Arizona_Retirement_System_24604_.pdf
PDF 46 KB Posted
- Attached to
- Master Agreement AZ|CTR061729
- Contract number
- CTR061729
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued on 07/31/2024 for Foley & Lardner LLP, with insurance coverage provided by Great Northern Insurance Company and Federal Insurance Company. The certificate is specifically related to Contract CTR061729 for Investment Legal Consulting Services with the Arizona Retirement System. The certificate holder is the State of Arizona, including its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees.
The insurance coverage includes Commercial General Liability with a $1,000,000 each occurrence limit, Automobile Liability with a $1,000,000 combined single limit, and Workers Compensation with statutory coverage and $1,000,000 limits for each accident and disease. The policy period runs from 08/01/2024 to 08/01/2025. The Arizona Retirement System is added as an Additional Insured for General and Automobile Liability, with the policies being primary and non-contributory. A waiver of subrogation is included for General Liability, Auto Liability, and Workers Compensation as required by the written contract.
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Text version
H o ld e r
Id e n ti fi e r
77777 77707 07070 00777 63616 06555 33307 62435 66712 65555 07763 11474 06241 33071 66374 60562 33110 74060 45772 76556 20757 63371 77066 76507 00533 75025 72322 07545 11706 72754 64076 25412 41137 02000 77727 25202 57731 10777 77770 70007 07007
66666 66606 06060 00626 06466 20444 62006 22204 40246 20062 06222 00404 22422 02062 22204 06006 02200 62220 24040 06000 20600 20062 62040 02006 22220 42402 40022 06220 00406 00620 02062 22224 04226 02020 66646 06224 06644 40666 66660 60006 06006
C e rt if ic a te
N o
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
07/31/2024
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 Central, Inc.
Chicago IL Office 200 East Randolph Chicago IL 60601 USA
PHONE
(A/C. No. Ext):
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
(312) 381-1000
INSURED 20303Great Northern Insurance Co.INSURER A:
20281Federal Insurance CompanyINSURER B:
INSURER C:
INSURER D:
INSURER E:
INSURER F:
FAX
(A/C. No.):
(312) 381-7007
CONTACT
NAME:
Foley & Lardner LLP.
777 East Wisconsin Avenue Milwaukee WI 53202-5367 USA
COVERAGES CERTIFICATE NUMBER: 570107422498 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
$25,000
$1,000,000
$2,000,000
Included
A 08/01/2024 08/01/2025
General Liability 35964843
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 X
BODILY INJURY (Per accident)
$1,000,000A 08/01/2024 08/01/2025
Auto
COMBINED SINGLE LIMIT
(Ea accident)
7356-92-37
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 STATUTEB 08/01/2024 08/01/2025
Workers Compensation
$1,000,000
Y / N
(Mandatory in NH)
ANY PROPRIETOR / PARTNER / EXECUTIVE
OFFICER/MEMBER EXCLUDED? N / AY
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
If yes, describe under DESCRIPTION OF OPERATIONS below
$1,000,000
2571750990
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: Contract CTR061729 for Investment Legal Consulting Services Arizona Retirement System, The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are added as Additional Insured as respects the General Liability and Automobile Liability as required per written contract. General Liability and Auto Liability are primary and non-contributory to other insurance available to the certificate holder, but only to the extent required by written contract with the insured. A waiver of subrogation in favor of Additional Insured as respect the General Liability, Auto Liability and Workers Compensation pursuant to a written contract.
CANCELLATIONCERTIFICATE HOLDER
AUTHORIZED REPRESENTATIVEArizona Retirement System 3300 N. Central Avenue 14th Floor Phoenix, AZ 85012 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.
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