CERT-186039463.pdf

PDF 5 MB Posted

Attached to
Master Agreement AZ|CTR055333
Contract number
CTR055333
Issued by
Arizona

About this file

This document is a comprehensive insurance certificate and policy endorsement package for DBA Construction, Inc., issued by Commercial West Insurance Agency and primarily underwritten by Phoenix Insurance Company, Travelers Property Casualty Company, and other insurers. The policy provides coverage for the State of Arizona and the Arizona Game and Fish Department, with the contract renewal identified as CTR55333, effective from January 1, 2024 to January 1, 2025.

The insurance coverage includes commercial general liability, automobile liability, umbrella liability, workers' compensation, pollution liability, and builder's risk policies. Key policy limits include $1,000,000 for general liability, $10,000,000 for umbrella liability, and $1,000,000 for workers' compensation. Additional specific coverages include a $750,000 limit for leased and rented equipment, a $5,000,000 pollution liability policy, and a blanket builder's risk policy. The policy provides additional insured status to the State of Arizona and the Arizona Game and Fish Department where required by written contract, with comprehensive coverage for potential risks associated with construction and related operations.

View the file

Other files

File Type Posted
20210511122850188_DBA_5-11-21.pdf PDF
DBA_01-01-2022_Insurance.pdf PDF
Due_Diligence_Check_List_RFP_5-10-21.pdf PDF
SRAZ_Mail_-_RE__Insurance_DBA.pdf PDF
STAZ_Mail_-_NOTICE_OF_ANTICIPATED_AWARD_BPM003283__DBA_Construction_5-17-21_9.08AM.pdf PDF
STAZ_Mail_-_RE__Best_and_Final_Offer-BPM003283_-_DBA_Construction.pdf PDF
STAZ_Mail_-_Re__DBA_Construction___Solicitation_BPM003283__Price_Negotiations_4-30-21_a.pdf PDF
STAZ_Mail_-_to__DBA_Construction_Price_Negotiations_due_4-15-21.pdf PDF
Sam___AZ_Copr_Yr_2_renewal_DBA_Construction_CTR055333.pdf PDF
01-01-26_cgl_al_ul_wc.pdf PDF
AZGF_Contract_CTR055333_Contract_Extension_DBA_5.2.23_fully_executed.pdf PDF
Award_Determination_DBA.pdf PDF
BPM003283_Pricing_due_4-15-21_from_DBA_Construction__Inc..pdf PDF
BPM003283__DBA_CONSTRUCTION_INC_Offer_and_Acceptance__signed.pdf PDF
CERT-538160105.pdf PDF
CTR055333_Renewal_YR3.pdf PDF
DBA_Construction_BPM003283_price_multipliers.pdf PDF
STAZMail_-_DBA_Construction__Solicitation_BPM003283___Price_Negotiations_question.pdf PDF
STAZMail_-_RE__DBA_Construction___Solicitation_BPM003283_Price_Negotiations_5-11-21.pdf PDF
STAZ_Mail_-_DBA_Construction__BPM003283_Price_Negotiations_INVITE.pdf PDF
STAZ_Mail_-_DBA_Construction___Solicitation_BPM003283__Response_4-30-21.pdf PDF
Sam_and_AZ_Corp_Commission_for_DBA_Construction.pdf PDF
01-01-2024_DBA_Construction_-BPM003283.pdf PDF
1-1-2024_Accord_WC_GL_CL_AL_UL_DBA_Const.pdf PDF
AZGF_BABA_Clause_DBA_Contract__CTR055333_executed__12.19.22.pdf PDF
CERT-689258069_DBA_1-1-22_to_1-1-23.pdf PDF
CTR055333_DBA_Const_Amendment_Basic_Renewal_Fully_Executed.pdf PDF
STAZMail_-_DBA_Construction__Solicitation_BPM003283___Price_Negotiations.pdf PDF
STAZ_Mail_-_From_DBA_negotiation_letter_due_4-15-21.pdf PDF
20210511122850188_DBA_5-11-21_BAFO.pdf PDF
CTR055333_Renewal_AZGFD_Signed.pdf PDF
EXECUTIVE_SUMMARY_BPM003283.pdf PDF
STAZMail_-_DBA_Construction__Solicitation_BPM003283___Price_Negotiations_question-2.pdf PDF
Show all 33

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

The ACORD name and logo are registered marks of ACORD

CERTIFICATE HOLDER

© 1988-2014 ACORD CORPORATION. All rights reserved.

ACORD 25 (2014/01)

AUTHORIZED REPRESENTATIVE

CANCELLATION

DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE

LOCJECT

PRO-POLICY

GEN'L AGGREGATE LIMIT APPLIES PER:

OCCURCLAIMS-MADE

COMMERCIAL GENERAL LIABILITY

PREMISES (Ea occurrence) $

DAMAGE TO RENTED

EACH OCCURRENCE $

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GENERAL AGGREGATE $

PRODUCTS - COMP/OP AGG $

$RETENTIONDED

CLAIMS-MADE

OCCUR

AGGREGATE $

EACH OCCURRENCE $UMBRELLA LIAB

EXCESS LIAB

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

INSR

LTR TYPE OF INSURANCE POLICY NUMBER

POLICY EFF

(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY) LIMITS

PER

STATUTE

OTH-

ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE

E.L. DISEASE - POLICY LIMIT

ANY PROPRIETOR/PARTNER/EXECUTIVE

If yes, describe under DESCRIPTION OF OPERATIONS below

(Mandatory in NH)

OFFICER/MEMBER EXCLUDED?

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY Y / N

AUTOMOBILE LIABILITY

ANY AUTO

ALL OWNED SCHEDULED

HIRED AUTOS

NON-OWNED

AUTOS AUTOS

AUTOS

COMBINED SINGLE LIMIT

BODILY INJURY (Per person)

BODILY INJURY (Per accident)

PROPERTY DAMAGE $

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.

INSD

ADDL

WVD

SUBR

N / A

(Ea accident)

(Per accident)

OTHER:

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 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:

INSURED

PHONE

(A/C, No, Ext):

PRODUCER

ADDRESS:

E-MAIL

FAX

(A/C, No):

CONTACT

NAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

INSURER(S) AFFORDING COVERAGE

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

12/28/2023

Commercial West Insurance Agency 2152 South Vineyard, Suite 107 Mesa AZ 85210

Lori Spelde 480-961-5400 480-961-5401

Lori@trycwi.com

Phoenix Insurance Company 25623 DBACO-1 Travelers Property Casualty Co 25674

DBA Construction, Inc.

P.O. Box 63035 Phoenix AZ 85082-3035

Travelers Casualty & Surety 31194 Continental Casualty Co. 20443 Westchester Surplus Lines Ins 10172

186039463

A X 1,000,000 X 300,000

5,000

1,000,000

2,000,000

X

Y Y DT-CO-9D586889-PHX-24 1/1/2024 1/1/2025

2,000,000

B 1,000,000 X

Y Y 810-2L968980-24-26-G 1/1/2024 1/1/2025

B X X 10,000,000CUP-0K482811-24-26

10,000,000

1/1/2024 1/1/2025

C

N

Y UB-9J634648-24-26-G 1/1/2024 1/1/2025 X

1,000,000

1,000,000

1,000,000 D E

Leased & Rented Equipment Pollution Liability

6079982568 G70963620004

1/1/2024 1/1/2024

1/1/2025 1/1/2025

Limit/Deductible Limit/Ded

750,000/1,000 5,000,000/10,000

Work Comp applies to all states excluding monopolistic - ND, OH, WA, WY *Blanket Builder's Risk Policy #6079982568|Contienental Casualty Company| Effective 01/01/2024 to 01/01/2025 $1,000,000 Policy Limit* *Motor Truck Legal Liability #6079982568|Continenental Casualty Company| Effective 01/01/2024 to 01/01/2025 $500,000 All Vehicles-Any One Loss* RE: Contract Renewal CTR55333. State of Arizona and the Arizona Game and Fish Department are additional insured where required by written contract.

Arizona Game & Fish Department 5000 W. Carefree Hwy Phoenix AZ 85086 lspelde.comme53 Highlight lspelde.comme53_1 lspelde.comme53_2 lspelde.comme53_3

ENDORSEMENT WC 00 03 13 (00) -

POLICY NUMBER:

EMPLOYERS LIABILITY POLICY

AND

WORKERS COMPENSATION

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

ONE TOWER SQUARE

HARTFORD CT 06183

UB-9J634648-22-26-G

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 applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)

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

SCHEDULE

DESIGNATED ORGANIZATION:

DESIGNATED PERSON:

ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED

BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS

WAIVER.

INCLUDING:

THE STATE OF ARIZONA, ARIZONA DEPARTMENT OF TRANSPORTATION,

ITS DEPARTMENTS, ITS OFFICERS, OFFICIALS, AGENTS AND

EMPLOYEES.

DATE OF ISSUE: PAGEST ASSIGN: OF01-03-22 1 101/01/2024

UB-9J634648-24-26-G

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