3-Attachment 7 Letter of Insurability - AMI_BPM006719_ 2.19.2025.pdf

PDF 196 KB Posted

Attached to
Master Agreement AZ|CTR077085
Contract number
CTR077085
Issued by
Arizona

About this file

This document is a Letter of Insurability from Arthur J. Gallagher & Co., addressed to the Arizona Department of Administration's State Procurement Office, detailing insurance coverage for AMI Expeditionary Healthcare, LLC and AMI Expeditionary Healthcare (USA) LLC, located in Reston, Virginia.

The letter outlines multiple insurance policies effective between March 2024 and July 2025, including General Liability (Markel - Evanston Insurance Company), Business Automobile Liability (Republic-Vanguard Insurance Company), Workers Compensation and Employers Liability (Liberty Mutual), Professional Liability and General Liability (Ascot), and Property insurance (RSUI - Covington Specialty Insurance Company). The policies provide varying coverage limits, with notable amounts including a $2,000,000 General Aggregate, $1,000,000 Each Occurrence for General Liability, and a $1,000,000 Combined Single Limit for Automobile Liability. The policies will offer Additional Insured status and include a Waiver of Subrogation, with the insurance designated as primary and noncontributory to coverage placed by the State of Arizona.

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Text version

1 © 2025 Arthur J. Gallagher & Co.

Arizona Department of Administration State Procurement Office 1802 W. Jackson, #100 Phoenix, AZ 85007 02/19/2025

Re: Letter of Insurability – Attachment – Supplement Insurance

This Letter of Insurability serves as confirmation of the current in-force insurance coverage Arthur J. Gallagher places and administers for AMI Expeditionary Healthcare, LLC:

Named Insured: AMI Expeditionary Healthcare LLC & AMI Expeditionary Healthcare (USA) LLC Address: 12030 Sunrise Valley Drive, Suite 400, Reston, Virginia 20192

Coverage: General Liability Policy Term: 3/31/2024 – 3/31/2025 Carrier: Markel – Evanston Insurance Company Policy Number: 3AA769432 Limits of Insurance: General Aggregate: $2,000,000 Each Occurrence: $1,000,000 Damages to Rented Premises: $100,000 Medical Expense Limit: $5,000

Coverage: Business Automobile Liability Policy Term: 7/31/2024 – 7/31/2025 Carrier: Republic-Vanguard Insurance Company Policy Number: CNO6290889-00 Limits of Insurance: Combined Single Limit $1,000,000

Coverage: Workers Compensation and Employers Liability Policy Term: 4/20/2024 – 4/20/2025 Carrier: Liberty Mutual Policy Number: WC5-33S-B23T70-014 Limits of Insurance: Workers Compensation: Statutory Employers Liability:

Each Accident: $1,000,000 Disease – Each Employee: $1,000,000 Disease – Policy Limit: $1,000,000

Coverage: Professional Liability and General Liability Policy Term: 3/31/2024 – 3/31/2025 Carrier: Ascot Policy Number: UA24RN461W4X Limits of Insurance: Professional Liability - Each Loss: $1,000,000

Professional Liability - Annual Aggregate: $5,000,000 General Liability - Each Loss: $3,000,000 General Liability - Annual Aggregate: $5,000,000 Affirmative SAM coverage Sub-limit: $1,000,000

Coverage: Property Policy Term: 3/31/2024 – 3/31/2025 Carrier: RSUI - Covington Specialty Insurance Company Policy Number: VBA973610 00 Limits of Insurance: Building, BPP, BI: Per Occurrence: $15,000

2 © 2025 Arthur J. Gallagher & Co.

The above policies will provide Additional Insured status for General Liability and Automobile Liability and a Waiver of Subrogation for General Liability, Automobile Liability, and Workers’ Compensation. This insurance will be primary and noncontributory to coverage placed by the State of Arizona.

Please let me know if you have any questions or require additional information.

Best Regards, Brandon Hensley

Brandon Hensley, ARM Arthur J. Gallagher Brandon_Hensley@ajg.com

File details come from the government source that posted it. Updated .