2024.01.01_COI_WC.pdf

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Attached to
Master Agreement AZ|CTR056107
Contract number
CTR056107
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance and Workers Compensation Policy Endorsement issued by CopperPoint Indemnity Insurance Company for United Cerebral Palsy of Southern Arizona, Inc. (UCPSA), located in Tucson, Arizona. The insurance certificate, dated 12/28/2022, lists Lovitt & Touché/A Marsh & McLennan Agency, LLC as the producer, and the State of Arizona's Department of Economic Security as the certificate holder. The policy provides coverage for workers' compensation and employers' liability, with a specific waiver of subrogation in favor of the State of Arizona and its various departments, agencies, boards, commissions, universities, and their respective officers, agents, and employees.

The policy includes workers' compensation coverage with limits of $1,000,000 for each accident, disease-per employee, and disease policy limit. The endorsement, effective 01/01/2023, contains a waiver of the insurance company's right to recover payments from parties listed in the Schedule, specifically the State of Arizona and its associated entities. The policy number is 1009784, and it provides insurance for employment-related services, pre-employment transition services, and work performed by or on behalf of the contractor. The coverage period runs from 11/1/2023 to 11/1/2024, with an endorsement effective date of 01/01/2023.

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