AZDOPS_COI.pdf

PDF 229 KB Posted

Attached to
AZ|CTR078106
Contract number
CTR078106
Issued by
Arizona

About this file

This document is an ACORD Certificate of Liability Insurance for Tyrrell-Marxen Chevrolet, located in Flagstaff, Arizona. The certificate is issued by Brightline Dealer Advisors and involves two primary insurance carriers: Columbia Casualty Company (NAIC 31127) and The Continental Insurance Company (NAIC 35289). The certificate holder is the Arizona Department of Public Safety, and the named insured entities include Tyrrell-Marxen Chevrolet, Inc., Terry Marxen Chevrolet dba Flagstaff Chevrolet, Harris Automotive Inc. dba Winslow Ford, and Mr. Harris Properties LLC.

The insurance policy provides comprehensive coverage with various limits, including a $1,000,000 general aggregate limit, $1,000,000 for each occurrence, and $5,000 for medical expenses. The policy covers commercial general liability, automobile liability (any auto), and umbrella liability, with policy periods from 7/1/2025 to 7/1/2026. The additional remarks schedule details garagekeepers legal liability for three locations in Flagstaff and Winslow, Arizona, with comprehensive/collision coverage ranging from $120,000 to $1,200,000 and deductibles of $1,000 for collision and $1,000/$5,000 for comprehensive coverage.

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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

E-MAIL

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 be low If yes , describe under

ANY P ROPRIETOR/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

06/27/2025

Brightline Deale r Advisors

15301 Dallas Pkwy

Suite 400

Addison TX 75001

Mike Morte nsen

(855) 955-2718 (469) 533-3854 mmortensen@brightlinedeale r.com

Tyrre ll-Marxen Chevrole t

1118 West Hwy 66

Fla gstaff AZ 86001

Columbia Casualty Company 31127

The Continenta l Insurance Company 35289

A

Garage

AYA737206122 7/1/2025 7/1/2026

1,000,000

100,000

5,000

1,000,000

2,000,000

1,000,000

Garage 1,000,000

A AYA737206122 7/1/2025 7/1/2026

1,000,000

A

10,000

AYU737207092 7/1/2025 7/1/2026

5,000,000

10,000,000

Named Insured(s ) Include:

Tyrre ll-Marxen Chevrole t, Inc.

Terry Ma rxen Chevrole t dba Flagstaff Chevrole t Harris Automotive Inc. dba Winslow Ford Mr Harris Properties LLC

Covered Location(s ) Include:...(continued on Form 101)...

AZ Department of Public Safety

EFFECTIVE DATE:

NAMED INSURED

POLICY NUMBER

NAIC CODECARRIER

AGENCY

LOC #:

AGENCY CUSTOMER ID:

ofPageADDITIONAL REMARKS SCHEDULE

ADDITIONAL REMARKS

FORM TITLE:FORM NUMBER:

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

© 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

ACORD 101 (2008/01)

1 1

25 Certifica te of Liability Insurance

Loc 1: 1118 West Hwy 66, Fla gstaff, AZ 86001 Loc 2: 805 We st Hwy 66, Flagstaff, AZ 86001 Loc 3: 840 Mike 's Pike St, Wins low, AZ 86047

Garagekeepers Legal Liability Comp / Collis ion Loc 1: $1,200,000 Loc 2: $120,000 Loc 3: $720,000

GK Deductible :

Collis ion: $1,000 Comprehens ive : $1,000/$5,000

File details come from the government source that posted it. Updated .