1-1-25_COI_GL_PL.pdf
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- Attached to
- Master Agreement AZ|CTR056869
- Contract number
- CTR056869
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by two different insurance providers (State Farm and Hiscox Insurance Company) for Sportscom, Inc., located in Scottsdale, Arizona. The certificates are prepared for the State of Arizona, with the state listed as the certificate holder at 1400 W. Washington, 3rd Floor in Phoenix. The contract number referenced on both certificates is CTR056869, and the policies are current for the 2024-2025 policy period.
The commercial general liability policy from State Farm provides coverage with limits including $1,000,000 per occurrence, $300,000 for damage to rented premises, $2,000,000 general aggregate, and $2,000,000 for products-completed operations. The Hiscox policy includes a professional liability policy with $1,000,000 per claim and $1,000,000 aggregate. Both insurance certificates are standard ACORD 25 forms and serve to certify insurance coverage for Sportscom, Inc. in connection with their contract with the State of Arizona, demonstrating the company's compliance with insurance requirements for a state and local contract.
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Text version
1001486 2005 155279 205 01-19-2023
INSR
LTR TYPE OF INSURANCE
ADD
INSD
SUB
WVD POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY) LIMITS
A
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY
PRO-
JECT LOC
OTHER:
Y Y 93-KU-5683-2 01/01/2024 01/01/2025
EACH OCCURRENCE 1,000,000$
DAMAGE TO RENTED
PREMISES (Ea occurrence) 300,000$
MED EXP (Any one person) 5,000$
PERSONAL & ADV INJURY 1,000,000$
GENERAL AGGREGATE 2,000,000$
PRODUCTS - COMP/OP AGG 2,000,000$
AUTOMOBILE LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
SCHEDULED
AUTOS
HIRED
AUTOS ONLY
NON-OWNED
AUTOS ONLY
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
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
Y / N N / A
PER
STATUTE
OTH-
ER $
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
CANCELLATION
AUTHORIZED REPRESENTATIVE
02/14/2024This form was system-generated on .
ADDRESS: stephanie.chavez.vaahlv@statefarm.com
CONTACT
NAME: Stephanie Chavez
PHONE
(A/C, No, Ext): 602-457-3825 FAX
(A/C, No):
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : State Farm Fire and Casualty Company 25143
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
PRODUCER
INSURED
Stephanie Chavez 2816 N 16th Street Suite C
Phoenix AZ 850061260
SPORTSCOM, INC
1217 N MILLER RD UNIT 24
SCOTTSDALE AZ 852573639
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.
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.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
02/14/2024
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
State of Arizona 1400 W. Washington, 3rd Floor
PHOENIX AZ 85007
The ACORD name and logo are registered marks of ACORD contract number (CTR056869)
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
02/15/2024
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 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 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.
PRODUCER Simply Business 1 Beacon Street 15th Floor Boston, MA 02108
CONTACT Simply BusinessNAME:
PHONE FAX
(A/C, No, Ext): (844) 654-7272 (A/C, No):
ADDRESS: contactus@simplybusiness.com
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : Hiscox Insurance Company Inc 10200 INSURED Sportscom INC. dba HMA Public Relations
4343 N Scottsdale Rd Ste. 150 Scottsdale, Arizona 85251
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSR
TYPE OF INSURANCE
ADDL SUBR
POLICY NUMBER
POLICY EFF POLICY EXP
LIMITSLTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY)
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
CLAIMS-MADE OCCUR
DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE
POLICY
PRO-
LOC PRODUCTS - COMP/OP AGGJECT
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident)
ANY AUTO BODILY INJURY (Per person)
OWNED
SCHEDULED BODILY INJURY (Per accident)
AUTOS ONLY
AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident)
UMBRELLA LIAB
OCCUR EACH OCCURRENCE
EXCESS LIAB CLAIMS-MADE
AGGREGATE
DED RETENTION
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY Y / N
STATUTE ER
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
N / AOFFICER/MEMBEREXCLUDED?
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE If yes, describe under
E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below
A PROFESSIONAL LIABILITY HIUS4340622XB 01/25/2024 01/25/2025 EACH CLAIM $1,000,000.00
AGGREGATE $1,000,000.00
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 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
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD contract number (CTR056869)
State of Arizona 1400 Washington, 3rd Floor Phoenix, AZ 85007
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