CTR074088.M24-0024_Certificate_of_Insurance_CN_Railroad_Tools.pdf
PDF 143 KB Posted
- Attached to
- Master Agreement AZ|CTR074088
- Contract number
- CTR074088
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance for Railroad Tools and Solutions, Inc., issued by Marsh & McLennan Agency LLC. The certificate involves multiple insurance carriers, including American Casualty Company of R, Continental Insurance Company, and Valley Forge Insurance. The primary certificate holder is the Arizona Department of Emergency and Military Affairs (DEMA), located in Phoenix, AZ. The insurance policies are effective from 4/30/2024 to 4/30/2025 and cover various types of liability including commercial general liability, automobile liability, umbrella liability, and workers' compensation.
The insurance coverage includes comprehensive protection for all work performed by the named insured on behalf of the certificate holder. The policy provides multiple coverage limits, with commercial general liability set at $1,000,000 per occurrence and $2,000,000 aggregate, automobile liability at $1,000,000, and an umbrella liability of $10,000,000. The certificate specifically adds the Arizona Department of Emergency and Military Affairs as an additional insured when required by written contract, on a primary and non-contributory basis for operations performed by the named insured. A waiver of subrogation is also included for worker's compensation, general liability, and automobile liability policies, where allowed by law and required by written contract.
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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
10/14/2024
Marsh & McLennan Agency LLC 20 North Martingale Road Suite 100 Schaumburg IL 60173
Angela Manfredini
(847) 463-7855
Angela.Manfredini@MarshMMA.com
American Casualty Company of R 20427 RAILSUP-01 Continental Insurance Company 35289
Railroad Tools and Solutions, Inc.
577 W Lamont Rd Elmhurst IL 60126
Valley Forge Insurance 20508
1106257584
A X 1,000,000 X 300,000
15,000
1,000,000
2,000,000
7091978759 4/30/2024 4/30/2025
2,000,000
B 1,000,000
X
X X
7091978731 4/30/2024 4/30/2025
B X 10,000,0007091978745 4/30/2024 4/30/2025
10,000,000 X 10,000
C X
N
7091978762 4/30/2024 4/30/2025
1,000,000
1,000,000
1,000,000
RE: All work performed by the Named Insured on behalf of the Certificate Holder.
It is agreed that the following are added as Additional Insureds, when required by written contract, on the General Liability and Automobile Liability on a primary and non-contributory basis with respect to operations performed by the Named Insured in connection with this project:
- The Arizona Department of Emergency and Military Affairs, agencies, boards, commissions, universities, officers, officials, agents and employees.
See Attached...
The Arizona Department of Emergency and Military Affairs DEMA Procurement Office, Building #M5800 5636 East McDowell Road Phoenix AZ 85008-3495
ACORD 101 (2008/01)
The ACORD name and logo are registered marks of ACORD
© 2008 ACORD CORPORATION. All rights reserved.
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: FORM TITLE:
ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY CUSTOMER ID:
LOC #:
AGENCY
CARRIER NAIC CODE
POLICY NUMBER
NAMED INSURED
EFFECTIVE DATE:
RAILSUP-01
1 1
Marsh & McLennan Agency LLC Railroad Tools and Solutions, Inc.
577 W Lamont Rd Elmhurst IL 60126
25 CERTIFICATE OF LIABILITY INSURANCE
A Waiver of Subrogation in favor of the Additional Insureds applies to the Worker’s Compensation, General Liability and Automobile Liability policies, when required by written contract and where allowed by law.
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