ArizonaDepartmentofChildSafety15924136_Redacted.pdf

PDF 56 KB Posted

Attached to
Master Agreement AZ|CTR071441
Contract number
CTR071441
Issued by
Arizona

About this file

This document is an ACORD Certificate of Liability Insurance for All About Kids, issued by Stinson & Associates as the producer, with coverage from Princeton Excess and Surplus Lines Company and Travelers. The certificate is designated for the Arizona Department of Child Safety, located in Phoenix, Arizona, as the certificate holder.

The insurance policy provides commercial general liability coverage with policy number G8A3GL0000013-01, effective from 11/15/2024 to 11/15/2025, with limits of $1,000,000 per occurrence and $3,000,000 aggregate. Additionally, the policy includes professional liability coverage with a $1,000,000 limit per claim and a $3,000,000 aggregate, along with a $500,000 sexual abuse mandate. Workers' compensation coverage is also included under policy number OG140978, with statutory limits of $1,000,000 for each accident, disease per employee, and disease policy limit, effective from 07/27/2024 to 07/27/2025.

View the file

Other files

File Type Posted
Congregate_Care_Services_Amendment_5.pdf PDF
Congregate_Care_Services_SOW_Amendment_2.pdf PDF
Contract_Amendment_1.pdf PDF
Contract_Amendment_4.pdf PDF
Exhibit VII Clothing Allowance Ledger.pdf PDF
Exhibit VIII Personal Allowance Ledger.pdf PDF
Exhibit XIV Provider Census Report.xlsm XLSM spreadsheet
Exhibit XIX ADJC Census Report.doc DOC document
Exhibit XV Discharge Summary.pdf PDF
Michael_Noyd_All_about_Kids_COI_Redacted.pdf PDF
Congregate_Care_Services_SOW_Amendment_1.pdf PDF
Congregate_Care_Services_SOW_Amendment_3.pdf PDF
Exhibit IV - Medication Error Report.pdf PDF
Exhibit VI Fees Log.pdf PDF
Exhibit X Returned Allowances Form.xlsx XLSX spreadsheet
Exhibit XVI Facility Modification Request.pdf PDF
Exhibit XX ADJC-5002 ADJC Service Providers Protocol ADJC.doc DOC document
2-Attachment_3-D_Boycott_of_Israel_Disclosure_Redacted.pdf PDF
Congregate_Care_Services_Amendment.pdf PDF
Contract_Amendment_3.pdf PDF
Exhibit IX Clothing and Property Inventory.pdf PDF
Exhibit V - Blood Sugar Log.pdf PDF
Exhibit XI One on One Supervision.pdf PDF
Exhibit XVII Quarterly Report.xlsm XLSM spreadsheet
Offer_and_Acceptance_Redacted.pdf PDF
2-Attachment_3-E_Forced_Labor_of_Ethnic_Uyghurs_Ban__2__Redacted.pdf PDF
20250709111038414__2__Redacted.pdf PDF
Attachment__ADCS_Business_Associate_Agreement_with_HITECH.pdf PDF
Congregate_Care_Services_SOW_2024_with_Terms_and_Conditions.pdf PDF
Directions_to_Procurement_File.docx DOCX document
Exhibit CS0-1015A.pdf PDF
Exhibit I - DCS 06-01 Limited English Proficiency.pdf PDF
Exhibit II - Personalized Service Plan.pdf PDF
Exhibit III - Medication Log.pdf PDF
Exhibit XII Bed Hold.pdf PDF
Exhibit XVIII ADJC Monthly Attendance Report.doc DOC document
Exhibit XXII ADJC Residential Services Invoice.docx DOCX document
Show all 37

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)

© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

11/21/2024

Stinson & Associates

3105 S Price Rd

Chandler AZ 85248

Derrick Stinson

(480) 855-3216 derrick@stinsonandassociates.net

All About Kids

PRINCETON EXCESS AND SURPLUS LINES COMPA 10786J

TRAVELERS 3548

A

Y Y G8A3GL0000013-01 11/15/2024 11/15/2025

1,000,000

50,000

1,000,000

3,000,000

3,000,000

B Y Y OG140978 07/27/2024 07/27/2025

1,000,000

1,000,000

1,000,000

A

PROFESSIONAL LIABILITY

G8A3GL0000013-01 11/15/2024 11/15/2025

EACH CLAIM 1,000,000

AGGRAGATE 3,000,000

SEXUAL ABUSE MOL 500,000

Arizona Department of Child Safety

3003 N Central Avenue Suite 2000

Mail Drop 1222

Phoenix AZ 85012

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