2026.05.08_COI_GL_AL_WC_EO.pdf
PDF 102 KB Posted
- Attached to
- Master Agreement AZ|CTR076432
- Contract number
- CTR076432
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance for Cybersoft Technologies Inc, issued by Arthur J. Gallagher Risk Management Services, LLC, with the Arizona Department of Education listed as the certificate holder. The insurance policies are underwritten by multiple insurers, including Hartford Lloyd's Insurance Company, Travelers Casualty and Surety Co of America, ACE American Insurance Company, and Hartford Accident and Indemnity Company.
The certificate covers multiple types of insurance, including Commercial General Liability with a $2,000,000 each occurrence limit and $4,000,000 aggregate limit, Automobile Liability, Umbrella Liability with a $3,000,000 each occurrence limit, Workers' Compensation, Crime - Fidelity Bond with a $1,000,000 limit, and Technology E&O including Cyber coverage with a $5,000,000 professional per-claim limit. The policies are effective from various dates in 2025 to 2026, with the general liability policy specifically running from 6/21/2025 to 6/21/2026. The certificate indicates that if required by written contract, there are blanket additional insured and blanket waiver of subrogation endorsements applicable to the general liability policy.
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Text version
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:
CONTACT
(A/C, No):
FAX
ADDRESS:
PRODUCER
(A/C, No, Ext):
PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
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.
OTHER:
(Per accident)
(Ea accident)
N / A
SUBR
WVD
ADDL
INSD
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.
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLY
NON-OWNED
SCHEDULEDOWNED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-
STATUTE
PER
LIMITS(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
OCCUR
CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED
$PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY
PRO-
JECT LOC
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
11/17/2025
Arthur J. Gallagher Risk Management Services, LLC 1900 West Loop South Suite 1600 Houston TX 77027
Courtney Rodrick 281-320-2010 281-320-0098
Courtney_Rodrick@ajg.com
Hartford Lloyd's Insurance Company 38253 Travelers Casualty and Surety Co of America 31194
Cybersoft Technologies Inc 4422 Cypress Creek Pkwy Ste 400 Houston TX 77068-3417
ACE American Insurance Company 22667 Hartford Accident and Indemnity Company 22357
1751891207
A X 2,000,000 X 300,000
10,000
2,000,000
4,000,000 X
Y Y 61SBABR8399 6/21/2025 6/21/2026
4,000,000
A 2,000,000
X X
Y Y 61SBABR8399 6/21/2025 6/21/2026
A X X 3,000,000Y 61SBABR8399 6/21/2025Y 6/21/2026
3,000,000 X 10,000
D XY 61WBCAS9231 5/8/2025 5/8/2026
1,000,000
1,000,000
1,000,000 B C
Crime - Fidelity Bond Technology E&O incl Cyber
106409189 F14937961007
5/8/2023 9/7/2025
5/8/2026 9/7/2026
3rd Party Crime Professional PerClaim
1,000,000 5,000,000
If required by written contract between the Insured and the Certificate Holder, the following endorsement form apply: General Liability - Blanket Additional Insured and Blanket Waiver of Subrogation under endorsement #SS 00 08 0405
Arizona Department of Education 1535 W. Jefferson Street Phoenix AZ 85007
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