2024-10-01_COI.pdf

PDF 68 KB Posted

Attached to
Master Agreement AZ|CTR078829
Contract number
CTR078829
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by Aon Risk Services Northeast, Inc. on 10/04/2023 for The Arizona Republic, covering multiple insurance policies through National Union Fire Insurance Company of Pittsburgh, AIU Insurance Company, and AIG Specialty Insurance Company. The certificate involves the State of Arizona, specifically the Arizona Department of Administration, and covers insurance for the contract ADSPO18-178338.

The contract pertains to legal, classified, and web-based recruitment advertising services. The insurance coverage includes Commercial General Liability with limits of $2,000,000 per occurrence and $4,000,000 aggregate, Automobile Liability with a $1,000,000 combined single limit, Workers' Compensation with statutory limits, and Errors & Omissions Professional Liability with $2,000,000 per each wrongful act and $2,000,000 claims-made aggregate. The policies are effective from 10/01/2023 to 10/01/2024, and include additional insured provisions for the State of Arizona, its departments, agencies, and employees, with primary and non-contributory coverage and a waiver of subrogation.

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H o ld e r

Id e n ti fi e r

77777 77707 07070 00777 61616 04557 11107 76617 13701 54572 07472 33746 35373 30072 76045 73653 33130 71514 13023 73112 10732 71006 52311 56207 56733 70225 27764 07725 41142 01371 31077 16010 46335 55210 76727 24203 57720 00777 77770 70007 07007

77777 77707 07070 00735 25677 11545 60007 22150 04712 77132 07033 33724 21721 00071 22237 34307 31000 70222 37342 16201 10712 33362 42162 11107 02233 72420 72011 07032 22725 31720 00071 23336 34207 31000 77756 16335 17655 40777 77770 70007 07007

C e rt if ic a te

N o

CERTIFICATE OF LIABILITY INSURANCE

DATE(MM/DD/YYYY)

10/04/2023

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.

PRODUCER

Aon Risk Services Northeast, Inc.

New York NY Office One Liberty Plaza 165 Broadway, Suite 3201 New York NY 10006 USA

PHONE

(A/C. No. Ext):

E-MAIL

ADDRESS:

INSURER(S) AFFORDING COVERAGE NAIC #

(866) 283-7122

INSURED 19445National Union Fire Ins Co of PittsburghINSURER A:

19399AIU Insurance CompanyINSURER B:

26883AIG Specialty Insurance CompanyINSURER C:

INSURER D:

INSURER E:

INSURER F:

FAX

(A/C. No.):

(800) 363-0105

CONTACT

NAME:

The Arizona Republic 200 E. Van Buren St.

Phoenix AZ 85004 USA

COVERAGES CERTIFICATE NUMBER: 570102095025 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. Limits shown are as requested

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

(MM/DD/YYYY)

SUBR

WVD

INSR

LTR

ADDL

INSD POLICY NUMBER TYPE OF INSURANCE LIMITS

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

POLICY LOC

EACH OCCURRENCE

DAMAGE TO RENTED

PREMISES (Ea occurrence)

MED EXP (Any one person)

PERSONAL & ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGG

X

X

X

GEN'L AGGREGATE LIMIT APPLIES PER:

$2,000,000

$2,000,000

$2,000,000

$4,000,000

$4,000,000

A 10/01/2023 10/01/20249941251

PRO-

JECT

OTHER:

AUTOMOBILE LIABILITY

ANY AUTO

OWNED

AUTOS ONLY

SCHEDULED

AUTOS

HIRED AUTOS

ONLY

NON-OWNED

AUTOS ONLY

BODILY INJURY ( Per person)

PROPERTY DAMAGE

(Per accident)

X

BODILY INJURY (Per accident)

$1,000,000A 10/01/2023 10/01/2024

AOS

7620249B 10/01/2023 10/01/2024

MA

COMBINED SINGLE LIMIT

(Ea accident)

7620248

EXCESS LIAB

OCCUR

CLAIMS-MADE AGGREGATE

EACH OCCURRENCE

DED

UMBRELLA LIAB

RETENTION

E.L. DISEASE-EA EMPLOYEE

E.L. DISEASE-POLICY LIMIT

E.L. EACH ACCIDENT $1,000,000

X OTH-

ER

PER STATUTEB 10/01/2023 10/01/2024

AOS

WC049154414B 10/01/2023 10/01/2024

$1,000,000

Y / N

(Mandatory in NH)

ANY PROPRIETOR / PARTNER / EXECUTIVE

OFFICER/MEMBER EXCLUDED? N / AN

CA

WORKERS COMPENSATION AND

EMPLOYERS' LIABILITY

If yes, describe under DESCRIPTION OF OPERATIONS below

$1,000,000

WC049154413

Each Wrongful Act015441843 10/01/2023 10/01/2024 Claims Made $2,000,000Aggregate

E&O - Miscellaneous Professional-Primary

C

SIR applies per policy terms & conditions

$2,000,000

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

RE: Contract ADSPO18-178338 - Legal, Classified and Web Based Recruitment Advertising.

The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees are included as Additional Insured in accordance with the policy provisions of the General Liability policy. General Liability and Auto Liability evidenced herein is Primary and Non-Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A Waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability and Auto Liability policy.

CANCELLATIONCERTIFICATE HOLDER

AUTHORIZED REPRESENTATIVEAZ Dept of Administration Charlotte Righetti, CPPB 100 N 15th Ave, Suite 201 Phoenix AS 85007 USA

ACORD 25 (2016/03)

©1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE

EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE

POLICY PROVISIONS.

AGENCY CUSTOMER ID:

ADDITIONAL REMARKS SCHEDULE

LOC #:

ADDITIONAL REMARKS

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance

EFFECTIVE DATE:

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSUREDAGENCY

See Certificate Number:

See Certificate Number:

570102095025

570102095025

Aon Risk Services Northeast, Inc.

570000082066

ADDITIONAL POLICIES

If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits.

INSURER

INSURER

INSURER

INSURER

INSURER(S) AFFORDING COVERAGE

Page _ of _

NAIC #

The Arizona Republic

TYPE OF INSURANCE

POLICY NUMBER LIMITS

WORKERS COMPENSATION

B WC049154415 10/01/2023 10/01/2024

WI

N/A

ADDL

INSD

INSR

LTR

SUBR

WVD

POLICY

EFFECTIVE

DATE

(MM/DD/YYYY)

POLICY

EXPIRATION

DATE

(MM/DD/YYYY)

ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

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