Certificate_ADOT_10.30.24.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

10/22/2024

Arthur J. Gallagher Risk Management Services, LLC 6967 South River Gate Dr.

Suite 200 Salt Lake City UT 84047

Carolyn Maldonado 801-924-1400 801-294-1441 certrequests@ajg.com

Zurich American Insurance Company 16535 INLAKEN-01 Travelers Property Casualty Co of America 25674

Inland Kenworth (US), Inc, dba Inland Kenworth 8314 W. Roosevelt St.

Tolleston , AZ 85353

870182510

A X 2,000,000 X 1,000,000

10,000

2,000,000

4,000,000 X

Y Y GLO038117009 7/1/2024 7/1/2025

4,000,000

A 2,000,000

X

Y Y GP038116909 7/1/2024 7/1/2025

B X X 10,000,000CUP2S41349424NF 7/1/2024 7/1/2025

10,000,000 X 10,000

A XY WC038116809 7/1/2024 7/1/2025

1,000,000

1,000,000

1,000,000 A Garage and Dealers GP038116909 7/1/2024 7/1/2025 Occurrence Limit

Aggregate Limit $2,000,000 $2,000,000

Verification of insurance subject to the terms and conditions of the policy RE: Any and all work performed for or on behalf of the State of Arizona/ADOT. The State of Arizona/ADOT is Additional Insured with respect to General Liability and Auto Liability policy. Coverage is primary and non-contributory as long as no other insurance applies. Waiver of Subrogation applies in favor of Additional Insured with respect to General Liability, Auto Liability and Workers Compensation policies.

The State of Arizona/ADOT 206 S. 17th Ave Phoenix, AZ 85007

USA

GP038116908

7/1/2023

GP038116909

7/1/2024

GLO038117008

7/1/2023

GP038116908GP038116909

7/1/2024

7/1/2023GLO038117008GLO038117009 7/1/2024

WC038116808 7/1/2023 WC0381168097/1/2024

GLO038117008 7/1/2023 7/1/20237/1/2024GLO038117009 7/1/2024 7/1/2025 7/1/2024