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
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 .