CTR052822_Workers_Compensation_05.01.2021_-_05.01.2022.pdf
PDF 808 KB Posted
- Attached to
- Master Agreement AZ|CTR052822
- Contract number
- CTR052822
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance issued by Pinnacol Assurance, located in Denver, Colorado, for American Target Company, also based in Denver. The certificate is dated September 17, 2021, and lists the Arizona Game and Fish Department in Phoenix, Arizona as the certificate holder. The insurance policy provides coverage for the period from May 1, 2021 to May 1, 2022, with a primary focus on coverage within Colorado.
The insurance policy includes commercial general liability coverage with a policy number 885002. The policy provides workers' compensation and employers' liability coverage with limits of $500,000 for each occurrence, including limits for employers' liability such as bodily injury by accident, disease-each employee, and disease-policy limit. The certificate specifies that unless otherwise stated in the policy provisions, the coverage is applicable only in Colorado. No specific details about goods, services, or contract-specific terms are provided in this liability insurance certificate.
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A X
Pinnacol Assurance 41190
Pinnacol Assurance 7501 E. Lowry Blvd.
Denver, CO 80230-7006
American Target Company 1328 S Jason St Denver, CO 80223
09/17/2021
885002 05/01/2021 05/01/2022 500,000 500,000 500,000
2202333 Arizona Game and Fish Department 5000 W Carefree Hwy Phoenix, AZ 85086 jscherbing@azgfd.gov
Pinnacol Assurance
Unless otherwise stated in the policy provisions, coverage in Colorado only.
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT (CONT)
CERTIFICATE HOLDER COPY
Arizona Game and Fish Department 5000 W Carefree Hwy Phoenix, AZ 85086
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File details come from the government source that posted it. Updated .