CTR056550_COI_Exp_5.1.24.pdf
PDF 62 KB Posted
- Attached to
- Master Agreement AZ|CTR069972
- Contract number
- CTR069972
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance for Equifax Inc. and its subsidiaries, with Marsh USA LLC as the producer. The certificate is issued for the State of Arizona, specifically the State Procurement Office located in Phoenix, and includes coverage for Appriss Insights LLC. The insurance is provided by multiple insurers, including Zurich American Insurance Company and Syndicates 2623/623 at Lloyd's, with the State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees listed as additional insureds.
The insurance certificate covers multiple types of liability, including commercial general liability, automobile liability, umbrella/excess liability, and workers' compensation, with policy periods running from 05/01/2023 to 05/01/2024. Key coverage limits include $1,000,000 for commercial general liability, $15,000,000 for umbrella liability, and $1,000,000 for workers' compensation. The policy includes a Self-Insured Retention (SIR) value of $20,000,000 and provides professional liability/cyber coverage with a $10,000,000 limit. The certificate ensures that waiver of subrogation is applicable where required by written contract, and coverage extends to various operational and vehicular risks for the insured entities.
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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)
© 1988-2016 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
A
1,000,000
05/01/2024
GLA 3906538-00
ATL-005448611-08
1,000,000
15,000,000
WC-4257158-00 (AZ)
X
37540
15,000,000
Louisville, KY 40223
SIR Value: $20,000,000 of Marsh USA LLC
ATLANTA, GA 30326
N
X05/01/2023
05/01/2024
12/15/2023
05/01/2024
GLA 3906538-00
Professional Liability/Cyber
A
2,000,000
1,000,000
Syndicates 2623/623 at Lloyd's
1,000,000
X
B
X
12/06/2023
05/01/2023
10,000,000
State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as additional insured on the general liability and auto liability policies where required by written contract. Waiver of subrogation is applicable where required by written contract.
X
05/01/2023
100 N 15th Avenue, Suite 305
Phoenix, AZ 85007
State of Arizona
A
CN101920890-APP-GAWUP-23-24
LIMIT:
10,000
05/01/2024
1,000,000
AUC-3850189-00
A
2,000,000
16535
1,000,000
1,000,000
12/15/2024
WC-4257158-00 (AOS)
TWO ALLIANCE CENTER
MARSH USA, LLC.
X
3560 LENOX ROAD, SUITE 2400
Attn: Atlanta.CertRequest@marsh.com / Fax: 212-948-4321
Equifax Inc. & All Subsidiaries
9901Linn Station Road, Suite 200, Appriss Insights LLC
X
W20485231201
05/01/2023
State Procurement Office
05/01/2023
A
05/01/2024
Zurich American Insurance Company
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