CTR066268_-_COI.pdf
PDF 2 MB Posted
- Attached to
- Master Agreement AZ|CTR066268
- Contract number
- CTR066268
- Issued by
- Arizona
About this file
This document is a comprehensive insurance certificate and related endorsements for Arbor E&T, LLC dba Equus Workforce Solutions, with Thompson Flanagan Executive Liability Group, LLC as the insurance producer. The primary insurance carriers include AXIS Insurance Company, Pennsylvania Manufacturers Indemnity Company, Underwriters at Lloyds London, and Allied World Assurance Company. The certificate holder is the State of Arizona and Department of Economic Security, located in Indianapolis, IN, with coverage effective from 9/30/2023 to 9/30/2024.
The insurance package provides multiple layers of liability coverage, including commercial general liability, automobile liability, umbrella liability, workers compensation, and various professional liability protections. Specific coverage limits include $1,000,000 per occurrence for general liability, $2,000,000 aggregate, $3,000,000 for umbrella liability, and additional specialized coverages such as professional liability, management liability, and employment practices liability. The policy includes extensive additional insured provisions for the State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees, with waivers of subrogation and primary non-contributory insurance conditions. The contract appears to be related to the AZ Jobs Program, with contract numbers ADS17-146348 and CTR066268.
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Text version
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
CG 24 04 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
SCHEDULE
Name Of Person(s) Or Organization(s):
The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds
1789 W. Jefferson, Mail Drop 1541 Phoenix, AZ 85007
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions:
We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above.
INSURED COPY
Pennsylvania Manufacturers’
Association Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Copyright, ISO Commercial Risk Services, Inc., 1983
Page
POLICY CHANGES
Policy Change Number
POLICY NUMBER POLICY
CHANGES
EFFECTIVE
COMPANY
NAMED INSURED AUTHORIZED REPRESENTATIVE
COVERAGE PARTS AFFECTED
CHANGES
Authorized Representative Signature
152375-14-89-67-3
09-30-23
ROSS INNOVATIVE EMPLOYMENT
THOMPSON FLANAGAN EXECUTIVE
LIABILITY GROUP LLC
626 W. JACKSON BLVD.
SUITE 500
CHICAGO IL 60661-0000
COMMERCIAL BUSINESS AUTO COVERAGE PART
NO CHARGE TO BE ADJUSTED AT AUDIT
THE FOLLOWING FORM(S) HAS BEEN ADDED:
CA 04 44 10-13 WVR OF TRNSFR OF RGHTS OF RCVRY AGNST
THE FOLLOWING FORM(S) HAS BEEN AMENDED:
CA 20 01 11-20 LESSOR-ADDL INSURED AND LOSS PAYEE
ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME
INSURED COPY
POLICY NUMBER: COMMERCIAL AUTO
CA 04 44 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CA 04 44 10 13 Insurance Services Office, Inc., 2011 Page 1 of 1
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured:
Endorsement Effective Date:
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the ‘‘accident’’ or the ‘‘loss’’ under a contract with that person or organization.
152375-14-89-67-3
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 CONTRACTOR.
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