CTR055523_2025-10-19_COI.pdf
PDF 47 KB Posted
- Attached to
- Master Agreement AZ|CTR055523
- Contract number
- CTR055523
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance for Human Resource Training Inc. (dba Clarvida), issued by Aon Risk Services South, Inc. on 11/04/2024. The certificate covers multiple contract numbers with the State of Arizona, specifically involving the Department of Child Safety, and includes insurance policies from American Zurich Insurance Company, Zurich American Insurance Company, and Illinois Union Insurance Company.
The insurance coverage includes Commercial General Liability with a $1,000,000 each occurrence limit and $3,000,000 aggregate limit, Automobile Liability with a $2,000,000 combined single limit, Umbrella Liability with $5,000,000 each occurrence and aggregate limits, Workers' Compensation with statutory coverage, and Professional Liability (E&O) with a $1,000,000 each occurrence limit. The policy period runs from 10/19/2024 to 11/01/2024, and the State of Arizona is listed as an additional insured with a waiver of subrogation. The certificate covers eight specific contract numbers, indicating a comprehensive service or goods provision relationship with the state.
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Text version
H o ld e r
Id e n ti fi e r
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77777 77707 07070 00735 25677 11545 60007 76140 10202 71575 07526 67735 65721 55071 32236 35317 30110 71222 27353 06301 10702 23262 52073 11007 02322 63421 73100 07033 33634 20621 00070 23336 25207 30000 77756 16335 17655 40777 77770 70007 07007
C e rt if ic a te
N o
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
11/04/2024
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.
PRODUCER
Aon Risk Services South, Inc.
Franklin TN Office 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA
PHONE
(A/C. No. Ext):
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
(866) 283-7122
INSURED 40142American Zurich Ins CoINSURER A:
16535Zurich American Ins CoINSURER B:
27960Illinois Union Insurance CompanyINSURER C:
INSURER D:
INSURER E:
INSURER F:
FAX
(A/C. No.):
(800) 363-0105
CONTACT
NAME:
Human Resource Training Inc.
dba Clarvida 2131 E. Broadway Road, Ste. 14 Tempe AZ 85282 USA
COVERAGES CERTIFICATE NUMBER: 570109272856 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. Limits shown are as requested
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
(MM/DD/YYYY)
SUBR
WVD
INSR
LTR
ADDL
INSD POLICY NUMBER TYPE OF INSURANCE LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
POLICY LOC
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
X
X
X
GEN'L AGGREGATE LIMIT APPLIES PER:
$1,000,000
$50,000
$5,000
$1,000,000
$3,000,000
$1,000,000
$1,000,000Abusive Act
C 11/01/2024 10/19/2025MLPG72547597004
PRO-
JECT
OTHER:
AUTOMOBILE LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
SCHEDULED
AUTOS
HIRED AUTOS
ONLY
NON-OWNED
AUTOS ONLY
BODILY INJURY ( Per person)
PROPERTY DAMAGE
(Per accident)
X
BODILY INJURY (Per accident)
$2,000,000B 11/01/2024 10/19/2025 COMBINED SINGLE LIMIT
(Ea accident)
BAP 2519669 06
EXCESS LIAB X
OCCUR
CLAIMS-MADE AGGREGATE
EACH OCCURRENCE
DED
$5,000,000
$5,000,000
11/01/2024UMBRELLA LIABC 10/19/2025XFLG72547603004
RETENTION
X
E.L. DISEASE-EA EMPLOYEE
E.L. DISEASE-POLICY LIMIT
E.L. EACH ACCIDENT $1,000,000
X OTH-
ER
PER STATUTEA 10/19/2024 10/19/2025
$1,000,000
Y / N
(Mandatory in NH)
ANY PROPRIETOR / PARTNER / EXECUTIVE
OFFICER/MEMBER EXCLUDED? N / AN
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
If yes, describe under DESCRIPTION OF OPERATIONS below
$1,000,000
WC251966806
Each Occurence LimitMLPG72547597004 11/01/2024 10/19/2025 Claims Made $3,000,000Aggregate Limit
E&O - Professional Liability
- Primary
C $1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: Contract Numbers include: ADCS18-200036, ADCS17-174432, ADCS16-119255, CTR045636, ADCS15-094739, AZDCS18-00007646, ADCS19-206583,CTR055523. The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees are included as Additional Insured in accordance with the policy provisions of the General Liability policy. A Waiver of Subrogation is granted in favor of The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees in accordance with the policy provisions of the General Liability policy.
CANCELLATIONCERTIFICATE HOLDER
AUTHORIZED REPRESENTATIVEDepartment of Child Safety Office of Procurement & Contracts Phoenix AZ 85007 USA
ACORD 25 (2016/03)
©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
POLICY PROVISIONS.
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