CTR069477 GL,AL,WC 11.01.23-11.01.24.pdf

PDF 2 MB Posted

Attached to
Master Agreement AZ|CTR069477
Contract number
CTR069477
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance for San Tan Auto Partners, LLC, with coverage issued by The Charter Oak Fire Insurance Company and Travelers Property Casualty Co of America. The certificate is for a commercial auto policy and is issued in connection with Contract #CTR069477 for Medium and Heavy Duty Cabs, Chassis and Busses, with the State of Arizona and Arizona Department of Transportation listed as the certificate holder.

The insurance policy provides comprehensive coverage including commercial general liability, automobile liability, umbrella liability, and workers' compensation, with policy periods from 11/1/2023 to 11/1/2024. Key coverage limits include $1,000,000 for general liability and automobile liability, $25,000,000 for umbrella liability, and $1,000,000 for workers' compensation. The policy includes additional insured provisions, waiver of subrogation, and specific endorsements such as garagekeepers liability, pollution liability, and auto dealers liability. Physical damage deductibles are set at $2,500 for comprehensive and $1,000 for collision, with a 30-day notice required for any material changes or cancellation.

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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)

© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

1/18/2024

Lovitt & Touché A Marsh and McLennan Agency, LLC 8605 E. Raintree Drive, Suite 200 Scottsdale AZ 85260

Betsy Fillicelli 602-397-0263

Betsy.Fillicelli@MarshMMA.com

The Charter Oak Fire Insurance Company 25615 SANTANA-C1 Travelers Property Casualty Co of Amer 25674

San Tan Auto Partners, LLC San Tan Ford 1429 E. Motorplex Loop Gilbert AZ 85297

1508843161

A X 1,000,000 X 300,000

5,000

1,000,000

3,000,000 X

AD2P570026 11/1/2023 11/1/2024

3,000,000

A 1,000,000

X

X Garagekeeper X Liability

AD2P570026 11/1/2023 11/1/2024

Comp or Coll Limits $2,000,000

B X X 25,000,000CUP2P578442 11/1/2023 11/1/2024

25,000,000 X 0 Products Comp Ops Agg 25,000,000

A X

N

UB0P56093A 11/1/2023 11/1/2024

1,000,000

1,000,000

1,000,000 A Auto Dealers Liability

Pollution

AD2P570026 11/1/2023 11/1/2024 Each Accident Aggregate Each Occurrence

1,000,000 3,000,000 1,000,000

The below-indicated Additional Insured are provided with respects to General Liability and Automobile Liability per form CAT619 01-18 and such coverage afforded by these policies for the benefit of the additional insured(s) is primary and any other coverage maintained by such additional insured(s) shall be non-contributory when required in a written and executed contract. Waiver of Subrogation are provided with respects to General Liability, Automobile Liability, Workers’ Compensation per forms CAT425 12-18 and WC000312(00)001. 30 Days Notice of Cancellation applies for material reduction in coverage, non-renewal or cancellation; 10 days notice for non-payment. Garagekeepers coverage is Primary and Physical Damage Deductibles are Comprehensive $2,500 each covered auto and Collision is $1,000 each covered auto. Supporting endorsements are attached.

Contract #CTR069477 for Medium and Heavy Duty Cabs, Chassis and Busses.

The State of Arizona or Arizona Department of Transportation 1324 N 22nd Ave.MD 128A Phoenix AZ 85009

B6370 Accepted

San Tan Auto Partners, LLC

AD2P570026 11/01/2023 11/01/2024

11/01/2023 11/01/2024AD2P570026

ENDORSEMENT WC 00 03 13 (00) -

EMPLOYERS LIABILITY POLICY

AND

WORKERS COMPENSATION

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

ONE TOWER SQUARE

HARTFORD CT 06183

We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)

This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule.

SCHEDULE

DESIGNATED ORGANIZATION:

DESIGNATED PERSON:

ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED

BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS

WAIVER.

PAGEST ASSIGN: OF1 1

INSURED:

POLICY#: POLICY PERIOD: TO:

11/01/2024UB0P56093A 11/01/2023

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