CERTIFICATE_OF_INSURANCE__COI_.Pdf

WLTR005

THE HARTFORD

BUSINESS SERVICE CENTER

3600 WISEMAN BLVD

SAN ANTONIO TX 78251 May 3, 2023

THE STATE OF ARIZONA

STATE PROCUREMENT OFFICE

100 N 15TH AVE STE 402

PHOENIX AZ 85007-2636

Account Information:

Policy Holder Details : DAMA COMMUNICATION

SERVICES, LLC

Contact Us Need Help?

Chat online or call us at

(866) 467-8730.

We're here Monday - Friday.

Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any questions or concerns.

Sincerely, Your Hartford Service Team

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)

05/03/2023 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 be endorsed. If SUBROGATIONIS 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).

PRODUCER

USI INSURANCE SERVICES LLC/PHS

59302112 The Hartford Business Service Center 3600 Wiseman Blvd San Antonio, TX 78251

CONTACT

NAME:

PHONE

(A/C, No, Ext):

(866) 467-8730 FAX

(A/C, No):

E-MAIL

ADDRESS:

INSURER(S) AFFORDING COVERAGE NAIC#

INSURED

DAMA COMMUNICATION SERVICES, LLC

80 W ENCANTO BLVD

PHOENIX AZ 85003-1109

INSURER A : Hartford Casualty Insurance Company 29424

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

COVERAGES CERTIFICATE NUMBER: 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.

INSR

LTR

TYPE OF INSURANCE ADDL

INSR

SUBR

WVD

POLICY NUMBER POLICY EFF

(MM/DD/YYYY)

POLICY EXP

(MM/DD/Y YYY)

LIMITS

A

COMMERCIAL GENERAL LIABILITY

X 59 SBA NI3434 05/01/2023 05/01/2024

EACH OCCURRENCE $1,000,000

CLAIMS-MADE X OCCUR DAMAGE TO RENTED

PREMISES (Ea occurrence) $300,000

X General Liability MED EXP (Any one person) $10,000

PERSONAL & ADV INJURY $1,000,000

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000

POLICY PRO-

JECT X LOC PRODUCTS - COMP/OP AGG $2,000,000

OTHER:

A

AUTOMOBILE LIABILITY

X 59 SBA NI3434 05/01/2023 05/01/2024

COMBINED SINGLE LIMIT

(Ea accident)

$1,000,000 ANY AUTO BODILY INJURY (Per person)

ALL OWNED

AUTOS

SCHEDULED

AUTOS BODILY INJURY (Per accident)

X HIRED

AUTOS X NON-OWNED

AUTOS

PROPERTY DAMAGE

(Per accident)

UMBRELLA LIAB

EXCESS LIAB

OCCUR

CLAIMS-

MADE

EACH OCCURRENCE

AGGREGATE

DED RETENTION $

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

ANY

PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below

N/ A

PER

STATUTE

OTH-

ER

Y/N E.L. EACH ACCIDENT

E.L. DISEASE -EA EMPLOYEE

E.L. DISEASE - POLICY LIMIT

A EMPLOYMENT PRACTICES

LIABILITY

59 SBA NI3434 05/01/2023 05/01/2024 Each Claim Limit Aggregate Limit

$5,000 $5,000

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

Those usual to the Insured's Operations. Please see Additional Remarks Schedule Acord Form 101 attached.

CERTIFICATE HOLDER CANCELLATION

THE STATE OF ARIZONA

STATE PROCUREMENT OFFICE

100 N 15TH AVE STE 402

PHOENIX AZ 85007-2636

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED

BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED

IN ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE

© 1988-2015 ACORD CORPORATION. All rights reserved.

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

ACORD 101 (2014/01) © 2014 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

AGENCY CUSTOMER ID:

LOC# :

ADDITIONAL REMARKS SCHEDULE Page 2 of 2

AGENCY

USI INSURANCE SERVICES LLC/PHS

NAMED INSURED

DAMA COMMUNICATION SERVICES, LLC

80 W ENCANTO BLVD

PHOENIX AZ 85003-1109

POLICY NUMBER

SEE ACORD 25

CARRIER

SEE ACORD 25

NAIC CODE

EFFECTIVE DATE: SEE ACORD 25

ADDITIONAL REMARKS

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM

FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE

The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees are an Additional Insured per the Business Liability Coverage Form SS0008, with respect to liability arising out of the activities performed by or on behalf of the Contractor. A Business Liability Waiver of Subrogation applies to the certificate holder per form SS0008 and Professional Liability Coverage.RE: CONTRACT #ADSPO18-00008136