WCD_Enterprises_Inc_-_General-Auto-Emp_Liability__Exp_06.29.24__Workers__Exp_01.13.24_.pdf
PDF 233 KB Posted
- Attached to
- Master Agreement AZ|CTR054330
- Contract number
- CTR054330
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by The Hartford on July 19, 2023, for WES DRYDEN WCD ENTERPRISES LLC, with Integra Insurance Group as the producer. The certificate is addressed to the State of Arizona Department of Emergency and Military Affairs (DEMA) Procurement Office, located in Phoenix, Arizona. The insurance is provided through Sentinel Insurance Company Ltd. and Hartford Fire and Its P&C Affiliates.
The insurance policy covers commercial general liability, automobile liability, umbrella liability, workers' compensation, and employment practices liability. The policy periods are from 06/29/2023 to 06/29/2024 for most coverages, with workers' compensation running from 01/13/2023 to 01/13/2024. Key coverage limits include $1,000,000 for general liability and automobile liability per occurrence, $5,000,000 for umbrella liability, and $1,000,000 for workers' compensation. The State of Arizona is listed as an additional insured, with a waiver of subrogation applied in their favor. The policy covers the insured's usual business operations, with no specific goods or services detailed in the document.
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Text version
WLTR005
THE HARTFORD
BUSINESS SERVICE CENTER
3600 WISEMAN BLVD
SAN ANTONIO TX 78251 July 19, 2023
THE STATE OF ARIZONA DEPARTMENT
OF EMERGENCY AND MILITARY AFFAIRS
DEMA PROCUREMENT OFFICE, BUILDING M5330
5636 E MCDOWELL RD
PHOENIX AZ 85008-3455
Account Information:
Policy Holder Details : WES DRYDEN WCD ENTERPRISES
LLC
Contact Us Need Help?
Chat online or call us at
(866) 467-8730.
We're here Monday - Friday.
Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any questions or concerns.
Sincerely, Your Hartford Service Team
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
07/19/2023 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.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS 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).
PRODUCER
INTEGRA INSURANCE GROUP
59304509
13350 N 94TH DRIVE SUITE B
PEORIA AZ 85381
CONTACT NAME:
PHONE
(A/C, No, Ext):
(623) 322-5955 FAX
(A/C, No):
E-MAIL ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC#
INSURER A : Sentinel Insurance Company Ltd. 11000
INSURED
WES DRYDEN WCD ENTERPRISES LLC
28150 N ALMA SCHOOL PKWY STE 103-452
SCOTTSDALE AZ 85262-8133
INSURER B : Hartford Fire and Its P&C Affiliates 00914
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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.
INSR
LTR
TYPE OF INSURANCE ADDL
INSR
SUBR
WVD
POLICY NUMBER POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/Y YYY)
LIMITS
A
COMMERCIAL GENERAL LIABILITY
X X 59 SBA PI1952 06/29/2023 06/29/2024
EACH OCCURRENCE $1,000,000
CLAIMS-MADE X OCCUR DAMAGE TO RENTED
PREMISES (Ea occurrence) $1,000,000
X General Liability MED EXP (Any one person) $10,000
PERSONAL & ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY X PRO-
JECT
LOC PRODUCTS - COMP/OP AGG $2,000,000
OTHER:
A
AUTOMOBILE LIABILITY
X 59 SBA PI1952 06/29/2023 06/29/2024
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000 ANY AUTO BODILY INJURY (Per person)
ALL OWNED
AUTOS
SCHEDULED
AUTOS BODILY INJURY (Per accident)
X HIRED
AUTOS X NON-OWNED
AUTOS
PROPERTY DAMAGE
(Per accident)
A
X UMBRELLA LIAB
EXCESS LIAB
X OCCUR
CLAIMS-
MADE 59 SBA PI1952 06/29/2023 06/29/2024
EACH OCCURRENCE $5,000,000
AGGREGATE $5,000,000
DED X RETENTION $ 10,000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY
PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
N/ A X 59 WEC AL4NPT 01/13/2023 01/13/2024
X PER
STATUTE
OTH-
ER
Y/N E.L. EACH ACCIDENT $1,000,000
E.L. DISEASE -EA EMPLOYEE $1,000,000
E.L. DISEASE - POLICY LIMIT $1,000,000
A EMPLOYMENT PRACTICES
LIABILITY
59 SBA PI1952 06/29/2023 06/29/2024 Each Claim Limit Aggregate Limit
$10,000 $10,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Those usual to the Insured's Operations.
CERTIFICATE HOLDER CANCELLATION
THE STATE OF ARIZONA DEPARTMENT
OF EMERGENCY AND MILITARY AFFAIRS
DEMA PROCUREMENT OFFICE, BUILDING M5330
5636 E MCDOWELL RD
PHOENIX AZ 85008-3455
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
ACORD 101 (2014/01) © 2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID:
LOC# :
ADDITIONAL REMARKS SCHEDULE Page 2 of 2
AGENCY
INTEGRA INSURANCE GROUP
NAMED INSURED
WES DRYDEN WCD ENTERPRISES LLC
28150 N ALMA SCHOOL PKWY STE 103-45
SCOTTSDALE AZ 85262-8133
POLICY NUMBER
SEE ACORD 25
CARRIER
SEE ACORD 25
NAIC CODE
EFFECTIVE DATE: SEE ACORD 25
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM
FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents and employees is an additional insured per the Business Liability Coverage Form SS0008 and the Hired Auto and Non-Owned Auto Endorsement SS0438, attached to this policy.Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy. Blanket Waiver of Subrogation applies in favor of the Certificate Holder per the Waiver of Our Right to Recover from Others Endorsement WC000313, attached to this policy.
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