Insurance_CTR060938_-_Wildlife_Telemetry_Equipment_and_Services_-_LOTEK.pdf
PDF 342 KB Posted
- Attached to
- Master Agreement AZ|CTR060938
- Contract number
- CTR060938
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by Intact Insurance Company, with Arthur J. Gallagher Canada Limited serving as the brokerage/agency. The certificate involves Lotek Wireless Inc. as the insured and Arizona Game & Fish Department as the certificate holder, with addresses located in Newmarket, Ontario and Phoenix, Arizona, respectively.
The insurance policy provides Commercial General Liability coverage with an effective date from 2023/05/30 to 2024/04/30. The policy includes $10,000,000 in bodily injury and property damage liability, with $2,000,000 aggregate limits for products and completed operations. Additional coverages include non-owned automobiles, excess liability with an umbrella form, and tenants legal liability. The certificate holder (Arizona Game & Fish Department) is added as an additional insured to the Commercial General Liability Coverage Policy, but only for liability arising from operations carried out by or on behalf of the named insured, explicitly excluding automobile liability.
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Text version
AUTHORIZED REPRESENTATIVE
c 2016, Centre for Study of Insurance Operations. All rights reserved.
This certificate is issued as a matter of information only and confers no rights upon the certificate holder and imposes no liability on the insurer.
CERTIFICATE OF LIABILITY INSURANCE
TYPE OF INSURANCE
COMMERCIAL GENERAL LIABILITY
POSTAL
CODE
BROKER CLIENT ID:
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 requirements, terms or conditions 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 terms, exclusions and conditions of such policies.
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSURANCE COMPANY
AND POLICY NUMBER
EFFECTIVE
DATE
EXPIRY
DATE
LIMITS OF LIABILITY
(Canadian dollars unless indicated otherwise)
NON-OWNED AUTOMOBILES
HIRED AUTOMOBILES
AUTOMOBILE LIABILITY
DESCRIBED AUTOMOBILES
ALL OWNED AUTOMOBILES
** ALL AUTOMOBILES LEASED IN EXCESS OF
30 DAYS WHERE THE INSURED IS REQUIRED
TO PROVIDE INSURANCE
EXCESS LIABILITY
UMBRELLA FORM
OTHER LIABILITY (SPECIFY)
BODILY INJURY AND PROPERTY
DAMAGE COMBINED
BODILY INJURY (PER PERSON)
BODILY INJURY (PER ACCIDENT)
PROPERTY DAMAGE
Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail ________ days written notice to the certificate holder named above, but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives.
AUTHORIZED REPRESENTATIVE
ISSUER
DATE
EACH OCCURRENCE
AGGREGATE
This certificate does not amend, extend or alter the coverage afforded by the policies below.
NON-OWNED AUTOMOBILES
POSTAL
CODE
POSTAL
CODE
1. CERTIFICATE HOLDER - NAME AND MAILING ADDRESS INSURED’S FULL NAME AND MAILING ADDRESS
DESCRIPTION OF OPERATIONS/LOCATIONS/AUTOMOBILES/SPECIAL ITEMS TO WHICH THIS CERTIFICATE APPLIES (but only with respect to the operations of the Named Insured)
COVERAGES
CANCELLATION
6. BROKERAGE/AGENCY FULL NAME AND MAILING ADDRESS
ADDITIONAL INSURED NAME AND MAILING ADDRESS
(Commercial General Liability- but only with respect to the operations of the Named Insured)
8. CERTIFICATE AUTHORIZATION
COMMERCIAL GENERAL LIABILITY
- GENERAL AGGREGATE
MEDICAL PAYMENTS
TENANTS LEGAL LIABILITY
PRODUCTS AND COMPLETED OPERATIONS
AGGREGATE
- EACH OCCURRENCE
DED.
AMOUNT OF
INSURANCECOVERAGE
BODILY INJURY AND PROPERTY DAMAGE
LIABILITY
YYYY/MM/DD YYYY/MM/DD
POSTAL
CODE
PERSONAL INJURY LIABILITY
PERSONAL AND ADVERTISING INJURY
LIABILITY
OR
POLLUTION LIABILITY EXTENSION
7.
CONTACT NUMBER(S)
TYPE
TYPE
NO.
NO.
TYPE
TYPE
NO.
NO.
EMAIL ADDRESS
SIGNATURE OF
CSIO - Certificate of Liability Insurance CA4301e 201609
HIRED AUTOMOBILES
CLAIMS MADE OR OCCURRENCE
PRODUCTS AND / OR COMPLETED OPERATIONS
EMPLOYER’S LIABILITY
CROSS LIABILITY
WAIVER OF SUBROGATION
2.
3.
4.
5.
LEASED AUTOMOBILES **
TENANTS LEGAL LIABILITY
POLLUTION LIABILITY EXTENSION
Arizona Game & Fish Departmet Lotek Wireless Inc.
Procurement Specialist 115 Pony Drive
5000 W Carefree Hwy
Phoenix AZ 85086 Newmarket ON L3Y 7B5
The certificate holder is added as an additional insured to the Commercial General Liability Coverage Policy, but only with respect to liability arising out of operations carried out by or on behalf of the Named Insured, excluding any automobile liability.
$10,000,000X X $2,500 $2,000,000 n/a $2,000,000 X
X n/a $2,000.000 n/a $2,500
X $2,500 $2,000,000
Intact Insurance Company
RRS806875
2023/05/30 2024/04/30
X Intact Insurance Company
RRS806875
2023/05/30 2024/04/30 $2,000,000
X
Intact Insurance Company
RRS806875
2023/05/30 2024/04/30 $8,000,000
$8,000,000
Arthur J. Gallagher Canada Limited Arizona Game & Fish Departmet
169 Enterprise Boulevard Procurement Specialist
Markham ON L6G 0E7 5000 W Carefree Hwy
Phoenix AZ 85086
Arthur J. Gallagher Canada Limited
Julie Rogers
2023/07/04 Sylvie_DeRose@ajg.com
File details come from the government source that posted it. Updated .