CTR055132_COI_Exp._3-5-22.pdf

PDF 105 KB Posted

Attached to
Master Agreement AZ|CTR055132
Contract number
CTR055132
Issued by
Arizona

About this file

This document is an ACORD Certificate of Liability Insurance dated 4/16/2021 for Pinpoint Testing, LLC, based in Little Rock, AR. The certificate involves multiple insurers including Continental Casualty Company, Great American E & S Insurance Company, Evanston Insurance Company, and Accident Fund National Insurance Company. The certificate holder is the Arizona Department of Public Safety, located in Phoenix, AZ, with Kapnick Insurance Group serving as the insurance producer.

The insurance coverage includes Commercial General Liability, Umbrella Liability, Workers Compensation, and Professional Liability policies. The Professional Liability policy has limits of $1,000,000 per claim and $3,000,000 aggregate. The certificate specifically notes that the Arizona Department of Public Safety is an Additional Insured per written contract, with a Waiver of Subrogation included. The policies were effective from various dates in 2020 and 2021, with coverage periods typically spanning one year. The Products Liability coverage includes a $2,000,000 Products & Completed Operations aggregate and a $1,000,000 Each Occurrence limit.

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Text version

The ACORD name and logo are registered marks of ACORD

CERTIFICATE HOLDER

© 1988-2014 ACORD CORPORATION. All rights reserved.

ACORD 25 (2014/01)

AUTHORIZED REPRESENTATIVE

CANCELLATION

DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE

LOCJECT

PRO-POLICY

GEN'L AGGREGATE LIMIT APPLIES PER:

OCCURCLAIMS-MADE

COMMERCIAL GENERAL LIABILITY

PREMISES (Ea occurrence) $

DAMAGE TO RENTED

EACH OCCURRENCE $

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GENERAL AGGREGATE $

PRODUCTS - COMP/OP AGG $

$RETENTIONDED

CLAIMS-MADE

OCCUR

AGGREGATE $

EACH OCCURRENCE $UMBRELLA LIAB

EXCESS LIAB

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

INSR

LTR TYPE OF INSURANCE POLICY NUMBER

POLICY EFF

(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY) LIMITS

PER

STATUTE

OTH-

ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE

E.L. DISEASE - POLICY LIMIT

ANY PROPRIETOR/PARTNER/EXECUTIVE

If yes, describe under DESCRIPTION OF OPERATIONS below

(Mandatory in NH)

OFFICER/MEMBER EXCLUDED?

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY Y / N

AUTOMOBILE LIABILITY

ANY AUTO

ALL OWNED SCHEDULED

HIRED AUTOS

NON-OWNED

AUTOS AUTOS

AUTOS

COMBINED SINGLE LIMIT

BODILY INJURY (Per person)

BODILY INJURY (Per accident)

PROPERTY DAMAGE $

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.

INSD

ADDL

WVD

SUBR

N / A

(Ea accident)

(Per accident)

OTHER:

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 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).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

INSURED

PHONE

(A/C, No, Ext):

PRODUCER

ADDRESS:

E-MAIL

FAX

(A/C, No):

CONTACT

NAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

INSURER(S) AFFORDING COVERAGE

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

4/16/2021

Kapnick Insurance Group P.O. Box 1801 Adrian MI 49221-7801

Janessa Baker 517-366-2769 517-263-6658 janessa.baker@kapnick.com

Continental Casualty Company 20443 PINPTES-01 Great American E & S Ins. Co. 37532

Pinpoint Testing, LLC 11925 Shady Ridge Drive Little Rock AR 72211

Evanston Insurance Company 35378 Accident Fund National Insurance Company 12305

887382445

C X 1,000,000 X 100,000

5,000

2,000,000

Y Y 2AA33454 8/20/2020 8/20/2021

B X 1,000,000 X

XS 9952285-04

X

8/20/2020 8/20/2021

D Y WCV6108806 2/17/2021 2/17/2022

500,000

500,000

500,000 A Professional Liability

Y Y

596554766 3/5/2021 3/5/2022 Per Claim Aggregate

$1,000,000 $3,000,000

Products Liability: PL9952283-01 Insurer: Great American E&S Insurance Products & Completed Operations aggregate: $2,000,000 Each Occurrence: $1,000,000 Arizona Department of Public Safety is Additional Insured per written contract. Wavier of Subrogation is included with respect to Arizona Department of Public Safety.

Arizona Department of Public Safety 2102 W Encanto Blvd. Ste 340 Phoeniz AZ 85009

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