CTR076250-_coi_expires_04-01-26.pdf
PDF 21 KB Posted
- Attached to
- Master Agreement AZ|CTR076250
- Contract number
- CTR076250
- Issued by
- Arizona
About this file
This is an ACORD Certificate of Liability Insurance for Brimhall Sand Rock & Building Materials Inc, issued by Hancock-Leavitt Insurance on 3/28/2025. The certificate involves multiple insurers including Ohio Security Insurance Company, Ohio Casualty Insurance Company, and BerkleyNet, with coverage for the Arizona Game and Fish Department located in Phoenix, Arizona.
The document details insurance coverage across multiple categories including commercial general liability, automobile liability, umbrella liability, workers' compensation, and inland marine insurance. The policy covers a contract #BPM006707 for AZGFD Aggregate Materials, with coverage periods from 6/26/2025 to 6/26/2026. Key liability limits include $1,000,000 per occurrence for general liability and automobile coverage, with an aggregate limit of $2,000,000. The inland marine coverage includes $75,000 for rented/leased equipment with a $1,000 deductible. The State of Arizona and its departments are named as additional insureds, and a waiver of subrogation is included in the policy terms.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
3/28/2025
Hancock-Leavitt Insurance PO Box 830
Taylor AZ 85939
Monti Hancock (928)536-4237 (866)821-4287 monti@leavitt.com
Brimhall Sand Rock & Building Materials Inc PO Box 750
Snowflake AZ 85937
Ohio Security Insurance Company 24082 Ohio Casualty Insurance Company 24074 BerkleyNet 32603
CL2532807928
A
X
X
X X
X Y BKS55175703 6/26/2025 6/26/2026
1,000,000
300,000
15,000
1,000,000
2,000,000
2,000,000
A
X X X
X Y BAO55175703 6/26/2025 6/26/2026
1,000,000
A
X X
X 10,000 USO55175703 6/26/2025 6/26/2026
1,000,000
1,000,000
B BNET708637705 4/1/2025 4/1/2026
x x
1,000,000
1,000,000
1,000,000
C Inland Marine CPI7204826 6/26/2025 6/26/2026 Rented/Leased Equipment $75,000
Deductible $1,000
Contract #BPM006707 - AZGFD Aggregate Materials. All Coverages and limits are subject to the terms, conditions, insuring agreement and exclusions provided in the policy. State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agent and employees are named as Additional insured with respect to liability arising out of activities performed by or on behalf of the permittee or contractor. Waiver of Subrogation applies.
ARIZONA GAME AND FISH DEPT
5000 West Carefree Highway Phoenix, AZ 85086
Monti Hancock/TAMATT
Y
The ACORD name and logo are registered marks of ACORD
CERTIFICATE HOLDER
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
AUTHORIZED REPRESENTATIVE
CANCELLATION
DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE
LOCJECT
PRO-
POLICY
GEN'L AGGREGATE LIMIT APPLIES PER:
OCCURCLAIMS-MADE
COMMERCIAL GENERAL LIABILITY
PREMISES (Ea occurrence) $
DAMAGE TO RENTED
EACH OCCURRENCE $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
$RETENTIONDED
CLAIMS-MADE
OCCUR
AGGREGATE $
EACH OCCURRENCE $UMBRELLA LIAB
EXCESS LIAB
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
INSR
LTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY) LIMITS
PER
STATUTE
OTH-
ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
ANY PROPRIETOR/PARTNER/EXECUTIVE
If yes, describe under DESCRIPTION OF OPERATIONS below
(Mandatory in NH)
OFFICER/MEMBER EXCLUDED?
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
HIRED AUTOS
NON-OWNED
AUTOS AUTOS
AUTOS
COMBINED SINGLE LIMIT
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE $
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.
INSD
ADDL
WVD
SUBR
N / A
(Ea accident)
(Per accident)
OTHER:
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 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).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSURED
PHONE
(A/C, No, Ext):
PRODUCER
ADDRESS:
FAX
(A/C, No):
CONTACT
NAME:
NAIC #
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
INSURER(S) AFFORDING COVERAGE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
INS025 (201401)
File details come from the government source that posted it. Updated .