CTR059871_Certificate_of_Insurance.pdf

PDF 103 KB Posted

Attached to
Master Agreement AZ|CTR059871
Contract number
CTR059871
Issued by
Arizona

About this file

This document is an ACORD Certificate of Liability Insurance for Global Market Innovators, Inc., issued by Crest Insurance Group, LLC on 8/17/2023. The certificate involves multiple insurance carriers, including HDI Specialty Insurance Company, Continental Casualty Company, Hartford Underwriters Insurance Company, and Nutmeg Insurance Company. The primary certificate holder is the State of Arizona, specifically the State Procurement Office, located in Phoenix, with the insurance policies designed to cover the insured's activities on behalf of the state.

The insurance coverage includes Commercial General Liability, Automobile Liability, Umbrella Liability, Cyber Liability, and Errors & Omissions (E&O) insurance. The policies are effective from 7/1/2023 to 7/1/2024, with various coverage limits ranging from $1,000,000 to $4,000,000 per occurrence and aggregate. The policies provide additional insured status to the State of Arizona, its departments, agencies, boards, commissions, universities, officers, and employees, with a waiver of subrogation. The insurance is primary, with any state-carried insurance being excess, and includes a 30-day cancellation notice provision as required by Arizona Revised Statutes.

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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

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)

© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

8/17/2023

Crest Insurance Group, LLC 5285 E. Williams Circle Suite 4500 Tucson AZ 85711

Marty Hastings 928-202-4027 520-325-3757 mhastings@crestins.com

License#: 967026 HDI Specialty Insurance Company 16131 GLOBMAR-01 Continental Casualty Company 20443

Global Market Innovators, Inc 13430 N. Black Canyon Highway Suite 250 Phoenix AZ 85029

Hartford Underwriters Insurance Company 30104 Nutmeg Insurance Company 39608

1596171655

C X 2,000,000 X 1,000,000

10,000

2,000,000

4,000,000

X Tech E&O

Y Y 59SBAAH1TNF 7/1/2023 7/1/2024

4,000,000

Occ/Agg 2,000,000 D 1,000,000

X

59UECBC9141 7/1/2023 7/1/2024

C X X 1,000,00059SBAAH1TNF 7/1/2023 7/1/2024

1,000,000 X 10,000

B A

Cyber Liability and E&O Cyber and E&O Excess

652523118

FRH-H-CT-00000653-01

4/27/2023 4/27/2023

4/27/2024 4/27/2024

Occ/Agg Occ/Agg

2,000,000 2,000,000

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds with respect to liability arising out of the activities performed by or on behalf of the named insured. Policy also contains a waiver of subrogation endorsement, in favor of the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Named Insured. Insurance provided by the Named Insured See Attached...

State of Arizona State Procurement Office 100 N 15th Ave Suite 104 Phoenix AZ 85007

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:

GLOBMAR-01

1 1

Crest Insurance Group, LLC Global Market Innovators, Inc 13430 N. Black Canyon Highway Suite 250 Phoenix AZ 85029

25 CERTIFICATE OF LIABILITY INSURANCE

is primary and that any insurance carried by the Department, its agents, officials, employees or the State of Arizona shall be excess and not contributory insurance, as provided by A.R.S. § 41-621 (E). A 30 Day notice of cancellation will be provided to the certificate holder.

File details come from the government source that posted it. Updated .