COI_101825.Pdf

PDF 110 KB Posted

Attached to
Master Agreement AZ|CTR072000
Contract number
CTR072000
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance for Language Connection, LLC, located in El Mirage, Arizona. The certificate is issued by Integra Insurance Group and covers multiple insurance policies through insurers including Twin City Fire Insurance Company, Hartford Accident and Indemnity Company, and Lloyds, Underwriters at Lloyds. The certificate holder is the Arizona Department of Administration State Procurement Office, located in Phoenix, Arizona, suggesting this is related to a state government contract.

The insurance coverage includes Commercial General Liability with a $2,000,000 per occurrence limit and a $4,000,000 aggregate limit, Professional Liability with a $2,000,000 occurrence and aggregate limit, and Workers' Compensation with statutory coverage. The policy is effective from 10/18/2024 to 10/18/2025 and references a specific contract number CTR072000. An additional Sexual Abuse and Molestation Policy is also in place with a $500,000 limit per claim and in aggregate. The policy includes provisions for additional insured status and waiver of subrogation in favor of the certificate holder, indicating a comprehensive insurance protection for a state-level contractual engagement.

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

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

10/15/2024 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

INTEGRA INSURANCE GROUP

59304509

13350 N 94TH DRIVE SUITE B

PEORIA AZ 85381

CONTACT NAME:

PHONE

(A/C, No, Ext):

(623) 322-5955 FAX

(A/C, No):

E-MAIL ADDRESS:

INSURER(S) AFFORDING COVERAGE NAIC#

INSURER A : Twin City Fire Insurance Company 29459

INSURED

LANGUAGE CONNECTION, LLC

PO BOX 1087

EL MIRAGE AZ 85335-1087

INSURER B : Hartford Accident and Indemnity Company 22357

INSURER C : Lloyds, Underwriters at Lloyds 15792

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 X 59 SBM BD1579 10/18/2024 10/18/2025

EACH OCCURRENCE $2,000,000

CLAIMS-MADE X OCCUR DAMAGE TO RENTED

PREMISES (Ea occurrence) $1,000,000

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

PERSONAL & ADV INJURY $2,000,000

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000

POLICY PRO-

JECT X LOC PRODUCTS - COMP/OP AGG $4,000,000

OTHER:

AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT

(Ea accident)

ANY AUTO BODILY INJURY (Per person)

ALL OWNED

AUTOS

SCHEDULED

AUTOS

BODILY INJURY (Per accident)

HIRED

AUTOS

NON-OWNED

AUTOS

PROPERTY DAMAGE

(Per accident)

UMBRELLA LIAB

EXCESS LIAB

OCCUR

CLAIMS-

MADE

EACH OCCURRENCE

AGGREGATE

DED RETENTION $

B

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 X 59 WEC AU90YV 11/04/2024 11/04/2025

X PER

STATUTE

OTH-

ER

Y/N E.L. EACH ACCIDENT $1,000,000

E.L. DISEASE -EA EMPLOYEE $1,000,000

E.L. DISEASE - POLICY LIMIT $1,000,000

A PROFESSIONAL LIABILITY 59 SBM BD1579 10/18/2024 10/18/2025 Occurrence Aggregate

$2,000,000 $2,000,000

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. Contract CTR072000 Insurer C: Sexual Abuse and Molestation Policy B0621PLANG002624 Effective 05/31/20204-05/31/2025 Limit Each Claim $500,000/$500,000 Aggregate

CERTIFICATE HOLDER CANCELLATION

Arizona Department of Administration State Procurement Office

100 N 15TH AVE

PHOENIX AZ 85007

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

INTEGRA INSURANCE GROUP

NAMED INSURED

LANGUAGE CONNECTION, LLC

PO BOX 1087

EL MIRAGE AZ 85335-1087

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

Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy.

Waiver of Subrogation applies in favor of the Certificate Holder per Waiver of our Right to Recover from Others Endorsement WC000313 attached to this policy.

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