CTR055086_2024-10-01_COI.pdf

PDF 113 KB Posted

Attached to
Master Agreement AZ|CTR055086
Contract number
CTR055086
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance for Arizona's Children Association (AZCA), issued by Lovitt & Touche, a Marsh & McLennan Agency LLC Co, located in Tucson, Arizona. The certificate involves multiple insurers, including CopperPoint Indemnity Insurance Company, Capitol Specialty Insurance Corporation, and Great American Insurance Company. The certificate holder is the State of Arizona Department of Child Safety Office of Procurement and Contracts, located in Phoenix, Arizona.

The insurance coverage includes Commercial General Liability, Automobile Liability, Umbrella Liability, Workers Compensation, and Professional Liability with Sexual Molestation coverage. The policies are effective from 10/1/2023 to 10/1/2024, with various coverage limits. The Commercial General Liability policy has a $1,000,000 per occurrence limit and a $3,000,000 aggregate limit. The Professional Liability includes a $1,000,000 per claim limit and a $3,000,000 policy aggregate. The contract references a CTR# 055086 and includes Sexual Abuse & Molestation coverage subject to all policy terms, conditions, definitions, and exclusions.

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Other files

File Type Posted
CTR055086_HIPPA_Agreement.pdf PDF
CTR055086_2021-10-01_COI.pdf PDF
Amendment_1.pdf PDF
CTR055086_Executed_Contract.pdf PDF
Contract_Amendment_2.pdf PDF

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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

10/2/2023

Lovitt & Touche A Marsh & McLennan Agency LLC Co 4703 E Camp Lowell Drive, #101 Tucson AZ 85712

Nichole Maurer

(928) 258-1376 520-722-7245 nmaurer@lovitt-touche.com

CopperPoint Indemnity Insurance Company 13928 ARIZCHI-C2 Capitol Specialty Insurance Corporation 10328

Arizona's Children Association (AZCA) c/o Jacob Schmitt 3716 E. Columbia Tucson AZ 85714

Great American Insurance Company 16691

600802060

B X 1,000,000 X 100,000

X 0 5,000

1,000,000

3,000,000 X

HS2021259803 10/1/2023 10/1/2024

3,000,000

C 1,000,000

X

X X

CAP532869500 10/1/2023 10/1/2024

B X 2,000,000 X

HS2021259903 10/1/2023 10/1/2024

2,000,000

A X1003483 7/1/2023 7/1/2024

1,000,000

1,000,000

1,000,000 B

Sexual Molestation Professional Liability

HS2021259803 10/1/2023 10/1/2024 Each Claim $1,000,000 $1,000,000

Policy Aggregate $3,000,000 $3,000,000

Subject to all policy terms, conditions, definitions & exclusions.

Sexual Abuse & Molestation coverage is included.

CTR#: 055086

State of Arizona Department of Child Safety Office of Procurement and Contracts 3003 N. Central Ave., C010-20 Phoenix AZ 85007

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