CTR074220_COI.pdf

PDF 91 KB Posted

Attached to
Master Agreement AZ|CTR074220
Contract number
CTR074220
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by Arthur J. Gallagher Risk Management Services, LLC for Eastern Research Group Inc and PG Environmental LLC. The certificate involves the State of Arizona, specifically the Arizona Department of Environmental Quality, as the certificate holder. The insurance is provided by multiple insurers, including Federal Insurance Company and Underwriters at Lloyd's London, covering the period from January 1, 2025 to January 1, 2026.

The insurance coverage includes Commercial General Liability, Automobile Liability, Umbrella Liability, Workers' Compensation, and Errors & Omissions and Pollution Liability. The policies provide various coverage limits, with 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 notes that the State of Arizona and its departments, agencies, boards, commissions, and universities are additional insureds under the General Liability and Auto Liability portions of the contract, which is associated with contract #CTR074220. A waiver of subrogation applies to General Liability, Auto Liability, and Workers' Compensation as required by the 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

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

1/2/2025

Arthur J. Gallagher Risk Management Services, LLC 145 Otis Street Northboro MA 01532

Tina Hayes 508-620-3403 781-586-7940

Tina_Hayes@ajg.com

Federal Insurance Company 20281 EASTRES-02 Underwriters at Lloyd's London 15792

Eastern Research Group Inc PG Environmental LLC 561 Virginia Rd.

STE 300, BLDG 4

Concord MA 01742

1239374965

A X 1,000,000 X 1,000,000

10,000

1,000,000

2,000,000 X X

Y Y 36032885 1/1/2025 1/1/2026

2,000,000

A 1,000,000

X

X X

Y Y 99494564 1/1/2025 1/1/2026

A X X 10,000,00078180750 1/1/2025 1/1/2026

10,000,000 X 10,000

A XY 71754105 1/1/2025 1/1/2026

1,000,000

1,000,000

1,000,000 B B

Errors&Omissions and Pollution Liability

B0621PNEKA000125

B0621PNEKA000125

1/1/2025 1/1/2025

1/1/2026 1/1/2026 per claim aggregate

$5,000,000 $5,000,000

The State of Arizona, its departments, agencies, boards, commissions, universities, and its officers, officials, agents, and employees are additional insureds with regard to General Liability and Auto Liability as required per their contract with the insured for contract #CTR074220. Waiver of subrogation applies with regard to General Liability, Auto Liability, and workers compensation as required per written contract with the insured.

Arizona Department of Environmental Quality 1110 W Washington St.

Phoenix AZ 85007

File details come from the government source that posted it. Updated .