BPM006681_SellMark_COI.pdf

PDF 99 KB Posted

Attached to
Master Agreement AZ|CTR075185
Contract number
CTR075185
Issued by
Arizona

About this file

This document is an ACORD Certificate of Liability Insurance for Sellmark Corporation, located in Mansfield, Texas, issued by Roach Howard Smith & Barton insurance agency. The certificate lists multiple insurers, including Zurich American Insurance Company and Great American E&S Insurance Company, with coverage for Sellmark Corporation. The certificate holder is the Arizona Game and Fish Department, located in Phoenix, Arizona.

The insurance certificate provides commercial general liability coverage with a policy period from 7/19/2024 to 7/19/2025, including a $1,000,000 per occurrence limit and a $2,000,000 general aggregate limit. Additional coverage includes automobile liability and an umbrella/excess liability policy with a $5,000,000 each occurrence and aggregate limit. The policy includes provisions for blanket additional insured endorsements, primary and non-contributory status, and a waiver of subrogation for entities required by written contract. The policies cover general liability, with workers' compensation explicitly marked as excluded.

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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 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

12/20/2024

Roach Howard Smith & Barton 1320 South University Drive, Suite 1000 Fort Worth TX 76107

Michelle Broome 817-390-3517 mbroome@rhsb.com

Zurich American Insurance Co 16535 SELLCOR-01 Great American E&S Ins Co 37532

Sellmark Corporation 2201 Heritage Pkwy Mansfield TX 76063

1960419263

A X 1,000,000 X 100,000

EXCLUDED

1,000,000

2,000,000 X

CPO0930820 7/19/2024 7/19/2025

2,000,000

A X X 5,000,000AUC0912007 7/19/2024 7/19/2025

5,000,000

B Excess $5M x $5M XSF225159 7/19/2024 7/19/2025 EACH OCCURENCE

AGGREGATE

5,000,000 5,000,000

General liability policy includes blanket automatic additional insured endorsement or provision that provides additional insured status to any person or organization the Named Insured is required by written contract to add as an additional insured. General Liability policy includes Primary and Non-Contributory status in favor of Additional Insureds when there is a written contract or agreement requiring such status. General liability policy includes blanket automatic waiver of subrogation endorsement or provision that provides this feature to any person or organization the Named Insured is required by written contract to provide a waiver of subrogation.

Arizona Game and Fish Department 5000 W Carefree Highway Phoenix AZ 85086

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