State-of-Arizona-De_Reddy-Ice-LLC_23-24-GL-AU-UMB_12-14-2023_280302131_1.pdf
PDF 116 KB Posted
- Attached to
- Master Agreement AZ|CTR069126
- Contract number
- CTR069126
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance dated 12/14/2023 for Reddy Ice LLC, located in Dallas, TX, with the State of Arizona Department of Corrections listed as the certificate holder. The insurance is provided through multiple insurers including Scottsdale Insurance Company, National Union Fire Insurance, Westchester Surplus Lines Insurance, Allied World Assurance Company, National Fire & Marine Insurance, and Endurance American Specialty Insurance.
The certificate covers multiple layers of insurance, including Commercial General Liability with a $1,000,000 each occurrence limit, Automobile Liability, Umbrella Liability with $5,000,000 aggregate limits, and Workers Compensation/Employers Liability. The policies are effective from 12/15/2023 to 12/15/2024, with additional excess liability coverage layers providing supplemental protection. The insurance policies cover various operational risks for Reddy Ice LLC, with different insurance companies providing coverage for specific jurisdictions including All States (AOS), California, and Texas, as noted in the workers' compensation and employers' indemnity sections.
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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)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
12/14/2023
Alliant Insurance Services, Inc.
333 S Hope St Ste 3700 Los Angeles CA 90071
Charita Tarutiyasiri
Charita.Tarutiyasiri@alliant.com
License#: 0C36861 Scottsdale Insurance Company 41297 REDDICE-02 National Union Fire Insurance 19445
Reddy Ice LLC 5710 LBJ Freeway Suite 300 Dallas , TX 75240
Westchester Surplus Lines Insu 10172 Allied World Assurance Company 19489 National Fire & Marine Insuran 20079 Endurance American Specialty I 41718
280302131
A X 1,000,000 X 300,000
Excluded
1,000,000
2,000,000 X
BCS2001119 12/15/2023 12/15/2024
2,000,000
B 2,000,000
X 172-24-89 12/15/2023 12/15/2024
C X X 5,000,000G72556239 003 12/15/2023 12/15/2024
5,000,000
X
N
See Remarks 1,000,000
1,000,000
1,000,000 D E F
Excess General Liability Excess Auto 1st Layer Excess Auto 2nd Layer
0313-6486
42-XSF-100376-10
ELD30001406404
12/15/2023 12/15/2023 12/15/2023
12/15/2024 12/15/2024 12/15/2024
Each Occ/Aggregate Each Occ/Aggregate Each Occ/Aggregate
$5,000,000 $3,000,000 $5,000,000
WC/EL (AOS) - AIU Insurance Company - 807-41-078 WC/EL (CA) - AIU Insurance Company - 807-41-079 Employer's Indemnity (TX) - Zurich American Insurance Company - NSL1138298-01
State of Arizona Department of Corrections 1645 W. Jefferson Phoenix, AZ 85007
File details come from the government source that posted it. Updated .