ACCEPTED ANY_ALL GL,AL 09.01.25-09.01.26.pdf
PDF 2 MB Posted
- Attached to
- Master Agreement AZ|CTR070573
- Contract number
- CTR070573
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance and Businessowners Liability Enhancements Endorsement for Specialized Office Systems, Inc., issued by ACE Property and Casualty Insurance Company through HBW Insurance Group Inc. The primary certificate holder is the Arizona Department of Transportation, located in Phoenix, Arizona. The insurance policy covers the period from September 1, 2025 to September 1, 2026.
The insurance provides comprehensive business liability coverage with a $2,000,000 general aggregate limit, $1,000,000 per occurrence limit, and includes additional protections such as Employment Practices Liability Insurance (EPLI) with a $250,000 limit. The policy covers property/special risks, including $3,003,223 in business personal property with a $2,500 deductible and business income/extra expense coverage. The Arizona Department of Transportation is listed as an additional insured, with the policy written on a primary and non-contributory basis and including a waiver of subrogation. The endorsement modifies various aspects of the businessowners coverage, including definitions of insured parties, coverage territories, and specific liability conditions.
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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
8/12/2025
HBW Insurance Group Inc
8865 Stanford Blvd
Suite 202
Columbia MD 21045
Howard Weisberg
(410) 744-4313
Certificates@hbwins.com
Specialized Office Systems, Inc
19235 N Cave Creek Rd
Phoenix AZ 85024
ACE PROP & CAS INS CO 20699C
A Y Y D98250487 09/01/2025 09/01/2026
2,000,000
1,000,000
5,000
2,000,000
4,000,000
4,000,000
EPLI 250,000
A D98250487 09/01/2025 09/01/2026
2,000,000
A Property/Special RC.
D98250487 09/01/2025 09/01/2026
Business Personal Property $3,003,223
Deductible $2,500
Business Income/Extra ExpenseIncluded ASL 12 Mnts
RE: Insurance Verification.
Arizona Department of Transportation is listed as additional insured as required by written contract or agreement.
Above mentioned general liability policy is written on a primary and non-contributory basis.
Waiver of subrogation is granted in favor of above listed parties.
Arizona Department of Transportation
1309 North 21st Avenue
Phoenix AZ 85009
Cindy Lewis GL-AL Only
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