Team_Converse_LLC_-_General-Auto__Exp_08.30.26__E_and_O_Prof_Liability__Exp_05.17.26__Workers__Exp_07.01.26_.pdf
PDF 94 KB Posted
- Attached to
- Master Agreement AZ|CTR066749
- Contract number
- CTR066749
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance for Team Converse, LLC, located in Peoria, Arizona. The certificate involves multiple insurance providers, including Hartford Underwriters Insurance Company, Auto-Owners Insurance Company, Hartford Insurance Company of the Midwest, and Lloyd's of London. The certificate holder is the Arizona Department of Emergency and Military Affairs, with insurance brokerage services provided by Imes Insurance Associates, Inc. in Mesa, Arizona.
The insurance coverage includes commercial general liability, automobile liability, workers' compensation, and errors & omissions policies. The policies are effective from various start dates in 2025, with most expiring in 2026. Coverage limits include $1,000,000 for each occurrence on the general liability policy, with a $2,000,000 aggregate limit. The automobile liability policy covers owned, scheduled, and non-owned vehicles. The certificate references a specific contract number CTR039494.M23-0074, and notes that the Arizona Department of Emergency and Military Affairs is designated as an additional insured on the general and professional liability policies. The policies are primary and non-contributory, with a 30-day cancellation notice provision.
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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
8/14/2025
Imes Insurance Associates, Inc.
2045 S Vineyard Ste152 Mesa AZ 85210
Henry DeVall 480-820-2020 480-820-5519 agency@imescovered.com
Hartford Underwriters Insurance Company 30104 TEAMCON-01 Auto-Owners Insurance Company 18988
Team Converse, LLC 29771 N 133rd Ave Peoria AZ 85383
Hartford Insurance Company of the Midwest 37478 Lloyd's of London
864278967
A X 1,000,000 X 1,000,000
10,000
1,000,000
2,000,000 X
Y Y 59SBAAT5HNY 8/30/2025 8/30/2026
2,000,000
B
1,000,000
X X X
5351249100 8/30/2025 8/30/2026
1,000,000
1,000,000
C XY 59WECAT1Y58 7/1/2025 7/1/2026
1,000,000
1,000,000
1,000,000 D Errors & Omissions
Errors & Omissions Y Y Y
Y ANE4461780.25 5/17/2025 5/17/2026 Occurrence Aggregate
1,000,000 3,000,000
Re: CTR039494.M23-0074 The Arizona Department of Emergency and Military Affairs is designated additional insured on the General and Professional Liability policies as required by written contract. Policies are primary and non-contributory. 30-day notice of cancellation applies. Coverage subject to policy forms, terms and conditions.
The Arizona Department of Emergency and Military Affairs 5645 E. McDowell Rd. Bldg #M5800 Phoenix AZ 85008
USA
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