Arizona_Game_and_Fish_Department__WOS__5000_West_Carefree_Highway__Phoenix__AZ__85086__Method_of_Distribution__Email_2___1_.pdf
PDF 21 KB Posted
- Attached to
- Master Agreement AZ|CTR055334
- Contract number
- CTR055334
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by AssuredPartners of Arizona, LLC for M D Merrett, with Employers Mutual Casualty Company as the primary insurer. The certificate is associated with Contract No. CTR055334 for the Arizona Game and Fish Department, located in Phoenix, Arizona. The insurance covers various liability policies for a project related to Wildlife Waters Construction & Redevelopment/Wildlife Habitat Construction.
The insurance coverage includes Commercial General Liability with a $1,000,000 each occurrence limit and $2,000,000 aggregate limit, Automobile Liability with a $1,000,000 combined single limit, Umbrella/Excess Liability with $2,000,000 each occurrence and aggregate limits, and Pollution Liability with a $1,000,000 aggregate limit. The policies are effective from 04/08/2025 to 04/08/2026, with the State of Arizona and its departments listed as additional insureds on a primary and non-contributory basis. The certificate includes a waiver of subrogation as required by the written contract for operations performed by the named insured.
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Text version
04/08/2025
AssuredPartners of Arizona, LLC 14614 N Kierland Blvd Ste #150
Scottsdale AZ 85254
Alyssa Canez
(800) 251-9622 (800) 251-9622
Alyssa.Canez@assuredpartners.com
M D Merrett
PO BOX 3804
CAREFREE AZ 85377-3804
Employers Mutual Casualty Company 21415
25/26 Master
A Y Y 5M10324 04/08/2025 04/08/2026
1,000,000 300,000 5,000 1,000,000 2,000,000 2,000,000
A Y Y 5E10324 04/08/2025 04/08/2026
1,000,000
A 5J10324 04/08/2025 04/08/2026 2,000,000 2,000,000
B Pollution Liability
5M10324 04/08/2025 04/08/2026 Agggregate Limit 1,000,000
RE: Wildlife Waters Construction & Redevelopment/Wildlife Habitat Construction The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents and employees as Additional Insureds on the General Liability policy shown above on a Primary & Non-Contributory basis and including a Waiver of Subrogation in their favor, if required by written contract for operations being performed for them by the named insured and subject to policy terms, forms and conditions. CG7393.1 (10-13) & CG2404 (05-09).
RE: Contract No. CTR055334
Arizona Game and Fish Department Purchasing Office 5000 West 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
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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