CTR055987 COI 2025-01-15 Weston_GAUWP.pdf

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Attached to
Master Agreement AZ|CTR055987
Contract number
CTR055987
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance for Weston Solutions, Inc., issued by multiple insurers including Greenwich Insurance Company, XL Insurance America, Inc., XL Specialty Insurance Company, Liberty Mutual Fire Insurance Company, and XL Insurance Company. The certificate is issued for a contract with the Arizona Department of Environmental Quality, specifically related to Solicitation No. BPM003359 for a Statewide Assessment and Remediation of Hazardous or Regulated Substances or Materials, with Contract #CTR0055987.

The insurance coverage includes Commercial General Liability, Automobile Liability, Umbrella Liability, and Workers' Compensation, with policy periods from January 15, 2024 to January 15, 2025. The policies provide various coverage limits, including $1,000,000 for each occurrence and $2,000,000 aggregate for General Liability, $1,000,000 for Automobile Liability, and $1,000,000 for Workers' Compensation. The State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as additional insured (except for workers' compensation and professional liability) as required by the written contract, with a waiver of subrogation applicable where 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)

© 1988-2016 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

01/15/2024

01/15/2025

10,000

X

D

23035

2,000,000

WC5-631-477160-054 (WI)

22322

PEC004536509

1,000,000

A

X

C

2,000,000

01/15/2025 X

XL Specialty Insurance Company

CONTRACTORS POLLUTION /

01/15/2024

CN102357761-WS-COPS-24-25

1,000,000

24554

01/15/2025

CLE-006750425-16

01/15/2024

X

2,000,000

02/01/2024

2,000,000

01/15/2025

PROFESSIONAL

1,000,000

X

AGGREGATE

1,000,000 1,000,000

B

01/15/2025

01/15/2024

01/15/2024

X

37885

AEC006277601

EACH OCCURRENCE

10,000

WA5-63D-477160-014 (AOS)

X

UEC004535209

SIR: $500,000

1,000,000

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as additional insured (except for workers' compensation and professional liability) as required by written contract. Waiver of subrogation is applicable where required by written contract.

Re: Solicitation No. BPM003359, Description: Statewide Assessment and Remediation of Hazardous or Regulated Substances or Materials Contract #CTR0055987

Liberty Mutual Fire Insurance Company

1400 WESTON WAY

WESTON SOLUTIONS, INC.

WEST CHESTER, PA 19380

1,000,000

Greenwich Insurance Company

X

1717 Arch Street

Marsh USA LLC

Attn: Philadelphia.certs@Marsh.com Fax: 212-948-0360 Philadelphia, PA 19103

GEC300071709

XL Insurance America, Inc.

N

1110 West Washington Street

Phoenix, AZ 85007

Arizona Department of Environmental

Quality

01/15/2024

D

1,000,000

X

X

A

1,000,000

01/15/2025

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