CTR055608_Certificate_of_Insurance__2_.pdf
PDF 230 KB Posted
- Attached to
- Master Agreement AZ|CTR055608
- Contract number
- CTR055608
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance for Vista Recycling Inc., issued by Allreds Insurance Agency, covering multiple insurance policies for the State of Arizona, specifically the Department of Corrections Rehabilitation & Reentry, Procurement Services. The certificate involves multiple insurers including Nautilus Insurance Company, Key Risk Insurance Company, GuideOne National Ins Co, Star Stone Specialty Ins Co, and Incline Casualty Company, with the certificate dated 05/02/24 and referencing Contract #CTR055608.
The insurance coverage includes Commercial General Liability, Automobile Liability, Umbrella/Excess Liability, and Workers Compensation, with various policy periods spanning from 11/04/23 to 04/01/25. Key coverage limits include $1,000,000 for each occurrence in general liability, $1,000,000 combined single limit for automobile liability, $2,000,000 for umbrella/excess liability, and $1,000,000 for workers compensation. The policy is specifically endorsed to include the State of Arizona and its departments as additional insureds, with a waiver of transfer of rights and primary non-contributory coverage. The contract appears to provide comprehensive insurance protection for Vista Recycling Inc.'s operations related to the state contract.
View the file
Other files
Show all 12
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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
Phoenix AZ 85034 Mail Code 55302 701 E Jefferson St Reentry, Procurement Services Dept of Corrections Rehabilitation & State of Arizona
This policy is endorsed, as required by this written agreement, to include the State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents and employees as additional insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor, with a waiver of transfer of rights, coverage is primary noncontributory. 30 Day notice of cancellation applies except for nonpayment of premium.
See attached forms that apply Contract #CTR055608
$2,000,000 $2,000,000
11/04/2411/04/23AXS7000202#2
Excess Liability 2 Million Excess over 2 Million ExcessD
1,000,000 1,000,000
1,000,00004/01/2504/01/24SWB10027600YYE
2,000,000 2,000,000
11/04/2411/04/23560002846-02C
1,000,000
11/04/2411/04/23BAP2036202-12YYB
2,000,000 2,000,000 1,000,000
5,000 100,000
1,000,000
11/04/2411/04/23GLP2036201-12YYA
11090Incline Casualty Company 44776Star Stone Specialty Ins Co 14167GuideOne National Ins Co 10885Key Risk Insurance Company 17370Nautilus Insurance Company
Safford, AZ 85546 114 West 8th St.
Vista Recycling Inc.
allredsins@vtc.net (928)428-1245(928)428-1244
Beau Allred
Safford, AZ 85546 201 W 5th St
ALLREDS INSURANCE AGENCY
05/02/24
File details come from the government source that posted it. Updated .