10-1-24_COI_GL_AL_WC.PDF
PDF 86 KB Posted
- Attached to
- Master Agreement AZ|CTR068174
- Contract number
- CTR068174
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance for UniFirst Corporation, issued by Willis Towers Watson Northeast, Inc., covering insurance policies for the period of 10/01/2023 to 10/01/2024. The certificate involves the State of Arizona's State Procurement Office, specifically referencing the Arizona State Department of Administration (ADOA) with Francine Whittington as the contact. The insurance coverage involves multiple insurers including ACE American Insurance Company, Indemnity Insurance Company of North America, and ACE Fire Underwriters Insurance Company.
The contract appears to be related to a specific contract number CTR068174, with UniFirst Corporation providing services under a statewide contract. The insurance certificate includes general liability coverage with limits of $2,000,000 per occurrence and $20,000,000 aggregate, along with workers' compensation and employers' liability coverage with $1,000,000 limits. The State of Arizona is listed as an additional insured under the general liability policy, and UniFirst Corporation has agreed to a waiver of subrogation. The certificate covers bodily injury, property damage, and potential risks associated with the company's operations, with insurance protections in place for the contract period.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| CTR068174_Contract_Amendment__1__1_.pdf | ||
| Key_Personnel.pdf | ||
| Copy_of_Unifirst_Pricing_Document__2__State_contract.xlsx | XLSX spreadsheet | |
| Exhibit_A_Uniform_Rental_Specifications.pdf | ||
| UniFirstCorporation_-_Client_Pack_-_3880825.PDF | ||
| Exhibit_B_Facility_Service_Product_Specifications.pdf | ||
| Organizational_Profile.pdf | ||
| CTR068174_Unifirst_contract.pdf | ||
| Unifirst_Pricing_Document.xlsx | XLSX spreadsheet |
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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)
© 1988-2016 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
Willis Towers Watson Northeast, Inc.
c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA
UniFirst Corporation and its Subsidiaries 68 Jonspin Road Wilmington, MA 01887
This Voids and Replaces Previously Issued Certificate Dated 10/20/2023 WITH ID: W30749710.
Division/Location: 315
Contract no.: CTR068174
SEE ATTACHED
ADOA State Procurement Office State of Arizona Attn: Francine Whittington, CPPB 1400 W. Washington, 3rd Floor Phoenix, AZ 85007
10/23/2023
1-877-945-7378 1-888-467-2378 certificates@willis.com
ACE American Insurance Company 22667
Indemnity Insurance Company of North Ameri
ACE Fire Underwriters Insurance Company
43575
20702
W30765630
A
2,000,000
1,000,000
5,000Contractual
2,000,000
20,000,000
4,000,000
Y Y HDOG47359624 10/01/2023 10/01/2024
A
4,000,000
10/01/202410/01/2023ISAH10773544
WLRC50739004 (AOS)
B 1,000,000
No 10/01/2023 10/01/2024 1,000,000
1,000,000
A Workers Compensation and
Employers Liability
EL Each AccidentWCUC50739181(OH) 10/01/2023 10/01/2024
EL Disease -Pol Limit
Per Statute EL Disease - Each Emp
318041124853282SR ID: BATCH:
$1,000,000
$1,000,000
$1,000,000
Willis Towers Watson Certificate Center
ACORD 101 (2008/01)
The ACORD name and logo are registered marks of ACORD
© 2008 ACORD CORPORATION. All rights reserved.
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: FORM TITLE:
ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY CUSTOMER ID:
LOC #:
AGENCY
CARRIER NAIC CODE
POLICY NUMBER
NAMED INSURED
EFFECTIVE DATE:
UniFirst Corporation and its Subsidiaries 68 Jonspin Road Wilmington, MA 01887
The State of Arizona is an Additional Insured under the General Liability policy for bodily injury and/or property damage resulting from the work or product of the Named Insured where required by a written contract with the Named Insured.
Waiver of Subrogation STD Wording: It is understood and agreed that UniFirst Corporation waives its right of subrogation against the Additional Insured which may arise by reason of a payment of claim under General Liability policy, if required by written contract
INSURER AFFORDING COVERAGE: ACE Fire Underwriters Insurance Company NAIC#: 20702
POLICY NUMBER: SCFC50739065 (WI) EFF DATE: 10/01/2023 EXP DATE: 10/01/2024
TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT:
Workers Compensation and EL Each Accident $1,000,000 Employers Liability EL Disease -Pol Limit $1,000,000 Per Statute EL Disease - Each Emp $1,000,000
2 2
Willis Towers Watson Northeast, Inc.
See Page 1
See Page 1 See Page 1 See Page 1
25 Certificate of Liability Insurance
W30765630CERT:3180411BATCH:24853282SR ID:
File details come from the government source that posted it. Updated .