CTR057649_Certificate_of_Insurance_to_CGL_4-27-24.pdf

PDF 41 KB Posted

Attached to
Master Agreement AZ|CTR057649
Contract number
CTR057649
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by NFP Property & Casualty Services, Inc. for Sprague's Sports, Inc., Sprague's Sports, LLC, and Gunsho II, LLC, with Clear Blue Insurance Company as the primary insurer. The certificate is for the State of Arizona, specifically naming the Arizona Game & Fish Department and the Arizona Department of Economic Security as additional insured parties. The insurance policy is effective from 4/27/2023 to 4/27/2024.

The insurance coverage includes Commercial General Liability with a $1,000,000 each occurrence limit, a $3,000,000 Umbrella Liability limit, and additional coverage for Building/Business Personal Property and Business Interruption totaling $11,208,000. A Cyber Liability component is also included with a $250,000 limit. The certificate holder (Arizona Game & Fish Department) is listed as an additional insured with respect to general liability limits for acts arising out of the operations of the named insured, as specified in the CG 20 26 12/19 endorsement form.

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Text version

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

INSR ADDL SUBR

LTR INSD WVD

PRODUCER

CONTACT

NAME:

FAXPHONE

(A/C, No):(A/C, No, Ext):

E-MAIL

ADDRESS:

INSURER A :

INSURED INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

POLICY NUMBER

POLICY EFF POLICY EXP

TYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)

AUTOMOBILE LIABILITY

UMBRELLA LIAB

EXCESS LIAB

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

AUTHORIZED REPRESENTATIVE

EACH OCCURRENCE $

DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT

OTHER: $

COMBINED SINGLE LIMIT

$(Ea accident)

ANY AUTO BODILY INJURY (Per person) $

OWNED SCHEDULED

BODILY INJURY (Per accident) $AUTOS ONLY AUTOS

HIRED NON-OWNED PROPERTY DAMAGE

$AUTOS ONLY AUTOS ONLY (Per accident)

OCCUR EACH OCCURRENCE

CLAIMS-MADE AGGREGATE $

DED RETENTION $

PER OTH-

STATUTE ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE $

If yes, describe under

E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below

INSURER(S) AFFORDING COVERAGE NAIC #

COMMERCIAL GENERAL LIABILITY

Y / N

N / A (Mandatory in NH)

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

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.

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.

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).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

CERTIFICATE HOLDER CANCELLATION

© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

The ACORD name and logo are registered marks of ACORD

7/10/2023

(303) 951-5050 (303) 951-5060

28860

Sprague's Sports, Inc.; Sprague's Sports, LLC; Gunsho II, LLC

345 W 32nd Street Yuma, AZ 85364

A 1,000,000

X BB01-CPP-000491-00 4/27/2023 4/27/2024 100,000

5,000

1,000,000

2,000,000

2,000,000

3,000,000A

BB01-UL-000211-00 4/27/2023 4/27/2024 3,000,000

10,000

A Building/BPP & BI/EE BB01-CPP-000491-00 4/27/2023 Building/BPP & BI/EE 11,208,000

A Cyber Liability - Co BB01-CPP-000491-00 4/27/2023 4/27/2024 250,000

Certificate holder is listed as additional insured with respect to the general liability limits for acts arising out of the operations of the named insured per form

CG 20 26 12/19.

Arizona Game & Fish Department State of Arizona 5000 W. Carefree Highway Phoenix, AZ 85086

SPRASPO-01 BRANDIHALLUM

NFP Property & Casualty Services, Inc.

1371 Hecla Drive Suite E Louisville, CO 80027

Clear Blue Insurance Company

4/27/2024

X

X

X

X

X

POLICY�NUMBER:BB01�CPP�000491�00 COMMERCIAL�GENERAL�LIABILITY

CG�20�26�12�19

THIS�ENDORSEMENT�CHANGES�THE�POLICY.��PLEASE�READ�IT�CAREFULLY.

CG�20�26�12�19 ©�Insurance�Services�Office,�Inc.,�2018� Page�1�of�1

ADDITIONAL�INSURED���DESIGNATED

PERSON�OR�ORGANIZATION

This�endorsement�modifies�insurance�provided�under�the�following:

COMMERCIAL�GENERAL�LIABILITY�COVERAGE�PART

SCHEDULE

Name�Of�Additional�Insured�Person(s)�Or�Organization(s):

�Arizona�Game�&�Fish�Department

Arizona�Department�of�Economic�Security

Information�required�to�complete�this�Schedule,�if�not�shown�above,�will�be�shown�in�the�Declarations.

A. Section� II� ��Who� Is� An� Insured� is� amended� to� include� as� an� additional� insured� the� person(s)� or� organization(s)� shown� in� the� Schedule,� but� only� with�respect�to�liability�for�"bodily�injury",�"property� damage"� or� "personal� and� advertising� injury"� caused,� in� whole� or� in� part,� by� your� acts� or� omissions�or�the�acts�or�omissions�of�those�acting� on�your�behalf:

1. In�the�performance�of�your�ongoing�operations;� or

2. In�connection�with�your�premises�owned�by�or� rented�to�you.

However:�

1. The� insurance� afforded� to� such� additional� insured�only�applies�to�the�extent�permitted�by� law;�and

2. If�coverage�provided�to�the�additional�insured�is� required� by� a� contract� or� agreement,� the� insurance� afforded� to� such� additional� insured will� not� be� broader� than� that� which� you� are� required� by� the� contract� or� agreement� to� provide�for�such�additional�insured.

B. With� respect� to� the� insurance� afforded� to� these� additional� insureds,� the� following� is� added� to� Section�III���Limits�Of�Insurance:�

If� coverage� provided� to� the� additional� insured� is� required�by�a�contract�or�agreement,�the�most�we� will� pay�on� behalf� of� the� additional� insured� is� the� amount�of�insurance:

1. Required�by�the�contract�or�agreement;�or�

2. Available� under� the� applicable� limits� of� insurance;

whichever�is�less.�

This� endorsement� shall� not� increase� the� applicable�limits�of�insurance.

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