Certicicate of Insurance GL - Auto - Vendtronics 9.5.2026.pdf
PDF 40 KB Posted
- Attached to
- Master Agreement AZ|CTR077301
- Contract number
- CTR077301
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by WaFd Insurance Group for Kenneth E. Vanleer dba Vendtronics, with Travelers Insurance as the primary insurer. The certificate names the State of Arizona, specifically the Department of Economic Security, as the certificate holder. The insurance coverage is valid from 9/5/2025 to 9/5/2026 and provides commercial general liability and automobile liability insurance.
The contract covers vending machine sales and repair services under the State of Arizona contract number CTR077301. The insurance policy includes a combined single limit of $1,000,000 for automobile liability and commercial general liability. The State of Arizona, including its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees, are listed as additional insureds with a waiver of subrogation. The policy provides coverage for potential damages, with aggregate limits of $2,000,000 for general liability and specific limits for medical expenses, personal injury, and property damage.
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Text version
CERTIFICATE HOLDER
© 1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09)
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
GENERAL LIABILITY
PREMISES (Ea occurrence) $
DAMAGE TO RENTED
EACH OCCURRENCE $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
$RETENTION
DEDUCTIBLE
CLAIMS-MADE
OCCUR
AGGREGATE $
EACH OCCURRENCE $UMBRELLA LIAB
EXCESS LIAB
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
INSR
LTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY) LIMITS
WC STATU-
TORY LIMITS
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 AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE
(Per accident) $
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.
INSR
ADDL
WVD
SUBR
N / A
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).
The ACORD name and logo are registered marks of ACORD
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSURED
PHONE
(A/C, No, Ext):
PRODUCER
PRODUCER
CUSTOMER ID #:
ADDRESS:
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.
9/2/2025
WaFd Insurance Group 6720 N Scottsdale Rd Ste 111 Scottsdale, AZ 85253
623-889-6366 623-889-6399 commercial@hanksure.com
Kenneth E. Vanleer dba Vendtronics 3056 W. 30th Ave.
Phoenix, AZ 85017
Travelers
A x x x
Y Y BIP7T615108-24-42 9/5/2025 9/5/2026 1,000,000
300,000 5,000 1,000,000 2,000,000 2,000,000
A x x x
Y Y BA7Y855503 9/5/2025 9/5/2026 1,000,000
State of Arizona Department of Economic Security c/o myCOI PO Box 501970 8710 Bash Street Indianapolis, IN 46256
Vending machine sales and repair. ADES - CTR077301 State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are additional insureds and waiver of subrogation applies.
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