CTR055987 COI 2025-01-15 Weston_GAUWP.pdf
PDF 1 MB Posted
- 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
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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