CTR056550_-_COI_Exp._5.1.23.pdf
PDF 1 MB Posted
- Attached to
- Master Agreement AZ|CTR069972
- Contract number
- CTR069972
- Issued by
- Arizona
About this file
The document is a Certificate of Liability Insurance issued by Marsh USA, Inc. for Equifax Inc. and its subsidiaries, including Appriss Insights LLC. The certificate covers multiple insurance policies from Travelers Insurance, including Commercial General Liability, Commercial Auto, Workers Compensation, and Professional Liability/Cyber insurance. The primary certificate holder is the State of Arizona State Procurement Office, with coverage extending to the state's departments, agencies, boards, commissions, universities, officers, officials, agents, and employees.
The insurance policies provide comprehensive coverage with various limits, including $1,000,000 for Commercial General Liability, $15,000,000 in Umbrella Liability, $1,000,000 for Automobile Liability, and $10,000,000 for Professional Liability/Cyber coverage. The policies are effective from May 1, 2022 to May 1, 2023, with additional insured provisions and waivers of subrogation. The policies specifically include the State of Arizona and its associated entities as additional insured where required by written contract, ensuring broad protection across multiple potential liability scenarios.
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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
B
1,000,000
05/01/2023
GLSA-8741P758-TIA-22
ATL-005448611-01
1,000,000
15,000,000
UB-7R024282-22-51-R (AZ,MA,WI)
X
25674
15,000,000
Louisville, KY 40223
ATLANTA, GA 30326
N
X05/01/2022
05/01/2023
12/15/2021
05/01/2023
CAP8F997819IND22
Professional Liability/Cyber
C
2,000,000
1,000,000
25666 Travelers Property Casualty Company Of America
1,000,000
X
D
X
06/28/2022
05/01/2022
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
05/01/2022
100 N 15th Avenue, Suite 305
Phoenix, AZ 85007
State of Arizona
Syndicates 2623(AA-1126623)/623 (AA-1126623) at
C
Travelers Indemnity Co Of America
CN101920890-APP-GAWUP-21-23
LIMIT:
10,000
05/01/2023
1,000,000
CUP9P52958522I3
A
2,000,000
25658
1,000,000
1,000,000
12/15/2022
UB-7R071781-22-51-K (AOS)
TWO ALLIANCE CENTER
*MARSH USA, INC.
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
W20485211001
05/01/2022
State Procurement Office
05/01/2022
B
05/01/2023
The Travelers Indemnity Company
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