8-Attachment 6_Supplement_Insurance.pdf

PDF 595 KB Posted

Attached to
Master Agreement AZ|CTR059872
Contract number
CTR059872
Issued by
Arizona

About this file

This document is an ACORD 25 Certificate of Liability Insurance dated 09/28/2021 for Sentinel Technologies, Inc., located in Downers Grove, IL. The insurance is provided by multiple insurers including The Phoenix Insurance Company, Travelers Property Casualty Company of America, and The Travelers Indemnity Company. The certificate was issued by GCG Risk Management Consultants LLC/Alper Services from Chicago, IL.

The certificate outlines various insurance coverages for Sentinel Technologies, including Commercial General Liability with a $1,000,000 limit and Sexual Abuse/Molestation coverage, Automobile Liability with a $1,000,000 combined single limit, Umbrella Liability with a $10,000,000 aggregate, Workers' Compensation, and Tech E&O/Cyber Liability with a $10,000,000 limit. The policies are effective from 09/29/2021 to 09/29/2022, with various policy numbers and specific deductibles. The document serves as a verification of insurance coverage, demonstrating the company's comprehensive insurance protections across multiple risk categories.

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Text version

09/28/2021

GCG Risk Management Consultants LLC/Alper Services 410 North Michigan Avenue 12th Floor Chicago IL 60611

(312) 642-1000 Certs@alperservices.com

Sentinel Technologies, Inc.

2550 Warrenville Road

Downers Grove IL 60515

The Phoenix Insurance Company 25623 Travelers Property Casualty Company of America 25674 The Travelers Indemnity Company 25658

21-22

A Sexual Abuse/Molestation Limit $1,000,000/Ded $25,000 630-6S529605 09/29/2021 09/29/2022

1,000,000 300,000 10,000 1,000,000 2,000,000 2,000,000

A

Comp: 1000 Coll:1000

630-6S529605 09/29/2021 09/29/2022

1,000,000

B 10,000

CUP-6S602272 09/29/2021 09/29/2022

10,000,000 10,000,000

C N UB-6S53151A 09/29/2021 09/29/2022

1,000,000 1,000,000 1,000,000

B Tech E&O/Cyber Liability

ZPL-16P12767 09/29/2021 09/29/2022 Limit 10,000,000

SPECIMEN Verification of Insurance Coverage

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

E-MAIL

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

SAMPLE

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