CTR063933_COI.pdf
PDF 100 KB Posted
- Attached to
- Master Agreement AZ|CTR063933
- Contract number
- CTR063933
- Issued by
- Arizona
About this file
This is an ACORD Certificate of Liability Insurance dated 12/2/2025 involving Lohman Helicopter, LLC and Lohman Excavating, located in Hayden, Idaho, with Marsh & McLennan Agency, LLC as the producer. The certificate holder is the Arizona Game and Fish Department in Phoenix, Arizona. The insurance is provided by Starr Indemnity and Liability Company, covering multiple insurance types including commercial general liability, automobile liability, workers' compensation, and aircraft liability.
The insurance policies are effective from 5/1/2025 to 5/1/2026, with various coverage limits. Commercial general liability is set at $5,000,000 per occurrence, with a $2,000,000 aggregate limit. Automobile liability covers any auto with a $1,000,000 limit. Workers' compensation provides $2,000,000 in coverage per statute. The certificate includes the State of Arizona as an additional insured with a waiver of subrogation, and requires 30 days' written notice prior to any policy cancellation or material changes. Aircraft liability is also included with a combined single limit of $10,000,000 per occurrence.
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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)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
12/2/2025
Marsh & McLennan Agency, LLC 7015 College Blvd Overland Park KS 66211
Donny Charlebois 913.529.3246 donny.charlebois@marshmma.com
STARR INDEMNITY AND LIABILITY 38318
LOHMHEL-01
Lohman Helicopter, LLC Lohman Excavating 3373 W Aviation Dr Hayden ID 83835-5193
1342784229
A X 5,000,000 X 250,000
5,000
5,000,000
2,000,000
Y Y SASICOM60063825-12 5/1/2025 5/1/2026
5,000,000
Fire Damage 100,000 A 1,000,000
X Y Y 1000659978251 5/1/2025 5/1/2026
5,000,000
5,000,000
A XN 1000003829 9/1/2025 5/1/2026
2,000,000
2,000,000
2,000,000
A AIRCRAFT Y Y SASICOM6006352512 5/1/2025 5/1/2026 CSL PER OCCURRENCE
MED PAY PER PERSON
PERSONAL INJURY
10,000,000 25,000 10,000,000
The certificate holder is included as an additional insured with a waiver of subrogation in favor of the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor.
Applicable to all insurance policies required within the Insurance Requirements of this Contract, Contractor’s insurance shall not be permitted to expire, be suspended, be canceled, or be materially changed for any reason without thirty (30) days prior written notice to the State of Arizona.
Arizona Game and Fish Department Purchasing Office 5000 West Carefree Highway Phoenix AZ 85086
File details come from the government source that posted it. Updated .