E.L. DISEASE - POLICY LIMIT
$ $ $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required)
CERTIFICATE HOLDER CANCELLATION
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
ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD Lockton Companies, LLC Denver
8110 E. Union Avenue Suite 700
Denver CO 80237 (303) 414-6000 Phoenix Mesa Gateway Airport Authority
5835 South Sossaman Road Mesa AZ 85212 PHOME00 7/1/2014 1368389 X X Comp/Coll X $1000 Ded 1,000,000 XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX
Airport Liability $200,000,000 per occ incl Prem Liab BI & Prop Damage
N
X
1,000,000 1,000,000 1,000,000 Travelers Property Casualty Co of America 25674
Liberty Insurance Corporation 42404
Commerce and Industry Insurance Company 19410
A 8102D412113TIL13 7/1/2013 7/1/2014
C AP02543745702 7/1/2013 7/1/2014
B WC7Z91447867014 1/1/2014 1/1/2015
NOT APPLICABLE
NOT APPLICABLE
Ajilon Professional Staffing
1201 South Alma School Road, Suite 16250 Mesa, AZ 85210
12435955
12435955
12/23/2013
Ajilon Professional Staffing is named as Additional Insured as respects General Liability where requred by written contract. It is agreed the company waives any right of subrogation it may acquire against the Ajilon Professional Staffing by reason of any payment made on account of injury, including death resulting there from, sustained by any employee of the insured where permitted by law.
N N
Y
ACORD
TMCERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
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 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).
PRODUCER CONTACTNAME:
PHONE
(A/C, No, Ext): FAX(A/C, No): E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
INSURED INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: XXXXXXX
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 ADDLINSR SUBR
WVD POLICY NUMBER (MM/DD/YYYY)POLICY EFF (MM/DD/YYYY)POLICY EXP LIMITS GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-JECT LOC
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG
$ $ $ $ $ $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON-OWNED AUTOS
COMBINED SINGLE LIMIT (Ea accident)
BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ $ $ $ $ UMBRELLA LIAB OCCUR
EXCESS LIAB CLAIMS-MADE
DED RETENTION $ EACH OCCURRENCE AGGREGATE $ $ $ WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
WC STATU-
TORY LIMITS OTH-ER
E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT
$ $ $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required)
CERTIFICATE HOLDER CANCELLATION
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
ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD Lockton Companies, LLC Denver
8110 E. Union Avenue Suite 700
Denver CO 80237 (303) 414-6000 Phoenix Mesa Gateway Airport Authority
5835 South Sossaman Road Mesa AZ 85212 PHOME00 7/1/2014 1368389 X X Comp/Coll X $1000 Ded 1,000,000 XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX
Airport Liability $200,000,000 per occ incl Prem Liab BI & Prop Damage
N
X
1,000,000 1,000,000 1,000,000 Travelers Property Casualty Co of America 25674
Liberty Insurance Corporation 42404
Commerce and Industry Insurance Company 19410
A 8102D412113TIL13 7/1/2013 7/1/2014
C AP02543745702 7/1/2013 7/1/2014
B WC7Z91447867014 1/1/2014 1/1/2015
NOT APPLICABLE
NOT APPLICABLE
Central Arizona Water Conservation District P.O. Box 43020
Phoenix AZ 85080-3020 12436475
12436475
12/23/2013
Central Arizona Water Conservation District, its officers, directors, employees, agents, consultants and each of any of them are included as Additional Insureds where required by written contract with respect to the liability arising out of the activities performed by or on behalf of the contractor. Waiver of Subrogation in favor of the Central Arizona Water Conservation District where required by written contract.
Y Y
Y
ACORD
TMCERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
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 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).
PRODUCER CONTACTNAME:
PHONE
(A/C, No, Ext): FAX(A/C, No): E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
INSURED INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: XXXXXXX
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 ADDLINSR SUBR
WVD POLICY NUMBER (MM/DD/YYYY)POLICY EFF (MM/DD/YYYY)POLICY EXP LIMITS GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-JECT LOC
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG
$ $ $ $ $ $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON-OWNED AUTOS
COMBINED SINGLE LIMIT (Ea accident)
BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ $ $ $ $ UMBRELLA LIAB OCCUR
EXCESS LIAB CLAIMS-MADE
DED RETENTION $ EACH OCCURRENCE AGGREGATE $ $ $ WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
WC STATU-
TORY LIMITS OTH-ER
E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT
$ $ $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required)
CERTIFICATE HOLDER CANCELLATION
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
ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD Lockton Companies, LLC Denver
8110 E. Union Avenue Suite 700
Denver CO 80237 (303) 414-6000 Phoenix Mesa Gateway Airport Authority
5835 South Sossaman Road Mesa AZ 85212 PHOME00 7/1/2014 1368389 X X Comp/Coll X $1000 Ded 1,000,000 XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX
Airport Liability $200,000,000 per occ incl Prem Liab BI & Prop Damage
N
X
1,000,000 1,000,000 1,000,000 Travelers Property Casualty Co of America 25674
Liberty Insurance Corporation 42404
Commerce and Industry Insurance Company 19410
A 8102D412113TIL13 7/1/2013 7/1/2014
C AP02543745702 7/1/2013 7/1/2014
B WC7Z91447867014 1/1/2014 1/1/2015
NOT APPLICABLE
NOT APPLICABLE
Maricopa County Community College District Attn: Risk Manager
2411 West 14th Street Tempe, AZ 85281 12432782
12432782
12/23/2013
The Maricopa County Community College District, and its agents, officers, officials, employees and volunteers are named as Additional Insured as respect Auto Liability where required by written contract. It is further agreed that sush insurance as is afforded shall be primary with any other insurance in force for or which may be purchased by the Additional Insureds.
Y N
N
ACORD
TMCERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
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 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).
PRODUCER CONTACTNAME:
PHONE
(A/C, No, Ext): FAX(A/C, No): E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
INSURED INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: XXXXXXX
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 ADDLINSR SUBR
WVD POLICY NUMBER (MM/DD/YYYY)POLICY EFF (MM/DD/YYYY)POLICY EXP LIMITS GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-JECT LOC
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG
$ $ $ $ $ $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON-OWNED AUTOS
COMBINED SINGLE LIMIT (Ea accident)
BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ $ $ $ $ UMBRELLA LIAB OCCUR
EXCESS LIAB CLAIMS-MADE
DED RETENTION $ EACH OCCURRENCE AGGREGATE $ $ $ WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
WC STATU-
TORY LIMITS OTH-ER
E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT
$ $ $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required)
CERTIFICATE HOLDER CANCELLATION
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
ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD Lockton Companies, LLC Denver
8110 E. Union Avenue Suite 700
Denver CO 80237 (303) 414-6000 Phoenix Mesa Gateway Airport Authority
5835 South Sossaman Road Mesa AZ 85212 PHOME00 7/1/2014 1368389 X X Comp/Coll X $1000 Ded 1,000,000 XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX XXXXXXX
Airport Liability $200,000,000 per occ incl Prem Liab BI & Prop Damage
N
X
1,000,000 1,000,000 1,000,000 Travelers Property Casualty Co of America 25674
Liberty Insurance Corporation 42404
Commerce and Industry Insurance Company 19410
A 8102D412113TIL13 7/1/2013 7/1/2014
C AP02543745702 7/1/2013 7/1/2014
B WC7Z91447867014 1/1/2014 1/1/2015
NOT APPLICABLE
NOT APPLICABLE
Mesa Police Department 130 North Robson Mesa, AZ 85201 12435971 12435971 12/23/2013 N N N N N
Phoenix-Mesa Gateway Airport 5835 South Sossaman Road Mesa, Arizona 85212-6014 Telephone: 480-988-7600 FAX: 480-988-2315
www.phxmesagateway.org
Action Item
Resolution No. 14-04
To: Board of Directors
From: Michael Merk, Interim Director, Business Development Through: Jane L. Morris, A.A.E., Executive Director
Re: Property Lease Agreement – Water Purity Solution, LLC Date: January 21, 2014
Proposed Motion:
Approve Resolution No. 14-04 approving a property lease agreement with Water Purity Solution, LLC, for the lease of the 22,710 square-foot building at 6410 S. Sossaman Road, and authorizing the expenditure of not to exceed $80,000 from Fiscal Year 2014 Amended Capital Budget contingency funds for improvements to the subject property.
Narrative:
Water Purity Solution, LLC is a new industrial water system manufacturer from Colorado, and will be manufacturing and assembling industrial stainless steel water purification systems at Phoenix-Mesa Gateway Airport Authority (PMGAA), initially employing 35 people. Effective date is April 1, 2014.
Fiscal Impact:
The lease has a four-year term with one three-year option to extend. Net rent is $123,180 per year payable in monthly installments of $10,265, with annual CPI or four percent rent increases.
Approximately $80,000 will be spent on tenant improvements by PMGAA. Attachment: Floor plan - 6410 S. Sossaman Road
RESOLUTION NO. 14-04