Arizona-Department-_Vertical-Screen_24-25-GL-AU-UM-_5-17-2024_946306227_1.pdf
PDF 103 KB Posted
- Attached to
- Master Agreement AZ|CTR061120
- Contract number
- CTR061120
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance for Vertical Screen, Inc., issued by Graham Company, a Marsh & McLennan Agency, LLC company. The certificate involves multiple insurers including Travelers Casualty & Surety Co. America, Chubb Indemnity Insurance Co., Federal Insurance Company, Chubb National Insurance Company, and Evanston Insurance Company. The certificate holder is the Arizona Department of Administration, State of Arizona State Procurement Office, located in Phoenix, Arizona.
The insurance coverage spans multiple policy types including Commercial General Liability, Automobile Liability, Umbrella Liability, Workers Compensation, Crime, Cyber, and Professional Liability. The policies are effective from 5/20/2024 to 5/20/2025, with various coverage limits ranging from $1,000,000 to $15,000,000. The contract is referenced by number CTR061120, and the State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are listed as additional insureds on the General Liability, Auto Liability, and Umbrella Liability policies. The document includes provisions for waiver of subrogation for work performed under the contract, subject to state law.
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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
5/17/2024
Graham Company, a Marsh & McLennan Agency, LLC company One Penn Square West Philadelphia PA 19102
Joseph Holden 215-567-6300 215-405-2694
Holden_Unit@grahamco.com
Travelers Casualty & Surety Co. America 31194 VERTSCR-01 Chubb Indemnity Insurance Co. 12777
Vertical Screen, Inc.
251 Veterans Way Warminster, PA 18974
Federal Insurance Company 20281 Chubb National Insurance Company 10052 Evanston Insurance Company 35378
946306227
B X 1,000,000 X 1,000,000
15,000
1,000,000
2,000,000 X
D97229077 5/20/2024 5/20/2025
2,000,000
C 1,000,000
X 7362-81-20 5/20/2024 5/20/2025
C X X 15,000,0007819-65-19 5/20/2024 5/20/2025
15,000,000
D X(25) 7183-33-94 5/20/2024 5/20/2025
1,000,000
1,000,000
1,000,000 A E E
Crime Cyber Professional Liability
105616465
MKLV2PEO001747
MKLV2PEO001747
5/20/2024 5/20/2024 5/20/2024
5/20/2025 5/20/2025 5/20/2025
Limit Limit
$10,000,000 5,000,000
Project#/ Reference: Contract Number: CTR061120 Contract Number: CTR061120
State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are additional insureds on the above General Liability, Auto Liability and Umbrella Liability Policies if required by written contract.
Prior to loss, and if required by written contract, Waiver of Subrogation is provided on General Liability, Auto Liability, Umbrella Liability and Workers Compensation Policies for work performed under contract if permissible by state law.
Arizona Department of Administration State of Arizona State Procurement Office 100 N 15th Ave, Suite 402 Phoenix AZ 85007
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