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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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

E-MAIL

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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