Certificate_-_AZ_State_CTR071992.pdf

PDF 322 KB Posted

Attached to
Master Agreement AZ|CTR071992
Contract number
CTR071992
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by Philadelphia Indemnity Insurance Company for AZ Language Solutions, Inc. (DBA: AZITA: AZ Interpretation and Translation Agency), with Inszone Insurance Services, LLC as the producer. The certificate is for a contract with the State of Arizona State Procurement Office, specifically referencing Contract #CTR069842. The insurance provides coverage for commercial general liability, automobile liability, and additional specialized liability protections, including sexual abuse/molestation liability and professional liability.

The insurance policy covers AZ Language Solutions with various coverage limits, including a $2,000,000 general aggregate limit, $1,000,000 automobile liability limit, and additional specific limits for sexual abuse/molestation liability ($1,000,000 aggregate limit, $500,000 each abusive conduct) and professional liability ($2,000,000 aggregate/occurrence). The policy is effective from 10/5/2024 to 10/5/2025 and includes the State of Arizona as an additional insured with a waiver of subrogation on the general liability coverage. The certificate indicates that the insurance is provided for the State of Arizona to the extent specified in the attached policy forms.

View the file

Other files

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

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

10/7/2024

Inszone Insurance Services, LLC 2721 Citrus Road, Suite A Rancho Cordova, CA 95742

Certificate Team 877-308-9663 916-400-2625 certs@inszoneins.com

License#: 0F82764 Philadelphia Indemnity Insurance Company 18058

ZAHROMA-01

AZ Language Solutions, Inc.

DBA: AZITA: AZ Interpretation and Translation Agency 4739 E. Culver Street Phoenix, AZ 85008

1263835473

A X 2,000,000 X 100,000

5,000

2,000,000

4,000,000 X

Y Y PHPK2593123-006 10/5/2024 10/5/2025

4,000,000

A 1,000,000

X X

PHPK2593123-006 10/5/2024 10/5/2025

A A A

Sexual Abuse or Molestation Liab Sexual Abuse or Molestation Liab Professional Liability

PHPK2593123-006

PHPK2593123-006

PHSD1823560-006

10/5/2024 10/5/2024 10/5/2024

10/5/2025 10/5/2025 10/5/2025

Aggregate limit Each Abusive Conduct Aggregate/Occurence

$1000000 $500000 $2000000

State of Arizona State Procurement Office 100 N. 16th Avenue, Ste. 201 Phoenix, AZ 86007

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

RE: Contract #CTR069842

Additional Insured with a Waiver of Subrogation on the General Liability.

The aforementioned coverage is provided to the extent in the attached forms for: State of Arizona

POLICY NUMBER: PHPK2593123-006 COMMERCIAL GENERAL LIABILITY

CG 20 26 0413

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED- DESIGNATED

PERSON OR ORGANIZATION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name Of Additional Insured Person(s) Or Organization(s):

State of Arizona State Procurement Office Contract# CTR071992

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf:

1. In the performance of your ongoing operations;

or

2. In connection with your premises owned by or rented to you.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

B. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill - Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable Limits of

Insurance shown in the Declarations;

whichever is less.

This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.

CG 20 26 0413 © Insurance Services Office, Inc., 2012 Page 2 of 3

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