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
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.
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