2024-2-1_COI_PL_Umbrella.PDF
PDF 121 KB Posted
- Attached to
- Master Agreement AZ|CTR066196
- Contract number
- CTR066196
- Issued by
- Arizona
About this file
This document is an Excess Liability Coverage Agreement Declarations page for Housing Solutions of Northern Arizona, Inc., detailing an insurance policy issued by the Social Service Contractors Indemnity Pool (SSCIP). The policy covers the named insured located in Flagstaff, Arizona, with a continuous coverage period from March 3, 2023, to February 1, 2024, and provides various liability protections including commercial general liability, automobile liability, sexual or physical abuse liability, employers liability, professional liability, and employee benefits liability.
The policy includes multiple coverage limits across different insurance categories, with aggregate limits ranging from $1,000,000 to $3,000,000 depending on the specific liability type. Key coverage details include a $1,000,000 limit for general liability each occurrence, $1,000,000 for automobile bodily injury and property damage, $1,000,000 per act of abuse with a $3,000,000 aggregate abuse limit, and $1,000,000 professional errors and omissions coverage per claim with a $3,000,000 aggregate limit. The policy's retroactive dates for professional liability and employers benefits liability are February 1, 2017, and March 1, 2023, respectively, with underlying insurance provided by SSCIP and Copperpoint.
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Text version
Social Service Contractors Indemnity Pool
EXCESS LIABILITY COVERAGE AGREEMENT DECLARATIONS_SSEDEC_01/21
SSEDEC (01-21) Includes wording © ISO Properties, Inc., used with permission Page 1 of 2
EXCESS LIABILITY COVERAGE AGREEMENT
DECLARATIONS
Policy # 6002943-1
Replaces Policy # New Business
THIS DECLARATIONS PAGE AND THE ATTACHED EXCESS LIABILITY COVERAGE AGREEMENT COMPLETE THIS COVERAGE PART.
Item 1. "NAMED INSURED":
Housing Solutions of Northern Arizona, Inc 2304 N Third St Flagstaff, AZ 86004
Item 2. CONTINOUS COVERAGE PERIOD:
12:01 A.M. Standard Time at Named Insured Mailing Address
Rating Period from: 03/03/2023 To: 02/01/2024
Item 3. LIMITS OF INSURANCE
Aggregate Limit of Liability
$ 1,000,000 $ 1,000,000
Item 4. EXCESS RETRO-ACTIVE DATE:
Professional (E & O): 02/01/2017
Employers Benefits Liability: 03/01/2023
Item 5. SCHEDULE OF "UNDERLYING INSURANCE COVERAGE":
Excess coverage applies only to coverage for which underlying Limits of Coverage are shown.
COMMERCIAL GENERAL LIABILITY LIMITS (OCCURRENCE)
Underlying Insurer: SSCIP Underlying Policy Number: 6002942 Policy Period: From: 03/01/2023 General Liability – Aggregate $ 3,000,000 General Liability – Each Occurrence $ 1,000,000
AUTOMOBILE LIABILITY LIMITS (OCCURRENCE)
SSEDEC (01-21) Includes wording © ISO Properties, Inc., used with permission Page 2 of 2
Underlying Insurer: SSCIP Underlying Policy Number: 6002942 Policy Period: From: 03/01/2023 Bodily Injury Liability - Each Accident Limit $ 1,000,000 Property Damage Liability -Each Accident Limit $ 1,000,000
SEXUAL OR PHYSICAL ABUSE OR MOLESTATION (OCCURRENCE)
Underlying Insurer: SSCIP Underlying Policy Number: 6002942 Policy Period: From: 03/01/2023 Each Act of Abuse Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000
EMPLOYERS LIABILITY (CLAIMS MADE)
Underlying Insurer: Copperpoint Underlying Policy Number: 01019752 Policy Period: From: 07/01/2022 Bodily Injury - By Accident Limit $ 1,000,000 Bodily Injury By Disease - Each Employee Limit $ 1,000,000 Bodily Injury By Disease - Policy Limit $ 1,000,000
PROFESSIONAL LIABILITY (E & O) (CLAIMS MADE)
Underlying Insurer: SSCIP Underlying Policy Number: 6002942 Policy Period: From: 03/01/2023 Errors and Omissions - Each Claim $ 1,000,000 Errors and Omissions - Aggregate $ 3,000,000
EMPLOYEE BENEFITS LIABILITY (CLAIMS MADE)
Underlying Insurer: SSCIP Underlying Policy Number: 6002942 Policy Period: From: 03/01/2023 Employee Benefits - Each Incident $ 1,000,000 Employee Benefits - Aggregate $ 1,000,000
Item 6. PREMIUM:
Item 7. COVERAGE FORMS AND ENDORSEMENTS APPLICABLE TO THIS COVERAGE:
SSECOV (01/21) SSECON (01/21)
SSCIP ELECTRONIC COMMUNICATION_SSELECCOM_11/21
File details come from the government source that posted it. Updated .