2026.02.10_COI.pdf

PDF 176 KB Posted

Attached to
Master Agreement AZ|CTR072354
Contract number
CTR072354
Issued by
Arizona

About this file

This document is a Certificate of Insurance issued by Chubb Insurance Company of Canada for bioLytical Laboratories Inc., brokered through Hub International Insurance Brokers. The certificate is specifically for the Arizona Department of Health Services, covering the State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insured parties.

The insurance policy provides Commercial General Liability coverage with limits of $2,000,000 per occurrence and $2,000,000 aggregate, including products and completed operations, employer's liability, cross liability, and non-owned automobile coverage. An additional umbrella liability policy provides $3,000,000 in coverage, and a products liability policy offers $5,000,000 per claim and in aggregate. The policy includes a waiver of subrogation and is designated as primary and non-contributory for the State of Arizona, with the insurance effective from February 25, 2010, to February 26, 2010.

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1-Proposal # 1-prop_items.xls XLS spreadsheet
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CTR072354_Contract_Documents.pdf PDF
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1-Proposal___1-prop_items.xls XLS spreadsheet
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Text version

CERTIFICATE OF INSURANCE

This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies below.

COMPANIES AFFORDING COVERAGE

COVERAGES

CERTIFICATE HOLDER CANCELLATION

CSIO CERT (6/00)

BROKER

BROKER'S CLIENT ID:

INSURED'S FULL NAME AND MAILING ADDRESS

CO

LTR

TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE

DAT E (YY/MM/DD)

POLICY EXPIRATION

DAT E (YY/MM/DD)

LIMITS OF LIABILITY

(Canadian dollars unless indicated otherwise)

COMMERCIAL GENERAL LIABILITY

AUT OMOBILE LIABILITY

EXCESS LIABILITY

OTHER LIABILITY (SPECIFY)

ADDIT IONAL INSURED DESCRIPTION OF OPERATIONS/LOCATIONS/AUTOMOBILES/SPECIAL ITEMS

SIGNATURE OF AUTHORIZED REPRESENTATIVE PRINT NAME INCLUDING POSITION HELD

FAX NUMBER EMAIL ADDRESS COMPANY DAT E

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.

COMPANY

A

COMPANY

B

COMPANY

C

COMPANY

D

CLAIMS MADE OR OCCURRENCE

PRODUCTS AND / OR COMPLETED OPERATIONS

EMPLOYER'S LIABILITY

CROSS LIABILITY

TENANT'S LEGAL LIABILITY

NON-OWNED

HIRED

POLLUTION LIABILITY EXTENSION

DESCRIBED AUTOMOBILES

ALL OWNED AUTOS

LEASED AUTOMOBILES

** ALL AUTOMOBILES LEASED IN EXCESS OF 30 DAYS WHERE

THE INSURED IS REQUIRED TO PROVIDE INSURANCE

UMBRELLA FORM

OTHER THAN UMBRELLA FORM

(Specify)___________________________________________________

EACH OCCURRENCE

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGG

PERSONAL INJURY

TENANT'S LEGAL LIABILITY

MED EXP (Any one person)

NON-OWNED AUTO

OPTIONAL POLLUTION

LIABILITY EXTENSION

(Per Occurrence)

(Aggregate)

BODILY INJURY

PROPERTY DAMAGE

COMBINED

BODILY INJURY

(Per person)

BODILY INJURY

(Per accident)

PROPERTY DAMAGE

EACH OCCURRENCE

AGGREGATE

DAT E (YY/MM/DD)

25/02/14

Hub International Insurance Brokers 505 Burrard Street, Suite 1900 Box 76 Vancouver BC V7X 1M5

BIOLLAB-T2 Chubb Insurance Company of Canada bioLytical Laboratories Inc.

13251 Delf Pl #406 Richmond BC V6V 2A2

2,000,000

X

X

X X

A 25/02/10 26/02/1036060350

2,000,000

See below

2,000,000

2,000,000

10,000

2,000,000

A 79892105 25/02/10 26/02/10 3,000,000

3,000,000

Products Liability A 36022797 25/02/10 26/02/10 Each Claim Limit

Aggregate $5,000,000 $5,000,000

Arizona Department of Health Services 150 North 18th Avenue, Suite 530 Phoenix AZ 85007-3247

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are added as Additional Insured on the Commercial General Liability policy but only with respect to the operations of the Named Insured.

Waiver of Subrogation:

See Attached...

Arizona Department of Health Services 150 North 18th Avenue, Suite 530 Phoenix AZ 85007-3247 USA

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED

BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY

WILL ENDEAVOR TO MAIL 0 DAYS WRITTEN NOTICE TO THE

CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL

SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY

KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.

Sarah Thompson, Chief Marketing Officer michael.baddeley@hubinternational.com Hub International Insurance Broker 25/02/14

DESCRIPTIONS Continued.

REMARKS:

A waiver of subrogation is included in favor of the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Named Insured.

Primary and Non-Contributory:

The insurance afforded to the State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees shall be primary and any insurance carried by the State of Arizona shall be excess and non-contributory.

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