CTR057662_Certificate_of_Insurance.pdf
PDF 3 MB Posted
- Attached to
- Master Agreement AZ|CTR057662
- Contract number
- CTR057662
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance for Data Axle, Inc., issued by Marsh USA, LLC on 08/18/2023. The insurance policies are provided by multiple insurers including National Fire Insurance of Hartford, Hartford Fire Insurance Company, and National Union Fire Insurance Company of Pittsburgh. The certificate holder is the Arizona Department of Administration, located in Phoenix, AZ, and the policies cover various insurance types including Commercial General Liability, Automobile Liability, Umbrella Liability, Professional Liability, Cyber Liability, and Workers' Compensation.
The insurance policies provide comprehensive coverage with varying limits, including $1,000,000 for each occurrence under Commercial General Liability, $1,000,000 for Automobile Liability, $5,000,000 for Umbrella Liability, $2,000,000 for Professional Liability, and $5,000,000 for Cyber Liability. The policies are effective from 03/31/2023 to 03/31/2024, with a Self-Insured Retention (SIR) of $1,000,000. The State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are listed as Additional Insureds when required by written contract. The insurance is primary and non-contributory, with a waiver of subrogation applicable where required by written contract.
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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
83UUNAG1175
HOU-004039026-01
1,000,000
5,000,000
X
19682
5,000,000
AggregateSIR: $1,000,000
Dallas, TX 75201-7357
N
X03/31/2023
03/31/2024
06/30/2023
03/31/2024
83UENAG1488
Professional Liability/
B
2,000,000
1,000,000
19445 Hartford Fire Insurance Company
1,000,000
X
C
X
08/18/2023
5,000,000
03/31/2023
5,000,000
State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are Additional Insureds when required by written contract, written agreement or permit, per General Liability Coverage Form CG 20 10 and Commercial Automobile Broad Form Endorsement. This insurance is primary and non-contributory over any existing insurance and limited to liability arising out
X
Phoenix, AZ 85007
Arizona Department of Administration
10,000 of the operations of the named insured subject to policy terms and conditions. Waiver of subrogation is applicable where required by written contract and subject to policy terms and conditions.
A
National Union Fire Insurance Company of Pittsburgh, CN102703309-STND-GAWUP-22-
Each Occurrence
10,000
03/31/2024
1,000,000
83XHUAG0040
Cyber Liability
2,000,000
20478
300,000
1,000,000
06/30/2024
83 WB AW2F69
4400 Comerica Bank Tower
MARSH USA, LLC.
X
1717 Main Street
Attn: Phone: (214) 303-8000
1001 Fort Crook Road North, Suite 150L
Data Axle, Inc.
Bellevue, NE 68005
X
X
01-233-95-84
03/31/2023
100 N 15th Ave, Suite 402
03/31/2023
B
03/31/2024
National Fire Insurance of Hartford
ACORD 101 (2008/01)
The ACORD name and logo are registered marks of ACORD
© 2008 ACORD CORPORATION. All rights reserved.
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: FORM TITLE:
ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY CUSTOMER ID:
LOC #:
AGENCY
CARRIER NAIC CODE
POLICY NUMBER
NAMED INSURED
EFFECTIVE DATE:
Yesmail Interactive London Limited�
YesMail, Inc.�
Data Axle Solutions Private Limited (India)�
Lake Group Media, Inc.�
Infogroup Parent Holdings, Inc.� Data Axle Inc.�
Dallas
Direct Media, LLC� Direct Media Holdings, Inc.�
Infogroup Canada Corp. � GoTime Corporation�
Other Named Insureds:�
B.J. Hunter Information, Inc.�
Certificate of Liability Insurance
CN102703309
infoUSA Inc.�
Walter Karl, Inc.�
Yesmail International Holdings, Inc.�
ConsumerBase, LLC dba Exact Data�
Data Axle International Holdings, Inc.�
DonorBase, Inc.
MARSH USA, LLC.�
1001 Fort Crook Road North, Suite 150L� Data Axle, Inc.�
Bellevue, NE 68005
Alerts.com, LLC�
InfoUSA Marketing, Inc.�
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