CAM Fleet CARE AZ Dot Certificate reflecting coverage eff 7-1-25.pdf

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

© 1988 201

Cindy Lewis Accepted

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)

CPI7222514

STATE OF ARIZONA/ADOT SEE LOCATION SCHEDULE

CPI7222514

ANY PERSON OR ORGANIZATION WITH WHOM THE INSURED HAS AGREED

TO WAIVE RIGHTS OF RECOVERY, PROVIDED SUCH AGREEMENT

IS MADE IN WRITING AND PRIOR TO THE LOSS.

Policy CPI7222514

Form_SCTNID_CTGRY.XX07161198_POLEND

983444547 Q CA01JFS INS POLEND U POLWHITEFONT ZQNOXOXTYZMIECO6V4B3V3FT6F0004 RPUID TRACWHITEFONT BDF_PCA

Policy number: 983444547 Underwritten by:

United Financial Casualty Company Insured:

CAM FLEET CARE INC.

June 27, 2025 Policy Period: Jul 3, 2025 - Jul 3, 2026

Mailing Address United Financial Casualty Company PO Box 94739 Cleveland, OH 44101

For customer service, 24 hours a day, 7 days a week

1-800-444-4487

SCOTTSDALE, AZ 85255

8700 E VISTA BONITA D

NEATE DUPEY INS GRP

3650 N 40TH AVE UNIT# 3

CAM FLEET CARE INC.

PHOENIX, AZ 85019

Additional insured endorsement

Name of Person or Organization The State of Arizona/ADOT 206 S 17th Ave Phoenix, AZ 85007 This endorsement modifies insurance provided under the commercial auto policy and any endorsements thereto affording liability coverage.

The person or organization named above is an insured with respect to such liability coverage as is afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability. We also agree with you that insurance provided by this endorsement will be primary for any power unit specifically described on the Declarations Page and showing liability coverage.

Limit of Liability Bodily Injury Not applicable Property Damage Not applicable Combined Liability $1,000,000 each accident

All other terms, limits and provisions of this policy remain unchanged.

This endorsement applies to Policy Number: 983444547 Issued to (Name of Insured): CAM FLEET CARE INC.

Effective date of endorsement: Policy expiration date: July 3, 2025 July 3, 2026 Form 1198 (07/16)

Form_SCTNID_CTGRY.XX02198610_POLEND

983444547 Q CA01JFS INS POLEND U POLWHITEFONT ZQNOXOXTYZMIECO6V4B3V3FT6F0004 RPUID TRACWHITEFONT BDF_PCA

Policy number: 983444547 Underwritten by:

United Financial Casualty Company Insured:

CAM FLEET CARE INC.

June 27, 2025 Policy Period: Jul 3, 2025 - Jul 3, 2026

Mailing Address United Financial Casualty Company PO Box 94739 Cleveland, OH 44101

For customer service, 24 hours a day, 7 days a week

1-800-444-4487

SCOTTSDALE, AZ 85255

8700 E VISTA BONITA D

NEATE DUPEY INS GRP

3650 N 40TH AVE UNIT# 3

CAM FLEET CARE INC.

PHOENIX, AZ 85019

Waiver of Subrogation Endorsement

This endorsement modifies insurance provided under the following:

Commercial Auto Policy Motor Truck Cargo Liability Coverage Endorsement Commercial General Liability Coverage Endorsement

We agree to waive any and all subrogation claims against the person or organization designated below.

Name of Person or Organization:

The State of ARizona/ADOT 206 S 17th Ave PHoenix, AZ 85007

This endorsement applies to policy number: 983444547 Issued to: CAM FLEET CARE INC.

Endorsement effective: July 3, 2025 Expiration: July 3, 2026

All other terms, limits and provisions of this policy remain unchanged.

Form 8610 (02/19)

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

Countersigned by Authorized Representative

Form WC 00 03 13 Printed in U.S.A.

Process Date: 06/26/25 Policy Expiration Date: 04/01/26

WAIVER OF OUR RIGHT TO RECOVER

FROM OTHERS ENDORSEMENT

Policy Number: 59 WEC BP8NW1 Endorsement Number: 004 Effective Date: 07/01/25 Effective hour is the same as stated on the Information Page of the policy.

Named Insured and Address: CAM Fleet Care Inc

3650 N 40TH AVE UNIT 3

PHOENIX AZ 85019

We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule.

This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.

SCHEDULE

The State of Arizona, ADOT, 206 S 17TH AVE, PHOENIX, AZ, 85007