MDM_WC_COI_CTR055334.pdf

The document is an ACORD Certificate of Liability Insurance issued on 9/30/2024 for M D Merrett Inc, located in Carefree, Arizona. The insurance is provided by CopperPoint General through Southwest Risk Management, LLC, with the certificate holder being the Arizona Game and Fish Department in Phoenix, Arizona. The policy contains a waiver of subrogation against the State of Arizona, its departments, agencies, boards, commissions, universities, and officers.

The insurance policy covers Workers' Compensation and Employers Liability with policy number 1006113, effective from 10/1/2024 to 10/1/2025. The policy includes limits of $1,000,000 per occurrence for employers liability, including $1,000,000 for each accident, $1,000,000 for disease-employee limit, and $1,000,000 for disease-policy limit. The endorsement (Endorsement No. 2) includes a waiver of the insurer's right to recover payments from others liable for an injury covered by the policy, with a premium of $298.00 for this endorsement.