Attachment_07_Certificate_of_Insurance_Akorbi.pdf
PDF 106 KB Posted
- Solicitation number
- BPM005633
- Issued by
- Arizona
About this file
This is a Certificate of Liability Insurance issued to Elahi Enterprises Inc., a Dallas-based company, by multiple insurers through producer Roach Howard Smith & Barton on behalf of the Arizona Department of Administration State Procurement Office. The certificate documents comprehensive insurance coverage effective August 27, 2023, through August 27, 2024, including Commercial General Liability with limits of $1,000,000 per occurrence and $2,000,000 general aggregate, Automobile Liability with $1,000,000 combined single limits, Workers Compensation and Employers' Liability, and an Excess Umbrella Liability policy with $10,000,000 coverage. The policies are issued by Travelers Property Casualty America, Travelers Indemnity Company of America, Standard Fire Insurance Company, Lloyds of London, and Federal Insurance Company, with the umbrella policy specifically issued by Federal Insurance Company as follow-form coverage excess over the underlying general liability, automobile liability, and employer's liability policies.
The certificate confirms that all general liability and technology errors and omissions policies include blanket automatic additional insured endorsements providing additional insured status to any person or organization the Named Insured is contractually required to add. Additionally, the general and auto liability and workers compensation policies contain blanket automatic waiver of subrogation endorsements when the insured has agreed to waive such rights through prior written contract or agreement. The certificate holder has no owned vehicles, and the company maintains Errors and Omissions coverage with primary and excess limits of $5,000,000 each, as well as Employee Theft coverage with $10,000,000 limits. All policies are subject to their respective terms, exclusions, and conditions, and the certificate is issued for informational purposes only without conferring rights upon the certificate holder independent of policy endorsements.
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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
10/17/2023
Roach Howard Smith & Barton 8750 N. Central Expressway, Suite 500 Dallas TX 75231
Denise Bump 972-231-1300 972-231-1368 dbump@rhsb.com
Travelers Prop Cas America 25674 ELAHENT-02 Travelers Indemnity Co America 25666
Elahi Enterprises Inc.
2901 Dallas Parkway, Suite 125 Plano TX 75093
Standard Fire Ins Company 19070 Lloyds of London 99997 Federal Ins Co 20281
1389561195
A 1,000,000 X 1,000,000
15,000
1,000,000
2,000,000 X
ZLP51N7172023 8/27/2023 8/27/2024
2,000,000
B 1,000,000
X X
BA8W47053123 8/27/2023 8/27/2024
A X X 10,000,000CUP8W49172323I5 8/27/2023 8/27/2024
10,000,000
C XUB8W47590723I5G 8/27/2023 8/27/2024
1,000,000
1,000,000
1,000,000 A D E
Errors & Omissions (Prim) Errors & Omissions(Excess) Employee Theft
ZPL21P7852623I5
PCY3438223AA
J06235335
8/27/2023 8/27/2023 8/27/2023
8/27/2024 8/27/2024 8/27/2024
Each Claim/Aggregate Each Claim/Aggregate Each Claim
5,000,000 5,000,000 10,000,000
General liability and Technology Errors and Omissions policies include blanket automatic additional insured endorsement or provision that provides additional insured status to any person or organization the Named Insured is required by written contract to add as an additional insured. The general and auto liability and workers compensation policies include a blanket automatic waiver of subrogation endorsement only when the insured has agreed to waive these rights as part of a written contract or agreement executed prior to loss. No Owned Autos. Umbrella is follow-form and is excess over underlying General Liability, Automobile Liability, and Employer's Liability policies referenced above.
Client Coverage: Insurer: Federal Insurance Co., Policy #J06235335, Eff Date 8/27/2023 to 8/27/2024, Each Claim Limit $5,000,000.
Arizona Department of Administration State Procurement Office 100 N 15th Avenue Phoenix AZ 85007
File details come from the government source that posted it. Updated .