CTR061131_Salibas_Supplement_Insurance.pdf
PDF 191 KB Posted
- Attached to
- Master Agreement AZ|CTR061131
- Contract number
- CTR061131
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance and an accompanying letter from USI Insurance Services, dated May 18, 2022, involving Guardian Pharmacy of Arizona, LLC (doing business as Saliba's Extended Care Pharmacy) and the Arizona Department of Veterans' Services. The certificate confirms insurance coverage for Guardian Pharmacy, with multiple insurers including TDC Specialty Insurance Company, Sentry Insurance Company, and Capitol Specialty Insurance Corporation, specifically for Solicitation No. BPM004543.
The insurance certificate covers multiple types of liability, including Commercial General Liability, Automobile Liability, Umbrella Liability, Workers' Compensation, and Professional Liability. Key coverage limits include $1,000,000 per occurrence for General Liability, $10,000,000 in Umbrella Liability, and $1,000,000 per incident/$3,000,000 aggregate for Professional Liability. The policy period runs from September 30, 2021, to September 30, 2022, and includes additional insured status for the State of Arizona and its departments, with the Arizona Department of Veterans' Services listed as the certificate holder.
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Text version
USI Insurance Services 1 Concourse Parkway, NE, Suite 700
Atlanta, GA 30328 Phone: 404‐923‐3700 www.usi.com
May 18, 2022
Arizona Department of Veterans' Services Procurement Unit 3839 N. 3rd St., Suite 209 Phoenix, AZ 85012
To Whom It May Concern, Guardian Pharmacy of Arizona, LLC currently possesses the required insurance as stated in the Section
6.2 of Special Terms and Conditions of Solicitation No. BPM004543.
Sincerely, Lillie Axelrod
See below
RE: RFP BPM004543
The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as additional insureds on General and Auto Liability as respects liability arising out of the operations of the named insured, subject to policy terms, conditions and exclusions. Waiver applies in favor of the same including Workers' Compensation if required by written contract, subject to policy's terms, conditions and exclusions.
GUARDPHA
5/18/2022
Gail Rapa Commercial Lines - (404) 923-3700 470.875.0345 USI Insurance Services LLC gail.rapa@usi.com 1 Concourse Parkway NE, Suite 700
Atlanta, GA 30328 TDC Specialty Insurance Company 34487
Sentry Insurance Company 24988 Guardian Pharmacy of Arizona, LLC Capitol Specialty Insurance Corporation 10328 dba Saliba's Extended Care Pharmacy Vantage Risk Specialty Ins Co 023285 925 E. Covey Lane Sentry Casualty Company 28460 Phoenix, AZ 85024
15547154
XA MFP010312102 1,000,00009/30/2021 09/30/2022
X 100,000
5,000
1,000,000
3,000,000
X 1,000,000 sex abuse/molestation included
B 9021211003 (AOS) 09/30/2021 09/30/2022 1,000,000
X 9021211005 (VA)
$2,000 Comp
X X $2,000 Coll
X X C MM2014218907 ($5mil prim) 09/30/2021 09/30/2022 10,000,000
D HC2021000222200 09/30/2021 09/30/2022 10,000,000
($5mil xs $5mil)
E 9021211001(AOS) 09/30/2021 09/30/2022 X
1,000,0009021211002 (WI)
1,000,000
1,000,000
A Professional Liability MFP010312102 09/30/202109/30/2021 09/30/2022 $1M Per Incident / $3M Aggregate
(This certificate replaces certificate# 15491617 issued on 1/4/2022)
Arizona Department of Veterans’ Services
Procurement Unit
3839 N. 3rd St., Suite 209 Phoenix, AZ 85012
File details come from the government source that posted it. Updated .