CMS_COI_Expires_9.30.26.pdf

PDF 1 MB Posted

Attached to
AZ|CTR076927
Contract number
CTR076927
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by Alliant Insurance Services, Inc. on behalf of multiple insurers, including Phoenix Insurance Company, St. Paul Guardian Insurance Co, Travelers Property Casualty Co, Farmington Casualty Company, Starr Indemnity & Liability Co, and St. Paul Surplus Lines Insuran. The certificate covers Quantum Industrial Services, LLC, V.O. Brothers Mechanical, LLC, and Crawford Mechanical Services (CMS), LLC, located in Mesa, Arizona. The certificate holder is the Arizona Secretary of State, with coverage effective from 9/30/2025 to 9/30/2026.

The insurance provides comprehensive coverage including commercial general liability, automobile liability, umbrella liability, workers' compensation, and employers' liability. Coverage limits vary by policy type, with general liability set at $1,000,000 per occurrence and $2,000,000 aggregate, automobile liability at $1,000,000, and workers' compensation meeting statutory requirements. Additional specialized coverages include leased and rented equipment, installation floater, professional and pollution liability, and cyber liability with a $5,000,000 limit. The policy includes provisions for additional insured status for the Arizona Secretary of State on a primary non-contributory basis, with a waiver of subrogation as required by the contract.

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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

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

9/24/2025

Alliant Insurance Services, Inc.

900 S College Rd., Suite 301 Lafayette LA 70503 penny.daigle@alliant.com 337-441-6639 601-709-4615

License#: 0C36861 Phoenix Insurance Company 25623 QUANIND-04 St. Paul Guardian Insurance Co 24775

Quantum Industrial Services, LLC V.O. Brothers Mechanical, LLC Crawford Mechanical Services (CMS), LLC 5026 S Ellsworth Rd Mesa AZ 85212

Travelers Property Casualty Co 25674 Farmington Casualty Company 41483 Starr Indemnity & Liability Co 38318 St. Paul Surplus Lines Insuran 30481

259680532

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

5,000

1,000,000

2,000,000 X

Y Y DTCOB5647635PHX25 9/30/2025 9/30/2026

2,000,000

B 1,000,000

X Y Y 810B565050A2526G 9/30/2025 9/30/2026

C X X 5,000,000Y CUPB56789252526 9/30/2025Y 9/30/2026

5,000,000 X 10,000

D X

N

Y UBB56782182526G 9/30/2025 9/30/2026

1,000,000

1,000,000

1,000,000 E E F

Leased & Rented Equipment Installation Floater Blkt Stored Professional & Pollution

ITH100065520125

ITH100065520125

ZCD81N97568

9/30/2025 9/30/2025 9/30/2025

9/30/2026 9/30/2026 9/30/2026

Limit Limit Limit

1,000,000 2,500,000 5,000,000

Cyber Liability Carrier: Coalition Insurance Company Effective Date: 9/30/2025-2026 $5,000,000 Limit

RE: Any & All Arizona Secretary of State as additionally insured on a primary non contributory basis & waiver of subrogation apply as required in written contract per the attached forms. Umbrella & Excess follows form.

Arizona Secretary of State 1700 W Washington St Phoenix AZ 85007

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