Cert_of_Ins_2025-2026_-_State_of_Arizona.PDF

PDF 27 KB Posted

Attached to
Master Agreement AZ|CTR057184
Contract number
CTR057184
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance for SilverLeaf Insurance Group, LLC, located in Scottsdale, Arizona, covering The Cable Guy LLC. The certificate is issued for the State of Arizona Department of Emergency and Military Affairs, with multiple insurance carriers including Continental Casualty Company, The Continental Insurance Company, and American Casualty Company. The insurance coverage is valid from 03/15/2025 to 03/15/2026, with the State of Arizona Department of Emergency and Military Affairs listed as an additional insured.

The insurance policy provides comprehensive coverage including general liability, automobile liability, workers' compensation, and technology errors and omissions. Specific coverage limits include $1,000,000 per occurrence for general liability, $5,000,000 aggregate, $1,000,000 for workers' compensation, and $1,000,000 for technology E&O. The policy includes additional provisions such as a $1,000 deductible for collision and comprehensive auto coverage, and covers leased/rented equipment up to $250,000. The certificate indicates primary and non-contributory coverage with a 30-day cancellation notice requirement.

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Text version

06/11/2025

SilverLeaf Insurance Group, LLC 20865 N 90th Pl, Ste 120 Scottsdale, AZ 85255 License #: 1086733

Diann Coons

(480)585-9725 (480)717-4780

Diann@silverleafinsure.com

00002559-0 280

The Cable Guy LLC 7741 E Gray Rd Ste 108 Scottsdale, AZ 85260

Continental Casualty Company 20443

A Y Y 6021007955 03/15/2025 03/15/2026X X

X

1,000,000 1,000,000

10,000 1,000,000 2,000,000 2,000,000

The Continental Insurance Company 20443

B Y Y 6081297830 03/15/2025 03/15/2026

X

X X X $1,000 ded coll X $1,000 ded comp

1,000,000

Continental Casualty Company 20443

A Y Y 6021008006 03/15/2025 03/15/2026XX

X 10,000

5,000,000 5,000,000

American Casualty Company 10030

C Y WC 6 21007972 03/15/2025 03/15/2026

N

X 1,000,000 1,000,000 1,000,000

Continental Casualty Company 20443

A 6020999533 03/15/2025 03/15/2026Technology E&O $1,000,000

The Continental Insurance Company 20443

B 6021007955 03/15/2025 03/15/2026Leased/Rented Equip $250,000

The State of Arizona Department of Emergency and Military Affairs is an additional insured as required by written contract.

Coverage is primary and non-contributory. 30 days notice of cancellation applies.

State of Arizona Department of Emergency and Military Affairs 5636 East McDowell Road, Building, #M5800 Phoenix, AZ 85008-3495

(DMC)

Printed by DMC on 06/11/2025 at 10:42AM

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

INSR ADDL SUBR

LTR INSD WVD

DATE (MM/DD/YYYY)

PRODUCER CONTACT

NAME:

FAXPHONE

(A/C, No):(A/C, No, Ext):

E-MAIL

ADDRESS:

INSURER A :

INSURED INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

POLICY NUMBER

POLICY EFF POLICY EXP

TYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)

AUTOMOBILE LIABILITY

UMBRELLA LIAB

EXCESS LIAB

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

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

AUTHORIZED REPRESENTATIVE

EACH OCCURRENCE $

DAMAGE TO RENTED

CLAIMS-MADE OCCUR $PREMISES (Ea occurrence)

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

PRO-

POLICY LOC PRODUCTS - COMP/OP AGG $JECT

OTHER: $

COMBINED SINGLE LIMIT $(Ea accident)

ANY AUTO BODILY INJURY (Per person) $

OWNED SCHEDULED BODILY INJURY (Per accident) $

AUTOS ONLY AUTOS

HIRED NON-OWNED PROPERTY DAMAGE $

AUTOS ONLY AUTOS ONLY (Per accident)

OCCUR EACH OCCURRENCE $

CLAIMS-MADE AGGREGATE $

DED RETENTION $ $

PER OTH-

STATUTE ER

E.L. EACH ACCIDENT $

E.L. DISEASE - EA EMPLOYEE $

If yes, describe under

E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below

INSURER(S) AFFORDING COVERAGE NAIC #

COMMERCIAL GENERAL LIABILITY

Y / N

N / A (Mandatory in NH)

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

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.

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.

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).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

CERTIFICATE HOLDER CANCELLATION

© 1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03)

CERTIFICATE OF LIABILITY INSURANCE

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