COI_10-1-25.pdf

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Attached to
Master Agreement AZ|CTR076539
Contract number
CTR076539
Issued by
Arizona

About this file

This document is an ACORD Certificate of Liability Insurance for Shive-Hattery, Inc., issued by Holmes Murphy & Associates and covering multiple insurance providers including Zurich American Insurance Company of IL, Travelers Property Casualty Co. America, and XL Specialty Insurance. The certificate is issued for the State of Arizona, specifically the Department of Administration's General Services Division, located in Phoenix, with an effective date of 4/17/2025.

The insurance coverage includes Commercial General Liability, Automobile Liability, Umbrella Liability, Workers' Compensation, and Professional Liability (Claims Made Coverage). Policy limits vary by type, with General Liability set at $1,000,000 per occurrence and $2,000,000 aggregate, Automobile Liability at $1,000,000, Umbrella Liability at $10,000,000, Workers' Compensation matching statutory requirements, and Professional Liability at $5,000,000 per claim and $10,000,000 aggregate. The policies are effective from 10/1/2024 to 10/1/2025, and the State of Arizona is listed as an Additional Insured on General Liability, Auto, and Umbrella policies as required by written 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

4/17/2025

Holmes Murphy & Associates 2727 Grand Prairie Parkway Waukee IA 50263

Barbara Klein 319-896-7736 bklein@holmesmurphy.com

Zurich American Insurance Company of IL 27855 SHIHATPC Travelers Property Casualty Co. America 25674

Shive-Hattery, Inc.

4330 N. Campbell Ave #268 Tuscon, AZ 85718

XL Specialty Insurance 37885

1303789555

A X 1,000,000 X 300,000

10,000

1,000,000

2,000,000 X X

GLO0203929 10/1/2024 10/1/2025

2,000,000

A 1,000,000

X

X X

BAP0203930 10/1/2024 10/1/2025

B X X 10,000,000CUP9S85276424NF 10/1/2024 10/1/2025

10,000,000

A X

N

WC0203928 10/1/2024 10/1/2025

1,000,000

1,000,000

1,000,000 C Professional Liability

(Claims Made Coverage) DPR5033849 10/1/2024 10/1/2025 Per Claim

Aggregate 5,000,000 10,000,000

The State of Arizona is an Additional Insured on General Liability, Auto and Umbrella as required by written contract with the insured, per policy terms and conditions.

The State of Arizona Dept of Administration | General Services Division 1400 W Washington Street, Ste B200 Phoenix AZ 85007

USA

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