ATS_COI_Arizona_Game_and_Fish.pdf
PDF 26 KB Posted
- Attached to
- Master Agreement AZ|CTR060942
- Contract number
- CTR060942
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance for Advanced Telemetry Systems, Inc., located in Isanti, Minnesota. The certificate involves multiple insurance providers including Great Northern Insurance, Federal Insurance Company, and Travelers Casualty & Surety Company. The primary certificate holder is the Arizona Game and Fish Department, located in Phoenix, Arizona, with the insurance covering various liability aspects for a contract numbered CTR060942.
The insurance coverage includes Commercial General Liability with a $1,000,000 per occurrence limit and a $2,000,000 aggregate limit, Automobile Liability with a $1,000,000 combined single limit, Umbrella Liability with a $5,000,000 each occurrence and aggregate limit, and Workers' Compensation with $500,000 limits. A Professional Liability policy is also included with a $1,000,000 limit and a $25,000 deductible. The policies are effective from 2/9/2025 to 2/9/2026, with the Arizona Game and Fish Department and the State of Arizona included as additional insureds under the General Liability policy when required by written contract.
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Text version
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
PRODUCER CONTACT
NAME:
FAXPHONE
(A/C, No):(A/C, No, Ext):
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER POLICY EFF POLICY EXPTYPE 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 RENTEDCLAIMS-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 AGGJECT
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 LIMITDESCRIPTION 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.ACORD 25 (2016/03)
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
The ACORD name and logo are registered marks of ACORD
4/25/2025
(952) 653-1144
20303
ADVANCED TELEMETRY SYSTEMS, INC.
470 - 1st Avenue North Isanti, MN 55040
20281 19038
A 1,000,000
99470928 2/9/2025 2/9/2026 1,000,000 10,000
1,000,000 2,000,000 1,000,000
1,000,000B 73583122 2/9/2025 2/9/2026
5,000,000B 79888132 2/9/2025 2/9/2026 5,000,000
C
UB3K07238A 2/9/2025 2/9/2026 500,000
N 500,000
500,000 A Professional D95881932 2/9/2025 Deduct $25,000 1,000,000
RE: Contract#CTR060942
Arizona Game and Fish Department, the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees is included as an Additional Insured under the General Liability when required by written contract. A Waiver of Subrogation in favor of the Arizona Game and Fish Department, the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees applies to the General Liability when required by written contract.
Arizona Game and Fish Department 5000 West Carefree Hwy Phoenix, AZ 85086
ADVATEL-01 DGAGNELIUS
Christensen Group, Inc.
9855 W 78th Street Suite 100 Eden Prairie, MN 55344-8004
Patrick Jarvenpa pjarvenpa@christensengroup.com
Great Northern Ins.
Federal Ins. Co.
TRAVELERS CASUALTY & SURETY CO
X
2/9/2026
X
X
X X
X
X
X
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