L.N._Curtis___Sons_-_General-Auto-Workers_Comp__Exp_04.01.26_.pdf
PDF 85 KB Posted
- Attached to
- Master Agreement AZ|CTR052553
- Contract number
- CTR052553
- Issued by
- Arizona
About this file
This document is an ACORD 25 Certificate of Liability Insurance for L. N. Curtis and Sons, Inc., issued by Marsh Risk & Insurance Services. The certificate involves multiple insurers, including Transverse Specialty Insurance Company, Great Northern Insurance Company, and Berkshire Hathaway Homestate Insurance Company. The certificate holder is the Arizona State Emergency and Military Affairs, specifically for Camp Navajo Resource Manager in Bellemont, Arizona.
The insurance covers Hurst service and Compressor service, with policies effective from 04/01/2025 to 04/01/2026. The commercial general liability policy has a $1,000,000 each occurrence limit and a $2,000,000 general aggregate limit. The automobile liability policy provides a $2,000,000 combined single limit. The policy includes additional insured provisions for the State of Arizona's departments, agencies, boards, commissions, universities, officers, officials, agents, and employees. The insurance is primary and non-contributory, with a waiver of subrogation applicable where required by 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
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
1,000,000
EMR-00000457-01
X
SEA-003521687-21
X
1,000,000
X
20303 of Marsh Risk & Insurance Services
SAN FRANCISCO, CA 94111
N
X
COMP/COLL DEDS:
04/01/2025
04/01/2026
20044
73583643
D
2,000,000
1,000,000
X
N/A Great Northern Insurance Company
1,000,000
X
X
Waiver of subrogation is applicable where required by written contract.
1,000
04/03/2025
04/01/2025
Re: Hurst service and Compressor service.
The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as additional insured (except workers’ compensation) where required
Excludes Tactical
X
Attn: Camp Navajo Resource Manager
#1 Hughes Avenue
Arizona State Emergency
Berkshire Hathaway Homestate Ins Co
Bellemont, AZ 86015 by written contract. This insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract.
A
N/A
CN101797553-STND-GAWU-25-26
10,000
04/01/2026
2,000,000
2,000,000
41807
100,000
1,000,000
LNWC626418
FOUR EMBARCADERO CENTER, SUITE 1100
MARSH RISK & INSURANCE SERVICES
CALIFORNIA LICENSE NO. 0437153
Attn: sanfrancisco.certs@marsh.com; Fax: 212-948-0398
Attn: John Viboch, CFO
L. N. Curtis and Sons, Inc.
Walnut Creek, CA 94598 185 Lennon Lane, Suite 110
04/01/2025
& Military Affairs Bellemont
B
04/01/2026
Transverse Specialty insurance company
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