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
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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