EurofinsNSCUSInc_-_Client_Pack_-_3763714.PDF
PDF 81 KB Posted
- Attached to
- Master Agreement AZ|CTR061674
- Contract number
- CTR061674
- Issued by
- Arizona
About this file
The document is a Certificate of Liability Insurance for Eurofins Environment Testing Southwest, LLC, involving the State of Arizona Department of Environmental Quality. The certificate includes multiple insurers such as ACE American Insurance Company, Travelers Property Casualty Company of America, and Great Northern Insurance Company. The State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are listed as additional insureds on the policy.
The insurance coverage spans multiple policy periods from 01/01/2025 to 01/01/2026, with various liability limits including $1,000,000 for general liability and contractual liability, and $2,000,000 aggregate. The policy references Contract #CTR061674 and provides comprehensive coverage including general liability, auto liability, and workers' compensation. The certificate includes provisions for primary and non-contributory insurance, with a waiver of subrogation in favor of additional insureds. The policy also includes an integrated liability and indemnity errors or omissions limit of $5,000,000 with a $250,000 deductible.
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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)
© 1988-2016 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
Willis Towers Watson Northeast, Inc.
c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA
Eurofins Environment Testing Southwest, LLC 4625 East Cotton Center Boulevard, Suite 189 Phoenix, AZ. 85040
Re: Contract # CTR061674
State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as Additional Insureds as respects to General Liability and Auto Liability.
Auto Liability policy shall be Primary and Non-contributory with any other insurance in force for or which may be
State of Arizona Department of Environmental Quality 1110 W. Washington St.
Phoenix, AZ 85007
01/03/2025
1-877-945-7378 1-888-467-2378 certificates@willis.com
ACE American Insurance Company 22667
Travelers Property Casualty Company of Ame
Great Northern Insurance Company
25674
20303
W37350613
A
1,000,000
1,000,000
10,000Contractual Liability
1,000,000
2,000,000
2,000,000
Y Y G46676725 01/01/2025 01/01/2026
B
1,000,000
01/01/202601/01/2025Y Y HC2JCAP-162D3822-TIL-25
UB-2R857672-25-I2-K
B Y
1,000,000 No 01/01/2025 01/01/2026
1,000,000
1,000,000
C Integrated Liability & Indemnity
Errors or Omission
Limit of Liability9951-0639 01/01/2025 01/01/2026
Limit of Liability
Deductible:
376371427051508SR ID: BATCH:
$250,000
$5,000,000
$5,000,000
Willis Towers Watson Certificate Center
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:
Eurofins Environment Testing Southwest, LLC 4625 East Cotton Center Boulevard, Suite 189 Phoenix, AZ. 85040 purchased by Additional Insureds.
Waiver of Subrogation applies in favor of Additional Insureds with respects to General Liability, Auto Liability and Workers Compensation as permitted by law.
2 2
Willis Towers Watson Northeast, Inc.
See Page 1
See Page 1 See Page 1 See Page 1
25 Certificate of Liability Insurance
W37350613CERT:3763714BATCH:27051508SR ID:
File details come from the government source that posted it. Updated .