Arizona_Department_of_Administration_COI.pdf

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07007 C er ti fi ca te N o

CERTIFICATE OF LIABILITY INSURANCE

DATE(MM/DD/YYYY)

02/21/2025

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.

PRODUCER

Aon Risk Services, Inc of Florida 701 Brickell Avenue Suite 3200 Miami FL 33131 USA

PHONE

(A/C. No. Ext):

E-MAIL

ADDRESS:

INSURER(S) AFFORDING COVERAGE NAIC #

(866) 283-7122

INSURED 19682Hartford Fire Insurance Co.INSURER A:

27120Trumbull Insurance CompanyINSURER B:

29459Twin City Fire Insurance CompanyINSURER C:

INSURER D:

INSURER E:

INSURER F:

FAX

(A/C. No.): (800) 363-0105

CONTACT

NAME:

Nextgen Communications, Inc 68 South Service Road Suite 230 Melville NY 11747 USA

COVERAGES CERTIFICATE NUMBER: 570110951683 REVISION NUMBER:

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. Limits shown are as requested

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

(MM/DD/YYYY)

SUBR

WVD

INSR

LTR

ADDL

INSD POLICY NUMBER TYPE OF INSURANCE LIMITS

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

POLICY LOC

EACH OCCURRENCE

DAMAGE TO RENTED

PREMISES (Ea occurrence)

MED EXP (Any one person)

PERSONAL & ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGG

X

X

X

GEN'L AGGREGATE LIMIT APPLIES PER:

$1,000,000

$1,000,000

$10,000

$1,000,000

$2,000,000

$2,000,000

A 04/30/2024 04/30/202513UENBB0TRL

PRO-

JECT

OTHER:

AUTOMOBILE LIABILITY

ANY AUTO

OWNED

AUTOS ONLY

SCHEDULED

AUTOS

HIRED AUTOS

ONLY

NON-OWNED

AUTOS ONLY

BODILY INJURY ( Per person)

PROPERTY DAMAGE

(Per accident)

X BODILY INJURY (Per accident)

$1,000,000B 04/30/2024 04/30/2025 COMBINED SINGLE LIMIT

(Ea accident)

13 UEN GC4839

EXCESS LIAB

OCCUR

CLAIMS-MADE AGGREGATE

EACH OCCURRENCE

DED

UMBRELLA LIAB

RETENTION

E.L. DISEASE-EA EMPLOYEE

E.L. DISEASE-POLICY LIMIT

E.L. EACH ACCIDENT $1,000,000

X OTH-

ER

PER STATUTEC 11/04/2024 11/04/2025

$1,000,000

Y / N

(Mandatory in NH)

ANY PROPRIETOR / PARTNER / EXECUTIVE

OFFICER/MEMBER EXCLUDED? N / AN

WORKERS COMPENSATION AND

EMPLOYERS' LIABILITY

If yes, describe under DESCRIPTION OF OPERATIONS below

$1,000,000

13WBAE2F7R

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

CANCELLATIONCERTIFICATE HOLDER

AUTHORIZED REPRESENTATIVEArizona Department of Administration State Procurement Office Attn: Michael Hillebrand 100 North 15th Avenue Suite 402 Phoenix AZ 85007 USA

ACORD 25 (2016/03)

©1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE

EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE

POLICY PROVISIONS.

Hartford Underwriting Companies By State

AGENCY CUSTOMER ID:

ADDITIONAL REMARKS SCHEDULE

LOC #:

ADDITIONAL REMARKS

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance

EFFECTIVE DATE:

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSUREDAGENCY

See Certificate Number:

See Certificate Number:

Aon Risk Services, Inc of Florida

570000090983

570110951683

570110951683

Page _ of _

Nextgen Communications, Inc

Policy Number: 13WB AE2F7R Policy Term: 11/04/2024 - 11/04/2025

Hartford Insurance Company of the Midwest - AL, GA Hartford Insurance Company of Illinois - AZ Sentinel Insurance Company Ltd. - CA, MS, VA Property and Casualty Insurance Company of Hartford - CO Twin City Fire Insurance Company CT, D.C., FL, ID, IN, IA, KS, KY, MI, MS, MT, NE, NV, NH, NJ, NM, OH, OK, OR, RI, SC, SD, TN, UT, WA, WV, WI

Property and Casualty Insurance Company of Hartford - IL, MD Hartford Underwriters Insurance Company - MA Hartford Fire Insurance Company - TX. MO Trumbull Insurance Company - NY Nutmeg Insurance Company - NC, PA Hartford Accident and Indemnity Company - VT

ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD