COI-Exp2024-12-31-CAuUmPolPro_ACT.pdf

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Attached to
Master Agreement AZ|CTR065778
Contract number
CTR065778
Issued by
Arizona

About this file

This is a Certificate of Liability Insurance for ACT Environmental Inc, issued by Homeland Insurance Company of New York through Crest Insurance Group, LLC. The certificate covers a contract (CTR065778) for Asbestos, Lead and Mold Consultant Services with the State of Arizona, Arizona Board of Regents, and the University of Arizona. The certificate holder is the Arizona Department of Environmental Quality, located in Phoenix, Arizona.

The insurance policy provides commercial general liability, automobile liability, umbrella liability, and professional liability coverage with policy limits ranging from $1,000,000 to $2,000,000. The policy is effective from 12/31/2023 to 12/31/2024, with a policy number of 793-00-73-90-0004. The coverage includes additional insured provisions for the state and university, is primary and non-contributory, and includes a waiver of subrogation. The policy specifically covers consulting services related to asbestos, lead, and mold, with a professional liability deductible of $2,500.

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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

7/16/2024

Crest Insurance Group, LLC 5285 E. Williams Circle Suite 4500 Tucson AZ 85711

Danel McCartin 520-881-5760 520-325-3757 dmccartin@crestins.com

Homeland Insurance Company of New York 34452

ACTENVI-02

ACT Environmental Inc 7592 N. La Cholla Blvd Tucson AZ 85741

1248519375

A X 1,000,000

100,000

5,000

1,000,000

2,000,000 X

Y Y 793-00-73-90-0004 12/31/2023 12/31/2024

2,000,000

A 1,000,000

X X

793-00-73-90-0004 12/31/2023 12/31/2024

A X X 2,000,000793-00-73-90-0004 12/31/2023 12/31/2024

A Professional Liability Claims Made Contractors Pollution Liabi

793-00-73-90-0004 12/31/2023 12/31/2024 Ea Claim Aggregate Deductible

$1,000,000 $2,000,000 $2,500

Certificate holder and others when required in a written contract or agreement are Additional Insured (General Liability) including Products Completed.

Coverage is Primary & Non-Contributory (General Liability). Waiver of Subrogation (General Liability) applies. Umbrella Liability is Follow-Form. This form is subject to all policy forms, terms, endorsements, conditions definitions & exclusions.

Re: Contract No. CTR065778.

Asbestos, Lead and Mold Consultant Services, The State of Arizona, Arizona Board of Regents, the University of Arizona, and its officers, officials, agents, and employees shall be named as additional insureds with respect to liability arising out of the activities performed by or on behalf of ACT Environmental, Inc.

Arizona Department of Environmental Quality 1110 W Washington Street Phoenix AZ 85007

793-00-73-90-0004

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