COI_7-30-2023.pdf

PDF 145 KB Posted

Attached to
Master Agreement AZ|CTR059896
Contract number
CTR059896
Issued by
Arizona

About this file

This document is an ACORD Certificate of Liability Insurance for Barcodes Holdings, LP, located in Chicago, IL, with multiple insurers including Continental Insurance Company, Valley Forge Insurance Company, and National Fire Insurance Company. The certificate is issued for Barcodes Holdings, LP and lists numerous affiliated companies such as Barcodes Group, Inc., BC Group Holdings, Inc., and various subsidiary entities. The certificate holder is the State of Arizona Department of Juvenile Corrections, located in Phoenix, AZ.

The insurance coverage includes Commercial General Liability with a $1,000,000 each occurrence limit, $2,000,000 general aggregate, and $15,000 medical expense limit. Automobile Liability covers any auto with a $1,000,000 combined single limit. Workers' Compensation and Employers' Liability are also included, with $1,000,000 limits for each accident and disease. Additionally, the policy provides Cyber Liability and Professional Services coverage with $5,000,000 limits and a $100,000 retention. The State of Arizona Department of Juvenile Corrections is listed as an Additional Insured on the General Liability policy as required by written contract, with all policies effective from 7/30/2022 to 7/30/2023.

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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

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

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

8/1/2022

Alliant Insurance Services, Inc.

32 Old Slip New York NY 10005

Michael N. Hutchinson 212.504.1842

Michael.Hutchinson@alliant.com

Continental Insurance Company 35289 BARCLLC-01 Valley Forge Insurance Company 20508

Barcodes Holdings, LP 200 W Monroe St Chicago IL 60606

National Fire Insurance Compan 20478 Sompo America Insurance Compan 11126 Lloyd's Underwriter Syndicate 0

1975721618

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

15,000

1,000,000

2,000,000 X

Y 7034115971 7/30/2022 7/30/2023

2,000,000

B 1,000,000

X X X X

7034115968 7/30/2022 7/30/2023

A C

X

N

7034115940 7034115954

7/30/2022 7/30/2022

7/30/2023 7/30/2023

1,000,000

1,000,000

1,000,000 D E

Cyber Liability/E&O XS Cyber Liability/E&O

PRO30023001100

01MRCT0000144-00

7/30/2022 7/30/2022

7/30/2023 7/30/2023

See Below

Professional Services, Technology and Media Liability: $5,000,000; Retention: $100,000 Network Security and Privacy Liability Limit: $5,000,000; Retention: $100,000 XS Cyber Liability/E&O Liability Limit: $5,000,000 excess Of $5,000,000

Named Insured List:

Barcodes Acquisition Inc.

Barcodes Intermediate Holdings, Inc.

BC Group Holdings, Inc.

See Attached...

State of Arizona Department of Juvenile Corrections 1624 West Adams Phoenix AZ 85007

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: FORM TITLE:

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE Page of

AGENCY CUSTOMER ID:

LOC #:

AGENCY

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSURED

EFFECTIVE DATE:

BARCLLC-01

1 1

Alliant Insurance Services, Inc. Barcodes Holdings, LP 200 W Monroe St Chicago IL 60606

25 CERTIFICATE OF LIABILITY INSURANCE

Barcodes Group, Inc.

Barcodes Holdings, LP Barcodes LLC OCR Canada Ltd.

Alpha Card Systems, LLC ID Security Inc.

Discounted ID.com LLC ID Card Group LLC Digital ID U.K. Limited Digital ID Group Limited Digital ID Limited The Smart Card Store Limited Informs, LLC

IDW, LLC

Emkat Solutions, Inc.

Plasco HoldCo, LLC Plasco, LLC

IDZ, LLC

Southeast ID, LLC Badge Express, LLC BCI Solutions, LLC Bracken Technology Services, Inc. dba Carlton Technologies, Inc.

Smart Label Solutions, LLC State of Arizona Department of Juvenile Corrections is shown as Additional Insured on the General Liability policy as required by written contract, subject to polocy terms, conditions and exclusions.

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