Arizona_Department_of_Administration_6306313_Allied_Universal_Topco__LLC__1_.pdf

PDF 2 MB Posted

Attached to
Master Agreement AZ|CTR068383
Contract number
CTR068383
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance for Allied Universal Topco, LLC, issued by multiple insurance carriers including Indian Harbor Insurance Company, Greenwich Insurance Company, XL Insurance America, XL Specialty Insurance Company, and Indemnity Insurance Company of North America. The certificate is issued for the State of Arizona, specifically the Arizona Department of Administration's State Procurement Office, and covers the period from 01/01/2025 to 01/01/2026.

The insurance coverage includes Commercial General Liability with a $30,000,000 aggregate limit, Automobile Liability with a $5,000,000 combined single limit, Umbrella/Excess Liability with a $10,000,000 limit, and Workers' Compensation with standard statutory limits. The policy includes additional insured provisions for the State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees. The coverage is primary and non-contributory where required by written contract, with a self-insured retention (SIR) of $1,750,000. The policy also includes waivers of subrogation and contractual liability provisions, ensuring comprehensive protection for Allied Universal Topco, LLC and its contractual obligations.

View the file

Other files

Show all 11

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

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

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)

© 1988-2016 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

E 01/01/2025

01/01/2026

X

C

43575

55,000,000

XL Specialty Insurance Company

RWR300120409 (WI)

SIR $1,750,000

36940

RES943799405

10,000,000

A

D

2,000,000

01/01/2026 X

XL Insurance America

Professional Liability

01/01/2025

CN118025105-ALL-STAND-25-26

1,000,000

22322

Marsh | U.S. Operations

01/01/2026

CLE-006306313-45

01/01/2025

X

55,000,000

12/24/2024

X

X

01/01/2026

2,000,000

01/01/2026

30,000,000

X

Aggregate

X

1,000,000 1,000,000

B

Philadelphia.Certs@marsh.com

01/01/2026

01/01/2025

01/01/2025

Auto Liability, and Workers' Comp

24554

RAD943781808

Claim

01/01/2025

RWD300120309 (AOS)

RWE943548209 (CA, OH)

XSM G72500027 005

SIR: $1,750,000

30,000,000 where required by written contract. Liability coverage shall be primary and non-contributory where required by written contract. Waiver of subrogation is applicable where required by written contract.

RE: BPM004732.

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as additional insured (except workers’ compensation and crime)

Indemnity Insurance Company of North America (See Attached for Additional Named Insureds)

Allied Universal Topco, LLC

Conshohocken, PA 19428 161 Washington Street, Suite 600

30,000,000

Indian Harbor Insurance Company

X

30 South 17th Street

MARSH USA LLC

Attn: Philadelphia.certs@marsh.com / Fax: (212) 948-0360 Philadelphia, PA 19103

RES943799405

Greenwich Insurance Company

N

100 N 15th Ave., Suite 402

Phoenix, AZ 85007

Arizona Department of Administration

State Procurement Office

01/01/2025

C

37885

5,000,000

866-966-4664

CONTRACTUAL LIABILITY

X

Excess of General Liability, A

10,000,000

01/01/2026

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: FORM TITLE:

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE Page of

AGENCY CUSTOMER ID:

LOC #:

AGENCY

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSURED

EFFECTIVE DATE:

MARSH USA LLC�

Policy No.: CPO13303734 �

SIR: $1,000,000�

Employers Liability Disease-Each Employee: $1,000,000 �

Limit:� Effective Dates: 1/1/2025 - 1/1/2026�

Employers Liability Disease-Policy Limit: $1,000,000 � Employers Liability Each Accident: $1,000,000 �

Excess Workers' Compensation�

Policy No.: RWE943548209�

Employee Theft or Dishonesty: $2,000,000�

Insurer: National Union Fire Insurance Co. �

Effective Dates: 01/01/2024 - 01/01/2026�

Contractors Pollution Liability�

Insurer: Commerce and Industry Insurance Company�

Philadelphia

Certificate of Liability Insurance

Clients' Property: $2,000,000�

Effective Dates: 08/15/2024 - 08/15/2025�

The General Liability and Professional Liability policies evidenced above share in the limits shown. The limits do not apply separately to the individual coverages�

Limit: $5,000,000 �

Crime �

Deductible: $750,000�

Insurer: XL Specialty Insurance Company �

Limit:�

Policy No.: 01-468-22-46�

(See Attached for Additional Named Insureds)� Allied Universal Topco, LLC�

161 Washington Street, Suite 600�

CN118025105

Conshohocken, PA 19428

Deductible: $250,000�

File details come from the government source that posted it. Updated .