CTR079416_Supplier_Consent_to_Assignment_2025-10-21.pdf
PDF 9 MB Posted
- Attached to
- Master Agreement AZ|CTR079416
- Contract number
- CTR079416
- Issued by
- Arizona
About this file
This document is a Consent to Assignment for a Wastewater Treatment Plant Chemicals contract between Avista Technologies, Inc. (the assignor) and Kurita America, Inc. (the assignee), with the Arizona Department of Corrections, Rehabilitation & Reentry acting as the state agency. The assignment is being processed following Avista's merger into Kurita America on April 1, 2025, which changes the legal entity name, tax identification number, and other contract details. The state of Arizona has consented to this assignment effective November 21, 2025.
The contract (Contract No. CTR068206) covers wastewater treatment plant chemicals, with the assignment maintaining the original contract's terms and conditions. The contract number CTR079416 will remain active, and Kurita America, Inc. will assume all responsibilities and obligations of the original contract. The effective date of the new company assuming responsibility is April 1, 2025, with a new tax identification number of 41-1255017 and a new state ID of F18772070. The assignment includes provisions for maintaining insurance coverage, transferring existing contract rights, and ensuring continuity of services for the Arizona Department of Corrections.
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Text version
11/07/2025
North Risk Partners
P.O. Box 64016
St Paul MN 55164
Marilyn Roof
(763) 536-8006 marilyn.roof@northriskpartners.com
Kurita America, Inc.
6600 94th Ave. N.
Minneapolis, MN 55445
Nautilus Ins Co Non-Admitted 17370
Great Divide Insurance Company 25224
25/26
A
$25k Ded.-Per Occurrence
GLP2012581-21 09/01/2025 09/01/2026
1,000,000
500,000
10,000
1,000,000
3,000,000
3,000,000
B
$25k Ded-Acc
BAP2012580-21 09/01/2025 09/01/2026
1,000,000
A
FFX2035635-14 09/01/2025 09/01/2026
10,000,000
10,000,000
B N WCA2012578-21 09/01/2025 09/01/2026
1,000,000
1,000,000
1,000,000
A Contractors Pollution Liability - Claims Made Form CPL2027018-17 09/01/2025 09/01/2026
General Aggregate $1,000,000
Each Pollution Condition $1,000,000
Per Claim Retention $10,000
Re: Contract CTR079416 Arizona Department of Corrections, Rehabilitation & Reentry is named as Additional Insured on the General Liability and Auto Liability policies when required by written contract per policy terms & conditions. Waiver of Subrogation applies to General Liability, Auto Liability and Worker's Compensation policies per policy terms & conditions.
Arizona Department of Corrections, Rehabilitation & Reentry
Procurement Services
701 E. Jefferson Street
Phoenix AZ 85034
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
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