ADOA__1_.pdf
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- Attached to
- Master Agreement AZ|CTR056870
- Contract number
- CTR056870
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance dated 11/18/2024 for Garvey-Hansen, LLC, with Strategic Market Solutions (dba: Commit Agency) as the insured. The certificate involves multiple insurance carriers, including Central Mutual Insurance Company, HISCOX Ins, Houston Casualty, and Technology Ins. The certificate holder is the Arizona Department of Administration (ADOA), State Procurement Office, located in Phoenix, Arizona.
The insurance coverage includes Commercial General Liability, Automobile Liability, Umbrella Liability, Workers Compensation, Professional Liability, and Cyber Liability. Key policy limits include $2,000,000 for general liability, $4,000,000 for umbrella liability, $1,000,000 for workers compensation, $5,000,000 for professional liability, and $2,000,000 for cyber liability. The policies are effective from various dates in early 2024 to early 2025, with primary and non-contributory coverage and a 30-day cancellation notice. The certificate includes additional insured status when required by written contract and includes a waiver of subrogation for general liability, auto liability, and workers compensation.
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Text version
11/18/2024
Garvey-Hansen, LLC
PO Box 20635
Fountain Hills AZ 85269
Mike Hansen
(480) 836-1468 (480) 836-4360 shanna@g-hins.com
Strategic Market Solutions dba: Commit Agency
58 W Buffalo St #200
Chandler, AZ 85225
Central Mutual Insurance Company 20230
HISCOX INs 10200
Houston Casualty 42374
Technology Ins 39071
A X
X
X
X X CLP 9789081 02/15/2024 02/15/2025
2,000,000
300,000
5,000
2,000,000
3,000,000
3,000,000
A
X X
X X CLP 9789081 02/15/2024 02/15/2025
2,000,000
A x
CXS 9789081 02/20/2024 02/20/2025
4,000,000
4,000,000
D Y X TWC4349317 01/20/2024 01/20/2025
1,000,000
1,000,000
1,000,000
B Professional Liability P100.708.862.8 10/15/2024 10/15/2025 $5,000,000 occ $5,000,000 agg
C Cyber Liability H24NGP210800-03 09/22/2024 09/22/2025 $2,000,000 occ $2,000,000 agg
Certificate Holder is included as additional insured when required by a written contract.
Insurance provided above is Primary and Non-Contributory. / 30 day notice of cancellation
Waiver of Subrogation included in regards to General Liability, Auto Liability and Workers Compensation
ADOA
State Procurement Office
State of Arizona
1400 W Washington, 3rd Floor
Phoenix, AZ 85007
<SF>
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSR WVD
DATE (MM/DD/YYYY)
PRODUCER CONTACT
NAME:
FAXPHONE
(A/C, No):(A/C, No, Ext):
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER
POLICY EFF POLICY EXP
TYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)
GENERAL LIABILITY
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $
DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY $PREMISES (Ea occurrence)
CLAIMS-MADE OCCUR MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
$PRO-
POLICY LOCJECT
COMBINED SINGLE LIMIT
$(Ea accident)
BODILY INJURY (Per person) $ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS
HIRED AUTOS
NON-OWNED PROPERTY DAMAGE $
AUTOS (Per accident)
OCCUR EACH OCCURRENCE $
CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WC STATU- OTH-
TORY LIMITS ER
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below
INSURER(S) AFFORDING COVERAGE NAIC #
Y / N
N / A (Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
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.
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).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
© 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORDACORD 25 (2010/05)
CERTIFICATE OF LIABILITY INSURANCE
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