CGI-Arizona_insurance_certificate_for_HRIS_CTR061240__GL-Auto-WC-EO__06042025.pdf
PDF 57 KB Posted
- Attached to
- Master Agreement AZ|CTR061240
- Contract number
- CTR061240
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by Aon Risk Services Central, Inc. for CGI Technologies and Solutions Inc, covering insurance policies for the State of Arizona. The certificate includes multiple insurers such as Travelers Casualty & Surety Company, Zurich American Insurance Company, and Travelers Property Casualty Company of America. The insurance covers CGI Technologies and Solutions Inc. for a contract related to the Human Resources Information System (HRIS) Replacement, with the State of Arizona's Department of Administration State Procurement Office as the certificate holder.
The insurance coverage includes Commercial General Liability, Automobile Liability, Workers Compensation, and Professional Liability (E&O) policies, with various coverage limits. The policy period runs from 06/01/2025 to 06/01/2026, with total aggregate limits ranging from $1,000,000 to $5,000,000 depending on the type of coverage. The Professional Liability policy includes Technology Errors & Omissions, Network/Cyber Security, and Privacy Liability, with a retroactive date of September 8, 1989. The State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as Additional Insured, with a waiver of subrogation granted in their favor.
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H o ld e r
Id e n ti fi e r
77777 77707 07070 00777 63616 06555 33307 73725 77703 65557 07662 00774 16353 00072 66144 61543 11130 70626 67532 56772 00736 00555 30076 53007 34205 55326 54130 07340 01175 62307 54077 24613 73027 01100 77727 25202 57731 10777 77770 70007 07007
66666 66606 06060 00626 06466 20444 62006 02002 62620 40220 06200 02606 22602 00062 20004 06026 00020 62222 06040 06002 20622 00042 42240 02006 22202 40420 40002 06202 20404 02622 02062 22224 26022 06220 66646 06224 06644 40666 66660 60006 06006
C e rt if ic a te
N o
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
06/04/2025
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.
PRODUCER
Aon Risk Services Central, Inc.
Minneapolis MN Office 5600 West 83rd Street 8200 Tower, Suite 1100 Minneapolis MN 55437 USA
PHONE
(A/C. No. Ext):
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
(866) 283-7122
INSURED 19038Travelers Casualty & Surety CompanyINSURER A:
16535Zurich American Ins CoINSURER B:
25674Travelers Property Cas Co of AmericaINSURER C:
27855Zurich American Ins Co of IllinoisINSURER D:
INSURER E:
INSURER F:
FAX
(A/C. No.):
(800) 363-0105
CONTACT
NAME:
CGI Technologies and Solutions Inc 11325 Random Hills Road Fairfax VA 22030 USA
COVERAGES CERTIFICATE NUMBER: 570113029850 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. Limits shown are as requested
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
(MM/DD/YYYY)
SUBR
WVD
INSR
LTR
ADDL
INSD POLICY NUMBER TYPE OF INSURANCE LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
POLICY LOC
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
X
X
X
GEN'L AGGREGATE LIMIT APPLIES PER:
$5,000,000
$1,000,000
$5,000
$5,000,000
$5,000,000
$5,000,000
B 06/01/2025 06/01/2026GLO379277518
PRO-
JECT
OTHER:
AUTOMOBILE LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
SCHEDULED
AUTOS
HIRED AUTOS
ONLY
NON-OWNED
AUTOS ONLY
BODILY INJURY ( Per person)
PROPERTY DAMAGE
(Per accident)
X
BODILY INJURY (Per accident)
$1,000,000D 06/01/2025 06/01/2026 COMBINED SINGLE LIMIT
(Ea accident)
BAP 3792988 - 17
EXCESS LIAB
OCCUR
CLAIMS-MADE AGGREGATE
EACH OCCURRENCE
DED
UMBRELLA LIAB
RETENTION
E.L. DISEASE-EA EMPLOYEE
E.L. DISEASE-POLICY LIMIT
E.L. EACH ACCIDENT $1,000,000
X OTH-
ER
PER STATUTEA 06/01/2025 06/01/2026
AOS
UB4P2459202551RC 06/01/2025 06/01/2026
$1,000,000
Y / N
(Mandatory in NH)
ANY PROPRIETOR / PARTNER / EXECUTIVE
OFFICER/MEMBER EXCLUDED? N / AN
MA, WI
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
If yes, describe under DESCRIPTION OF OPERATIONS below
$1,000,000
UB4P3327872551K
Per ClaimEOC435890518 06/01/2025 06/01/2026 Claims Made $20,000,000Aggregate
E&O - Miscellaneous Professional-Primary
B
SIR applies per policy terms & conditions
$20,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: Contract Award No. CTR061240, Human Resources Information System (HRIS) Replacement State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as Additional Insured in accordance with the policy provisions of the General Liability, Automobile Liability and Professional Liability(E&O) policies.
A Waiver of Subrogation is granted in favor of State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees in accordance with the policy provisions of the General Liability, Automobile Liability, Works Compensation and Professional Liability(E&O) policies.
CANCELLATIONCERTIFICATE HOLDER
AUTHORIZED REPRESENTATIVEState of Arizona Department of Administration State Procurement Office 100 N 5th Avenue Phoenix AZ 85007 USA
ACORD 25 (2016/03)
©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
POLICY PROVISIONS.
General Liability, Automobile Liability, Works Compensation and Professional Liability(E&O) evidenced herein is Primary and Non-Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions.
Should the General Liability, Automobile Liability, Workers Compensation and Professional Liability(E&O) policies be cancelled before the expiration date thereof, the policy provisions will govern how the 30-Day notice of cancellation may be delivered to certificate holders in accordance with the policy provisions of each policy.
The Professional Liability policy includes an extension of Technology Errors & Omission, Network/Cyber Security and Privacy Liability. With respect to the Professional Liability the Retroactive Date is September 8,1989.
FORM TITLE:FORM NUMBER:
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
ADDITIONAL REMARKS
EFFECTIVE DATE:
CARRIER NAIC CODE
POLICY NUMBER
Aon Risk Services Central, Inc.
NAMED INSUREDAGENCY
LOC #:
570000058858AGENCY CUSTOMER ID:
© 2008 ACORD CORPORATION. All rights reserved.
See Certificate Number:
See Certificate Number:
The ACORD name and logo are registered marks of ACORD
570113029850
570113029850
ACORD 25 Certificate of Liability Insurance Additional Description of Operations / Locations / Vehicles:
ACORD 101 (2008/01)
ADDITIONAL REMARKS SCHEDULE Page _ of _
CGI Technologies and Solutions Inc
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