CTR073968.M24-0028_Certificate_of_Insurance_Lightning_Protection_System_OOD.pdf
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- Attached to
- Master Agreement AZ|CTR073968
- Contract number
- CTR073968
- Issued by
- Arizona
About this file
This document is a collection of insurance certificates and policy endorsements for Classic Lightning Protection Incorporated, based in Phoenix, Arizona. The primary insurance providers are Owners Insurance Company, Auto-Owners Insurance Company, Twin City Fire Insurance Company, and Capital West Insurance. The certificates are issued for various liability coverages and are addressed to the Arizona Department of Emergency and Military Affairs, located in Phoenix. The documents include commercial general liability, automobile liability, workers' compensation, and umbrella liability insurance policies with effective dates between April and May 2024, expiring in 2025.
The insurance policies cover lightning protection system operations, with a focus on a specific project identified as "Lightning Protection System OOD" under contract BPM006457/M24-0028. The policies provide various coverage limits, including $1,000,000 for general liability, $4,000,000 for umbrella liability, and workers' compensation coverage. The certificates include provisions for additional insured status, waivers of subrogation, and primary and non-contributory insurance conditions. The policies are designed to protect against bodily injury, property damage, and other potential liabilities associated with the company's operations, with specific endorsements that modify and extend the standard policy terms.
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Text version
09/25/2024
Crabdree & Shepherd Insurance LLC 431-2 S. Beeline Highway
Payson AZ 85541
Certificate Processing Department
(317) 846-5554 (317) 846-5444 certs@shepherdins.com
Classic Lightning Protection Inc PO Box 10457
Phoenix AZ 85064-0457
Owners Ins Co 32700 Auto-Owners Insurance Co 18988
CL244226166
A 45015848 04/18/2024 04/18/2025
1,000,000 300,000 10,000 1,000,000 2,000,000 2,000,000
B 4795924600 04/08/2024 04/08/2025
1,000,000
B Waived
4605793000 04/18/2024 04/18/2025 4,000,000 4,000,000
Automatic Additional Insured applies to General Liability on a Primary & Non-Contributory Basis where required by written contract subject to policy terms, conditions & exclusions. Waiver of Subrogation applies to General Liability & Auto Liability coverage where required by written contract subject to policy terms, conditions & exclusions. The coverage extensions referenced on this certificate are achieved through the following forms which are included on the policy & attached to this certificate: CG 2038 04 13, CG 20 01 04 13, 58583 1 15, 55091 5 17, 55200 6-96 Umbrella Liability extends over the General Liability and Automobile Liability policies.
Arizona Department of Emergency and Military Affairs 5636 East McDowell Road Bldg, M5800 Phoenix AZ 85008-3495
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
Agency Code Policy Number25-0090-00 47-959-246-00
58583 (1-15)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF OUR RIGHT TO RECOVER PAYMENTS
(WAIVER OF SUBROGATION) - BLANKET
This endorsement modifies insurance provided under the following:
COMMERCIAL AUTO POLICY
SECTION V CONDITIONS, A. LOSS CONDITIONS is amended. 5. Our Right to Recover Payments is de-leted and replaced by the following condition.
5. Our Right to Recover Payments
If we make a payment under this policy and the per-son to or for whom payment is made has a right to recover damages from another, we will be entitled to that right. That person shall do everything neces-sary to transfer that right to us and do nothing to prejudice it.
However, we waive our right to recover payments made for bodily injury or property damage:
a. Covered by the policy; and
b. Arising out of the operation of autos covered by the policy, in accordance with the terms and conditions of a written contract between you and such person or entity only if such rights have been waived by the written con-tract prior to the accident or loss which caused the bodily injury or property damage.
All other policy terms and conditions apply.
58583 (1-15) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1
Agency Code Policy Number25-0090-00 084625-45015848
COMMERCIAL GENERAL LIABILITY
CG 20 01 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance Condition and supersedes any provision to the contrary:
Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that:
(1) The additional insured is a Named Insured under such other insurance; and
(2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured.
CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1
COMMERCIAL GENERAL LIABILITY
CG 20 38 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - AUTOMATIC STATUS FOR OTHER
PARTIES WHEN REQUIRED IN WRITTEN
CONSTRUCTION AGREEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II – Who Is An Insured is amended to include as an additional insured:
1. Any person or organization for whom you are performing operations when you and such per-son or organization have agreed in writing in a contract or agreement that such person or orga-nization be added as an additional insured on your policy; and
2. Any other person or organization you are re-quired to add as an additional insured under the contract or agreement described in Paragraph 1.
above.
Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily in-jury", "property damage" or "personal and advertis-ing injury" caused, in whole or in part, by:
a. Your acts or omissions; or
b. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured.
However, the insurance afforded to such additional insured described above:
a. Only applies to the extent permitted by law;
and
b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
A person's or organization's status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph 1. above are completed.
B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to:
1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render-ing of, or the failure to render, any professional architectural, engineering or surveying services, including:
a. The preparing, approving, or failing to pre-pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica-tions; or
b. Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitor-ing of others by that insured, if the "occurrence" which caused the "bodily injury" or "property dam-age", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, en-gineering or surveying services.
2. "Bodily injury" or "property damage" occurring after:
a. All work, including materials, parts or equipment 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 insured(s) at the location of the covered operations has been completed; or
b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or
CG 20 38 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 subcontractor engaged in performing opera-tions for a principal as a part of the same project.
C. With respect to the insurance afforded to these addi-tional insureds, the following is added to Section III - Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the contract or agreement de-scribed in Paragraph A.1.; or
2. Available under the applicable Limits of Insur-ance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
CG 20 38 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL GENERAL LIABILITY PLUS COVERAGE
55091 (5-17)
1. EXTENDED WATERCRAFT LIABILITY
SECTION I - COVERAGES, COVERAGE A -
BODILY INJURY AND PROPERTY DAMAGE LIA-
BILITY, 2. Exclusions is amended. Exclusion g.(2) is deleted and is replaced by the following exclusion.
(2) A watercraft you do not own that is:
(a) Less than 50 feet long; and
(b) Not being used to carry persons or property for a charge;
2. HIRED AUTO AND NON-OWNED AUTO
LIABILITY
Coverage for "bodily injury" and "property damage" liability provided under SECTION I - COVERAGES, COVERAGE A - BODILY INJURY AND PROP-
ERTY DAMAGE LIABILITY, is extended as follows under this item, but only if you do not have any other insurance available to you which affords the same or similar coverage.
Coverage We will pay those sums the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" arising out of the main-tenance or use of an "auto":
a. You do not own;
b. Which is not registered in your name; or
c. Which is not leased or rented to you for more than ninety consecutive days and which is used in your business.
Exclusions With respect to only HIRED AUTO AND NON- OWNED AUTO LIABILITY, the exclusions which apply to SECTION I - COVERAGES, COVERAGE A
- BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, other than the Nuclear Energy Liability Exclusion Endorsement, do not apply. The following exclusions apply to this coverage.
This coverage does not apply to:
a. "Bodily injury" or "property damage" expected or intended from the standpoint of the insured.
This exclusion does not apply to "bodily injury" resulting from the use of reasonable force to protect persons or property.
b. Any obligation of the insured under a workers compensation, disability benefits or unemploy-ment compensation law or any similar law.
c. (1) "Bodily injury" or "property damage" arising out of the actual, alleged or threatened dis-charge, dispersal, seepage, migration, re-lease or escape of "pollutants":
(a) That are, or are contained in any prop-erty that is:
1) Being transported or towed by, han-dled or prepared for placement into or upon, or taken from the "auto";
2) Otherwise in the course of transit by you or on your behalf; or
3) Being disposed of, stored, treated or processed into or upon the "auto";
(b) Before such "pollutants" or property con-taining "pollutants" are moved from the place they are accepted by you or any-one acting on your behalf for placement into or onto the "auto"; or
(c) After such "pollutants" or property con-taining "pollutants" are removed from the "auto" to where they are delivered, disposed of or abandoned by you or anyone acting on your behalf.
Paragraph c.(1)(a) does not apply to "pol-lutants" that are needed or result from the normal mechanical, electrical or hydraulic functioning of the "auto" or its parts, if the discharge, release, escape, seepage, mi-gration or dispersal of such "pollutants" is directly from a part of the "auto" designed to hold, store, receive or dispose of such "pollutants" by the "auto" manufacturer.
55091 (5-17) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 6
55091 (5-17) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 6
Paragraphs c.(1)(b) and c.(1)(c) do not ap-ply, if as a direct result of maintenance or use of the "auto", "pollutants" or property containing "pollutants" which are not in or upon the "auto", are upset, overturned or damaged at any premises not owned by or leased to you. The discharge, release, es-cape, seepage, migration or dispersal of the "pollutants" must be directly caused by such upset, overturn or damage.
(2) Any loss, cost or expense arising out of any:
(a) Request, demand or order that any in-sured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of "pollutants"; or
(b) Claim or "suit" by or on behalf of a gov-ernmental authority for damages be-cause of testing for, monitoring, cleaning up, removing, containing, treating, de-toxifying or neutralizing, or in any way responding to, or assessing the effects of "pollutants".
d. "Bodily injury" or "property damage" however caused, arising directly or indirectly, out of:
(1) War, including undeclared or civil war;
(2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any govern-ment, sovereign or other authority using mili-tary personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these.
e. "Bodily injury" or "property damage" for which the insured is obligated to pay damages by rea-son of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages:
(1) Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subse-quent to the execution of the contract or agreement. However, if the insurance under this policy does not apply to the liability of the insured, it also does not apply to such liability assumed by the insured under an "insured contract".
(2) That the insured would have in the absence of the contract or agreement.
f. "Property damage" to:
(1) Property owned or being transported by, or rented or loaned to any insured; or
(2) Property in the care, custody or control of any insured other than "property damage" to a residence or a private garage by a private passenger "auto" covered by this coverage.
g. (1) "Bodily injury" to:
(a) An "employee" of the insured arising out of and in the course of employment by the insured; or
(b) The spouse, child, parent, brother or sis-ter of that "employee" as a consequence of Paragraph g.(1)(a).
(2) This exclusion applies:
(a) Whether the insured may be liable as an employer or in any other capacity; and
(b) To any obligation to share damages with or repay someone else who must pay damages because of the injury.
(3) This exclusion does not apply to:
(a) Liability assumed by the insured under an "insured contract".
(b) "Bodily injury" to any "employee" of the insured arising out of and in the course of his or her domestic employment by the insured unless benefits for such in-jury are in whole or in part either pay-able or required to be provided under any workers compensation law.
Who Is An Insured With respect to only this coverage, SECTION II - WHO IS AN INSURED is deleted and replaced by the following provision.
SECTION II - WHO IS AN INSURED
a. Each of the following is an insured with respect to this coverage.
(1) You.
(2) Your partners if you are designated in the
Declarations as a partnership or a joint venture.
(3) Your members if you are designated in the Declarations as a limited liability company.
(4) Your "executive officers" if you are desig-nated in the Declarations as an organization other than a partnership, joint venture or limited liability company.
(5) Any person using the "auto" and any person or organization legally responsible for the use of an "auto" not owned by such person or organization, provided the actual use is with your permission.
b. None of the following is an insured:
(1) Any person engaged in the business of his or her employer with respect to "bodily in-jury" to any co-"employee" of such person injured in the course of employment.
(2) Any person using the "auto" and any person other than you, legally responsible for its use with respect to an "auto" owned or reg-istered in the name of:
55091 (5-17) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 6
(a) Such person; or
(b) Any partner or "executive officer" of yours or a member of his or her household; or
(c) Any "employee" or agent of yours who is granted an operating allowance of any sort for the use of such "auto".
(3) Any person while employed in or otherwise engaged in duties in connection with an "auto business", other than an "auto busi-ness" you operate.
(4) The owner or lessee (of whom you are a sub-lessee) of a hired "auto" or the owner of an "auto" you do not own or which is not registered in your name which is used in your business or any agent or employee of any such owner or lessee.
(5) Any person or organization with respect to the conduct of any current or past partner-ship or joint venture that is not shown as a Named Insured in the Declarations.
Additional Definitions The following definition applies to only this coverage.
"Auto business" means the business or occupation of selling, repairing, servicing, storing or parking "autos".
Limits of Insurance With respect to only this coverage, SECTION III - LIMITS OF INSURANCE is deleted and replaced by the following provision.
SECTION III - LIMITS OF INSURANCE
a. The Limits of Insurance shown in the Declara-tions and the rules below fix the most we will pay regardless of the number of:
(1) Insureds;
(2) Claims made or "suits" brought; or
(3) Persons or organizations making claims or bringing "suits".
b. We will pay damages for "bodily injury" or "prop-erty damage" up to the limits of liability shown in the Declarations for this coverage. Such dam-ages shall be paid as follows:
(1) When Hired Auto and Non-Owned Auto
Each Occurrence Limit is shown in the Dec-larations, such limit is the total amount of coverage and the most we will pay for all damages because of or arising out of all "bodily injury" and "property damage" in any one "occurrence".
(2) When Bodily Injury Hired Auto and Non- Owned Auto Each Occurrence Limit and Property Damage Hired Auto and Non- Owned Auto Each Occurrence Limit are shown in the Declarations:
(a) The limit shown for Bodily Injury Hired Auto and Non-Owned Auto Each Occur-rence is the total amount of coverage and the most we will pay for all dam-ages because of or arising out of all "bodily injury" in any one "occurrence".
(b) The limit shown for Property Damage Hired Auto and Non-Owned Auto Each Occurrence is the total amount of cover-age and the most we will pay for all damages because of or arising out of all "property damage" in any one "occur-rence".
3. BROADENED SUPPLEMENTARY PAYMENTS
SUPPLEMENTARY PAYMENTS - COVERAGES A
AND B, Paragraph 1.d. is amended.
The amount we will pay for the actual loss of earn-ings is increased from $250 per day to $400 per day.
4. ADDITIONAL PRODUCTS-COMPLETED OPERA-
TIONS AGGREGATE LIMIT
If the endorsement, EXCLUSION - PRODUCTS
COMPLETED OPERATIONS HAZARD, CG 21 04,
is not attached to this policy, then the following pro-vision is added to SECTION III - LIMITS OF
INSURANCE.
Commencing with the effective date of this policy, we will provide one additional Products-Completed Operations Aggregate Limit, for each annual period, equal to the amount of the Products-Completed Operations Aggregate Limit shown in the Declara-tions. The maximum Products-Completed Opera-tions Aggregate Limit for any annual period will be no more than two times the original Products-Com-pleted Operations Aggregate Limit.
5. PERSONAL INJURY EXTENSION
a. If the endorsement EXCLUSION - PERSONAL
AND ADVERTISING INJURY, CG 21 38, is attached to this policy, then this provision, 5.
PERSONAL INJURY EXTENSION, does not apply.
b. If the endorsement EXCLUSION - PERSONAL AND ADVERTISING INJURY, CG 21 38, is not attached to this policy, then under SECTION V - DEFINITIONS, 14. "Personal and advertising injury" is deleted and replaced by the following definition.
14. "Personal and advertising injury" means in-jury, including consequential "bodily injury", arising out of one or more of the following offenses:
a. False arrest, detention or imprisonment;
b. Malicious prosecution;
c. The wrongful eviction from, wrongful en-try into, or invasion of the right of private
55091 (5-17) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 6 occupancy of a room, dwelling or prem-ises that a person occupies, committed by or on behalf of its owner, landlord or lessor;
d. Oral or written publication, in any man-ner, of material that slanders or libels a person or organization or disparages a person's or organization's goods, pro-ducts or services;
e. Oral or written publication, in any man-ner, of material that violates a person's right of privacy;
f. The use of another's advertising idea in your "advertisement";
g. Infringing upon another's copyright, trade dress or slogan in your "advertisement"; or
h. Discrimination, humiliation, sexual ha-rassment and any violation of civil rights caused by such discrimination, humilia-tion or sexual harassment.
6. BROADENED KNOWLEDGE OF OCCURRENCE
SECTION IV - COMMERCIAL GENERAL LIABIL-
ITY CONDITIONS, 2. Duties In The Event Of Oc-currence, Offense, Claim Or Suit is amended. The following condition is added.
Paragraphs a. and b. of this condition will not serve to deny any claim for failure to provide us with notice as soon as practicable after an "occurrence" or an offense which may result in a claim:
a. If the notice of a new claim is given to your "em-ployee"; and
b. That "employee" fails to provide us with notice as soon as practicable.
This exception shall not apply to you or to any offi-cer, director, partner, risk manager or insurance manager of yours.
7. DAMAGE TO PREMISES RENTED TO YOU
a. SECTION I - COVERAGES, COVERAGE A -
BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, 2. Exclusions is amended.
(1) The last paragraph is deleted and replaced by the following paragraph.
Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or water damage to premises rented to you or temporarily occupied by you with permis-sion of the owner. A separate limit of insur-ance applies to this coverage as described in 7. DAMAGE TO PREMISES RENTED TO YOU, b. Limits of Insurance.
(2) The following additional exclusions apply to "property damage" arising out of water damage to premises rented to you or temporarily occupied by you with permission of the owner.
(a) "Property damage" to:
1) The interior of the premises caused by or resulting from rain or snow, whether driven by wind or not; or
2) Heating, air conditioning, plumbing or fire protection systems, or other equipment or appliances.
(b) "Property damage" caused by or resulting from any of the following:
1) Mechanical breakdown, including bursting or rupture caused by centrifugal force;
2) Cracking, settling, expansion or shrinking;
3) Smoke or smog;
4) Birds, insects, rodents or other animals;
5) Wear and tear;
6) Corrosion, rust, decay, fungus, de-terioration, hidden or latent defect or any quality in property that causes such property to destroy or damage itself; or
7) Water that flows or leaks from any heating, air conditioning, plumbing or fire protection system caused by or resulting from freezing, unless:
a) You make a reasonable effort to maintain heat in the building or structure; or
b) You drain the equipment and shut off the water supply if the heat is not maintained.
(c) "Property damage" caused directly or indirectly by any of the following:
1) Water that backs up from a drain or sewer;
2) Mud flow or mudslide;
3) Volcanic eruption, explosion or effusion;
4) Any earth movement, such as earth-quake, landslide, mine subsidence, earth sinking, earth rising or earth shifting;
5) Regardless of the cause, flood, surface water, waves, tides, tidal waves, storm surge, overflow of any body of water, or their spray, all whether wind driven or not; or
6) Water under the ground surface pressing on, or seeping or flowing through:
a) Walls, foundations, floors or paved surfaces;
55091 (5-17) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 6
b) Basements, whether paved or not; or
c) Doors, windows or other openings.
(d) "Property damage" for which the insured is obligated to pay as damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of this contract or agreement.
b. Limits of Insurance With respect to this coverage only, under SEC- TION III - LIMITS OF INSURANCE, Paragraph
6. is deleted and replaced by the following Paragraph.
6. The most we will pay under Coverage A for damages because of "property damage" to premises rented to you or temporarily occu-pied by you with permission of the owner arising out of or caused by fire, lightning, explosion, smoke and water damage is the amount shown in the Declarations under Damage to Premises Rented to You.
c. SECTION IV - COMMERCIAL GENERAL LIA- BILITY CONDITIONS, 4. Other Insurance, Paragraph b. is amended. The word fire is amended to include fire, lightning, explosion, smoke or water damage.
8. BLANKET ADDITIONAL INSURED - LESSOR OF
LEASED EQUIPMENT
a. (1) SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization with whom you have agreed:
(a) In a written contract or agreement, exe-cuted prior to loss, to name as an addi-tional insured; or
(b) In an oral contract or agreement, exe-cuted prior to loss, to name as an addi-tional insured only if a Certificate of Insurance was issued prior to loss indi-cating that the person or organization was an additional insured.
(2) This provision applies only with respect to liability for:
(a) "Bodily injury";
(b) "Property damage"; or
(c) "Personal and advertising injury" caused in whole or in part, by your mainte-nance, operation or use of equipment leased to you by such person or organization.
b. With respect to the insurance afforded to an additional insured, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires.
c. The following provision is added to SECTION
III - LIMITS OF INSURANCE.
The Limits of Insurance for the additional in-sured are those specified in the written contract or agreement between the insured and the les-sor, not to exceed the limits provided in this pol-icy. These limits are inclusive of and not in addi-tion to the Limits of Insurance shown in the Declarations.
9. BLANKET ADDITIONAL INSURED - MANAGERS
OR LESSORS OF PREMISES
a. SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization with whom you have agreed:
(1) In a written contract or agreement, executed prior to loss, to name as an additional insured; or
(2) In an oral contract or agreement, executed prior to loss, to name as an additional in-sured only if a Certificate of Insurance was issued prior to loss indicating that the per-son or organization was an additional insured but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you.
b. This provision is subject to the following addi-tional exclusions.
(1) Any "occurrence" which takes place after you cease to be a tenant in that premises.
(2) Structural alterations, new constructions or demolition operations performed by or on behalf of the additional insured.
c. The following provision is added to SECTION
III - LIMITS OF INSURANCE.
The Limits of Insurance for the additional in-sured are those specified in the written contract or agreement between the insured and the manager or lessor of the premises, not to ex-ceed the limits provided in this policy. These limits are inclusive of and not in addition to the Limits of Insurance shown in the Declarations.
10. NEWLY FORMED OR ACQUIRED ORGANIZA-
TIONS
SECTION II - WHO IS AN INSURED is amended.
Paragraph 3. is deleted and replaced by the follow-ing provision.
3. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain
55091 (5-17) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 6 ownership or majority interest, will qualify as a Named Insured if there is no other similar insur-ance available to that organization. However:
a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the pol-icy period, whichever is earlier;
b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization;
and
c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization.
No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability com-pany that is not shown as a Named Insured in the Declarations.
11. BLANKET WAIVER OF SUBROGATION
SECTION IV - COMMERCIAL GENERAL LIABIL-
ITY CONDITIONS is amended. The following provi-sion is added to 8. Transfer Of Rights of Recov-ery Against Others To Us.
When you have agreed to waive your right of subro-gation in a written contract, executed prior to loss, with any person or organization, we waive any right to recovery we may have against such person or organization because of payments we make for in-jury or damage arising out of your ongoing opera-tions or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard".
All other policy terms and conditions apply.
55200 (6-96)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT OF LOCATION AND PROJECT
AGGREGATE LIMITS OF INSURANCE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
1. The General Aggregate Limit under LIMITS OF INSURANCE (Section III) applies separately to each of your "loca-tions" owned by or rented to you.
"Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad.
2. The General Aggregate Limit under LIMITS OF INSURANCE (SECTION III) applies separately to each of your pro-jects away from premises owned by or rented to you.
Includes copyrighted material of Insurance Services Office, Inc., with its permission 55200 (6-96) Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1
55885 (5-17)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT OF GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SECTION III – LIMITS OF INSURANCE is amended.
The following provision is added.
Beginning with the effective date of this policy, we will provide twice the General Aggregate Limit (other than Products-Completed Operations), shown in the Declarations.
If this policy is written for more than one 12 month period, the General Aggregate Limit for each 12 month period shall never exceed twice the General Aggregate Limit shown in the Declarations. The General Aggregate Limit applies separately to each 12 month period starting with the beginning of the policy period shown in the Declarations.
All other policy terms and conditions apply.
55885 (5-17) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1
It is agreed:
09/25/2024
Capital West Insurance 8501 N Scottsdale Rd Ste 200 Scottsdale AZ 85253
Jessica Gerlock
(480) 838-8000 (480) 838-8002 jessica@capitalwestins.com
Classic Lightning Protection Incorporated Po Box 10457
Phoenix AZ 85064-0457
Twin City Fire 29459
CL2441744307
A Y Y 59WECAB6C5Z 05/16/2024 05/16/2025
1,000,000 1,000,000 1,000,000
A Waiver of Subrogation applies on behalf of the certificate holder. The Arizona Department of Emergency and Military Affairs 5645 E McDowell Rd. Building #M5800 Phoenix, AZ 85008 Project:Lightning Protection System OOD
BPM006457/M24-0028
The Arizona Department of Emergency and Military Affairs 5645 E McDowell Rd.
Building #M5800 Phoenix AZ 85008-3495
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
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Countersigned by Authorized Representative
Form WC 00 03 13 Printed in U.S.A.
Process Date: 04/06/24 Policy Expiration Date: 05/16/25
WAIVER OF OUR RIGHT TO RECOVER
FROM OTHERS ENDORSEMENT
Policy Number: 59 WEC AB6C5Z Endorsement Number:
Effective Date: 05/16/24 Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address: CLASSIC LIGHTNING PROTECTION INCORPORATED
PO BOX 10457
PHOENIX AZ 85064
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 shall not operate directly or indirectly to benefit anyone not named in the Schedule.
SCHEDULE
Any person or organization for whom you are required by contract or agreement to obtain this waiver from us.
Endorsement is not applicable in KY, NH, NJ or for any MO construction risk
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Countersigned by Authorized Representative
Form WC 00 03 13 Printed in U.S.A.
Process Date: 04/06/24 Policy Expiration Date: 05/16/25
WAIVER OF OUR RIGHT TO RECOVER
FROM OTHERS ENDORSEMENT
Policy Number: 59 WEC AB6C5Z Endorsement Number:
Effective Date: 05/16/24 Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address: CLASSIC LIGHTNING PROTECTION INCORPORATED
PO BOX 10457
PHOENIX AZ 85064
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 shall not operate directly or indirectly to benefit anyone not named in the Schedule.
SCHEDULE
ANY PERSON OR ORGANIZATION
File details come from the government source that posted it. Updated .