the California workers’ compensation premium otherwise due on such remuneration.
Schedule
Person or Organization
Job Description
WC 04 03 06 Countersigned by__________________________________________ (Ed. 4-84) Authorized Representative
01/01/23
Parsons Transportation Group Inc.
Phoenix, AZ 85009
Where required by written contract or agreement.
1324 N. 22nd Ave.
WC013-75-1719(CA)
AIU INS CO
The State of Arizona
SUPP (10/00)
SUPPLEMENT TO CERTIFICATE OF INSURANCE
DATE
NAME OF INSURED:
Parsons Transportation Group Inc.
12/21/2022 notification to that effect.
cancellation, or reduction in coverage or limits, of any insurance within thirty (30) days of receipt of insurers'
The named insured, Parsons Corporation or its Insurance Broker shall notify the certificate holder of any
Cancellation Notice:
by the policy).
General Liability includes Contractual Liability (insurance is available only to the extent provided
Contractual Liability:
SPECIAL CLAUSES
File details come from the government source that posted it. Updated .