ACORD_Form_20241023-164957.pdf
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- Attached to
- AZ|CTR070563
- Contract number
- CTR070563
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by Chastain & Associates Insurance on 10/23/2024, covering MediaLab Parent LLC, MediaLab Intermediate LLC, MediaLab Buyer LLC, and MediaLab Solutions LLC and LabCE, LLC. The insurance is provided through multiple insurers, including Philadelphia Insurance Companies, Allmerica Financial Benefit, and Certain Underwriters at Lloyd's, London. The certificate holder is the Arizona Department of Health Services, located in Phoenix, Arizona.
The insurance certificate provides comprehensive coverage across multiple policy types, including Commercial General Liability, Automobile Liability, Umbrella Liability, Workers Compensation, and Commercial Cyber and Privacy Liability. The policies are effective from 12/30/2023 to 12/30/2024, with some cyber coverage extending to 10/21/2025. Coverage limits vary by policy type, with general liability set at $2,000,000 per occurrence, a $3,000,000 umbrella liability, and specialized cyber and media liability coverage of $5,000,000 each. The policies cover various aspects of business operations, including general aggregate, personal injury, and network security risks.
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Text version
10/23/2024
Chastain & Associates Ins P.O. Box 1908
Athens GA 30603
Meggan Autry
(706) 543-2575 (706) 543-4847 mautry@chastain-assoc.com
MediaLab Parent LLC, MediaLab Intermediate LLC, MediaLab Buyer LLC, and MediaLab Solutions LLC and LabCE, LLC dba MediaLab 1745 N Brown Rd Suite 300 Lawrenceville GA 30043
Philadelphia Insurance Companies 23850 Allmerica Financial Benefit 41840 Certain Underwriters at Lloyd's, London
CL24102345036
A Y PHPK2632752 12/30/2023 12/30/2024
2,000,000 100,000 5,000 2,000,000 4,000,000 4,000,000
A Y PHPK2632752 12/30/2023 12/30/2024
2,000,000
A 10,000
Y PHUB892424 12/30/2023 12/30/2024
3,000,000 3,000,000
B Y W2AJ61361900 12/30/2023 12/30/2024
1,000,000 1,000,000 1,000,000
C Commercial Cyber and Privacy Liability
Y CANCT0010000 10/21/2024 10/21/2025
Media Liability $5,000,000 Network Security and Privacy Liab
$5,000,000
Arizona Department of Health Services 150 North 18th Ave
Phoenix AZ 85007
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
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