9-2-2022_COI_GL.pdf
PDF 33 KB Posted
- Attached to
- Master Agreement AZ|CTR056868
- Contract number
- CTR056868
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance issued on 12/9/2021, involving The Houston Taylor Group LLC (producer) and Spiral Creative Services LLC (insured), with Twin City Fire Insurance Co as the primary insurer. The certificate is issued for a contract with the State of Arizona, specifically the Arizona Department of Administration's State Procurement Office, located in Phoenix, AZ.
The insurance certificate covers a contract (No. CTR056868) with a policy period from 9/2/2021 to 9/2/2022. The commercial general liability policy includes coverage limits of $1,000,000 per occurrence, $2,000,000 general aggregate, $1,000,000 personal and advertising injury, and $10,000 for medical expenses. The State of Arizona and its departments, agencies, boards, commissions, and universities are named as additional insured, with a waiver of subrogation in favor of the general liability policy. The certificate ensures insurance coverage for the contractor's activities performed on behalf of the state.
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Text version
12/9/2021
The Houston Taylor Group LLC P.O. Box 30407 Phoenix AZ 85046
Paul Houston (602)234-0405 (602)493-1699 phouston@houston-taylor.com
Spiral Creative Services LLC 4521 E. Ford Avenue Gilbert AZ 85234
Twin City Fire Insurance Co 29459
A x x x
X Y
59SBAIR7102 9/2/2021 9/2/2022 1,000,000
1,000,000
10,000 1,000,000 2,000,000 2,000,000
The State of Arizona Arizona Department of Administration State Procurement Office 100 N 15th Ave Ste 305 Phoenix, AZ 85007
CERTIFICATE HOLDER
© 1988-2010 ACORD CORPORATION. All rights reserved.ACORD 25 (2010/05)
AUTHORIZED REPRESENTATIVE
CANCELLATION
DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE
LOCJECT
PRO-
POLICY
GEN'L AGGREGATE LIMIT APPLIES PER:
OCCURCLAIMS-MADE
COMMERCIAL GENERAL LIABILITY
GENERAL LIABILITY
PREMISES (Ea occurrence) $
DAMAGE TO RENTED
EACH OCCURRENCE $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
$RETENTIONDED
CLAIMS-MADE
OCCUR
AGGREGATE $
EACH OCCURRENCE $UMBRELLA LIAB
EXCESS LIAB
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Contract No. CTR056868 The State of Arizona, it departments, agencies, boards, commissions, universities and its officers, agents and employees shall be named as additional insured with respect to liability arising out of the activities performed by or on behalf of the contractor, Waiver of subrogation in favor of the GL
INSR
LTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY) LIMITS
WC STATU-
TORY LIMITS
OTH-
ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
ANY PROPRIETOR/PARTNER/EXECUTIVE
If yes, describe under DESCRIPTION OF OPERATIONS below
(Mandatory in NH)
OFFICER/MEMBER EXCLUDED?
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
HIRED AUTOS
NON-OWNED
AUTOS AUTOS
AUTOS
COMBINED SINGLE LIMIT
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE $
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.
INSR
ADDL
WVD
SUBR
N / A
(Ea accident)
(Per accident)
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.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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).
The ACORD name and logo are registered marks of ACORD
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSURED
PHONE
(A/C, No, Ext):
PRODUCER
ADDRESS:
FAX
(A/C, No):
CONTACT
NAME:
NAIC #
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
INSURER(S) AFFORDING 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.
INS025 (201005).01
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