CTR071190_COI_2025-08-01_AL_GL_WC.pdf

PDF 2 MB Posted

Attached to
Master Agreement AZ|CTR071190
Contract number
CTR071190
Issued by
Arizona

About this file

This document is a comprehensive Certificate of Liability Insurance for Sun Eagle Corporation, issued by USI Insurance Services LLC, with multiple insurance carriers including Valley Forge Insurance Company, Continental Insurance Company, and National Fire Insurance Co. of Hartford. The certificate covers insurance policies for Sun Eagle Corporation, with the Arizona Department of Corrections Rehabilitation & Reentry listed as the certificate holder. The policies include Commercial General Liability, Automobile Liability, Umbrella Liability, and Workers Compensation, effective from 08/01/2024 to 08/01/2025.

The insurance policies provide coverage for a fire suppression system project at the ASPC-Lewis facility (contract number CTR071190), with various coverage limits. The Commercial General Liability policy has a $1,000,000 each occurrence limit and a $2,000,000 general aggregate limit. The Automobile Liability policy offers a $1,000,000 combined single limit, and the Umbrella Liability provides $9,000,000 in coverage. Additional endorsements include provisions for Additional Insured status, Waiver of Subrogation, and specific protections for leased/rented equipment and installation. The policies also include automatic Additional Insured endorsements for the Arizona Department of Corrections when there is a written contract requiring such status.

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INSR ADDL SUBR

LTR INSR WVD

DATE (MM/DD/YYYY)

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)

COMMERCIAL GENERAL LIABILITY

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

INSURER(S) AFFORDING COVERAGE NAIC #

Y / N

N / A (Mandatory in NH)

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

EACH OCCURRENCE $

DAMAGE TO RENTED

$PREMISES (Ea occurrence)CLAIMS-MADE OCCUR

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GENERAL AGGREGATE $GEN'L AGGREGATE LIMIT APPLIES PER:

PRODUCTS - COMP/OP AGG $

PRO-

OTHER:

LOCJECT

COMBINED SINGLE LIMIT

$(Ea accident)

BODILY INJURY (Per person) $ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS

AUTOS ONLY

HIRED PROPERTY DAMAGE $

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 LIMIT $DESCRIPTION OF OPERATIONS below

POLICY

NON-OWNED

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 any 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.

The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03)

ACORDTM CERTIFICATE OF LIABILITY INSURANCE

Valley Forge Insurance Company

Continental Insurance Company

National Fire Insurance Co. of Hartford

7/22/2024

USI Insurance Services LLC 2375 E. Camelback Rd, Suite 250 Phoenix, AZ 85016

Heather Cloke 602-374-1357 heather.cloke@usi.com

Sun Eagle Corporation 461 N. Dean Ave.

Chandler, AZ 85226

20508 35289 20478

A X X

X PD Ded:5,000

X

X X 6078810509 08/01/2024 08/01/2025 1,000,000 100,000 15,000 1,000,000 2,000,000 2,000,000

A X

X X

X X 6078810476 08/01/2024 08/01/2025 1,000,000

B X X

X 10,000

6078810445 08/01/2024 08/01/2025 9,000,000 9,000,000

C

Y

X 6078810459 08/01/2024 08/01/2025 X 1,000,000

1,000,000 1,000,000

A

A

Leased/Rented Equipment Installation Fltr

6078810476

6078810476

08/01/2024

08/01/2024

08/01/2025

08/01/2025

$275,000 Limit $2,500 Deductible $100,000 Lmt/$1,000 Ded

The General Liability and Automobile Liability policies include an automatic Additional Insured endorsement that provides Additional Insured status to the Certificate Holder only when there is a written contract that requires such status, and only with regard to work performed on behalf of the named insured. The General Liability and Automobile Liability policies contain a special endorsement with "Primary and (See Attached Descriptions)

AZ Dept of Corrections Rehabilitation & Reentry 701 E. Jefferson Street- Mail Code 55302 Phoenix, AZ 85034

#S45614563/M45608401

SUNEAGLEClient#: 871910

MLKZP

#S45614563/M45608401

SAGITTA 25.3 (2016/03)

DESCRIPTIONS (Continued from Page 1) Noncontributory" wording, when required by written contract. The General Liability, Automobile Liability, and Workers Compensation policies provide a Waiver of Subrogation when required by written contract. Per Project Aggregate applies.

RE: CMAR-Fire Suppression System ASPC- Lewis CTR071190. Additional Insured Includes: AZ Dept of Corrections Rehabilitation & Reentry

#S45614563/M45608401

€NA

CNA PARAMOUNT

Additional Insured - Owners, Lessees Or Contractors - Scheduled Person Or Organization

Location(s) Of Covered Operations

Information required to complete this S c h e d u l e , if not shown above, will be shown in the Declarations.

A. Section II - Who Is An Insured is amended to i n cl u d e as an additional insured the person(s) or organization(s) shown in the S c h e d u l e , but o n l y with respect to l iability for bodily injury, property damage or personal and advertising injury c aus ed , in whole or in part, by:

1 . Your acts or o m i s s i o n s ; or

2. The acts or omi ssi o ns of those acting on your behalf;

in the performance of your o n g o i n g operations for the additional insured(s) at the location(s) designated above.

However:

1 . The insurance afforded to such ad d i ti o n al insured only a p p l i e s to the extent permitted by law; and

2. If coverage provided to the ad d i t i o nal i nsured is required by a contract or agreement, the insurance afforded to such additi o nal insured will not be broader than that which you are required by the contract or agreement to provide for such a d d i t i o n a l i n s u r e d .

B. With respect to the i n s u ra n c e afforded to these additional i n s u r e d s , the following additional exclusions apply:

This insurance does not ap p l y to bodily injury or property damage occurring after:

1 . All work, i n cl u d i n g materials, parts or e q u i p m e n t furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional i n s u r e d ( s ) at the location of the covered operations has been completed; or

2. That portion of your work out of which the injury or d a m a g e arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.

C. With respect to the insurance afforded to these a d d i t i o n a l i n s u r e d s , the following is added to Section Ill - Limits Of Insurance:

If coverage provided to the ad d i t i o nal insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amo un t of i n s u r a n c e :

1 . Required by the contract or agreement; or

2. Available u nd e r the a p p l i c a b l e limits of i n s u r a n c e ;

whichever is less.

This endorsement shall not increase the a p p l i c a b l e limits of insurance.

CG 20 10 1 2 1 9

VALLEY FORGE INSURANCE COMPANY

Insured N a m e : SUN EAGLE CORPORATION

Copyright Insurance Services Office, Inc. , 2018

Policy No: 6 0 7 8 8 1 0 5 0 9

Endorsement No: 3 3

Effective Date:

heather.cloke Typewritten text State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents and employees. 701 E. Jefferson Street. Phoenix AZ. 85034 heather.cloke Typewritten text 08/01/2024

€NA CNA PARAMOUNT

Additional Insured - Owners, Lessees Or Contractors - Completed Operations

Location And Description Of Completed Operations

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 or property damage caused, in whole or in part, by your work at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the products-completed operations hazard.

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 Ill - 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.

CG 20 37 12 19

VALLEY FORGE INSURANCE COMPANY

Insured Name: SUN EAGLE CORPORATION

Copyright Insurance Services Office, Inc., 2018

Policy No: 6078810509 Endorsement No: 34

Effective Date:

heather.cloke Typewritten text State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents and employees.

701 E. Jefferson Street.

Phoenix AZ. 85034 heather.cloke Typewritten text 08/01/2024

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