2022_03_10_COI_CL_AL_UL_PL_SAM_WC.pdf
PDF 916 KB Posted
- Attached to
- Master Agreement AZ|CTR058022
- Contract number
- CTR058022
- Issued by
- Arizona
About this file
This document is a comprehensive insurance policy package comprising multiple certificates of liability insurance for Odyssey Services Corporation, issued by Philadelphia Indemnity Insurance Company and Wesco Insurance Company, with Pinnacle Insurance Consultants as the producer. The policies cover various liability types for Odyssey Services Corporation and specifically name the State of Arizona, its departments, agencies, boards, commissions, universities, and employees as additional insureds. The policy period runs from 01/29/2022 to 01/29/2023.
The insurance coverage includes Commercial General Liability, Commercial Auto Liability, Professional Liability, and Workers Compensation, with each type having specific coverage limits. The policies cover services related to Career Exploration (CTR049906), Pre-Employment Transition Services (CTR056119-2), Tutoring Service (CTR044676), Supported Education Services for Vocational Rehabilitation Clients (CTR051931), and Small Business Consultation (CTR058022). The Commercial Umbrella Liability Insurance has a retained limit of $10,000 and provides aggregate liability coverage of $1,000,000 per occurrence, with a total premium of $3,240.00. The policies include waivers of subrogation and transfer of rights of recovery, primarily benefiting the State of Arizona and its various entities.
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Text version
POLICY CHANGE DOCUMENT
POLICY NO.:
CHANGE EFFECTIVE CHANGE # REVISION #
DESCRIPTION
PHPK2227220
102/03/2021
02/05/2021____________________ Issue Date
Amended:
Manuscript- Addl Insured Full Name-State of Arizona
Per attached Form
Philadelphia Indemnity Insurance Company
NAMED INSURED
25827 Pinnacle Insurance Consultants
Odyssey Services Corporation
MAILING ADDRESS 8947 E Quill St Mesa, AZ 85207-9724
POLICY PERIOD: FROM TO at 12:01 A.M. Standard Time at your mailing address shown above.
Path ID 14437737
0.00
NO CHANGE
COUNTERSIGNED BY
(Date) (Authorized Representative)
01/29/2021 01/29/2022
In consideration of the premium reflected, the policy is amended as indicated below:
Total Annual 0.00Additional/Return Premium $ Additional/Return Premium $
Total Prorate
NO CHANGE
Insurance Policy
PI-MANU-1 (01/00)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
All other terms and conditions of this Policy remain unchanged.
The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor
Policy Number: PHPK2227220
Addl Insured Full Name-State of Arizona
| 2022 03 10 CL AL UL PL SAM WC.pdf |
| COI thru 012923.pdf |
| CGL-AL - same policy number - Addnl Insured END EXP 1-29-22 |
| Insurance Policy |
| Policy Change Document |
| Manuscript Endorsement |
Waiver (1).pdf
File details come from the government source that posted it. Updated .