COI_for_Arizona_Game_and_Fish_Department.pdf

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Attached to
Master Agreement AZ|CTR071841
Contract number
CTR071841
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by Insurance Services Group LLC on 04/30/2024 for Atlas Trap Company, LLC, located in Benton, Kansas. The certificate is issued for the Arizona Game and Fish Department, with coverage provided by EMCASCO Insurance Company and Employers Mutual Casualty Company. The insurance policies are effective from 07/10/2023 to 07/10/2024.

The certificate outlines multiple insurance coverages including Commercial General Liability with a $1,000,000 each occurrence limit, Automobile Liability with a $1,000,000 combined single limit, Workers Compensation, and Commercial Cyber and Privacy Liability. The policies include specific sublimits such as $50,000 for Data Compromise Response Expense, $25,000 for Legal Review, and $50,000 for Named Malware. The insurance is primary and applies to the contractor's operations, with the Arizona Game and Fish Department listed as the certificate holder.

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Text version

04/30/2024

Insurance Services Group LLC 1720 N Webb Rd Suite 110 Wichita KS 67206

Stephanie McFaul

(316) 928-0044 certs@isgkansas.com

ATLAS TRAP COMPANY, LLC

14200 SW 50TH ST

BENTON KS 67017-9165

EMCASCO Insurance Company 21407 Employers Mutual Casualty Company 21415 EMC Insurance 21415

CL2443001698

A Y Y 6D46431 07/10/2023 07/10/2024

1,000,000

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

Damage to Premises Rented to You

300,000

B Y Y 6E46431 07/10/2023 07/10/2024

1,000,000

Uninsured motorist combined single limit

1,000,000

A Y Y 6H46431 07/10/2023 07/10/2024 1,000,000 1,000,000 1,000,000

C Commercial Cyber and Privacy Liability

6Q46431 07/10/2023 07/10/2024

DATA COMPROMISE -

RESPONSE EXPENSE

$50,000

LEGAL REVIEW

SUBLIMIT

$25,000

NAMED MALWARE

SUBLIMIT

$50,000

The Contractor's policies, as applicable, shall stipulate that the insurance afforded the Contractor shall be primary and that any insurance carried by the Department, its agents, officials, employees or the State of Arizona.

Arizona Game and Fish Department 5000 W. Carefree Highway

Phoenix AZ 85086

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

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