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.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 1-Proposal # 1-prop_items.xls | XLS spreadsheet | |
| 2025.04.13 COI WC.pdf | ||
| Biolytical Labs Attachment C.pdf | ||
| Biolytical Labs Attachment E.pdf | ||
| CTR072354_Contract_Documents.pdf | ||
| Licensing and Credentialing.zip | ZIP file | |
| 1-Proposal___1-prop_items.xls | XLS spreadsheet | |
| Biolytical Labs Attachment B.pdf | ||
| CTR072354_Contract_Amendment_1.pdf | ||
| 2025.02.10 COI GL PL.pdf | ||
| Biolytical Labs Attachment A.pdf | ||
| 1-65-1214(C) INSTI Product Specifications Sheet USA (2).pdf | ||
| Biolytical Labs Attachment D.pdf |
Show all 13
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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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