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
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.
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