CTR069054_COI_CGL_Auto_WC_PL_Exp_07.01.24.pdf
PDF 971 KB Posted
- Attached to
- Master Agreement AZ|CTR069054
- Contract number
- CTR069054
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance for Catholic Charities Community Services, Inc., located in Phoenix, Arizona, issued by Lockton Companies. The primary insurers are Social Services Contractors Indemnity Pool and CopperPoint American Insurance Company. The certificate covers multiple insurance types, including Commercial General Liability, Automobile Liability, Umbrella Liability, Workers' Compensation, and additional coverages like Professional Liability and Crime Coverage. The certificate holder is the State of Arizona and Department of Economic Security, with coverage effective from 7/1/2023 to 7/1/2024.
The insurance policy provides comprehensive coverage with various limits, including $1,000,000 per occurrence for General Liability and Automobile Liability, $5,000,000 for Umbrella Liability, and $1,000,000 for Workers' Compensation. Additional specialized coverages include $3,000,000 aggregate for Professional Liability, $3,000,000 for Sexual Abuse/Molestation coverage, and crime insurance with limits ranging from $10,000 to $25,000 per occurrence for different types of theft and fraud. The policy includes a waiver of subrogation in favor of the State of Arizona and its departments, and covers activities related to multiple contract numbers in the ADES (Arizona Department of Economic Security) division.
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I-1.coRo• CERTIFICATE OF LIABILITY INSURANCE DAT£ C-,'OQYYY'f")
7/112024 10/25/2022 THIS CERTIACATE IS ISSU ED AS A MATTER OF INFORMATION ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFtcATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE ODES NOT CONSmUTE A CONTRACT BETWEEN THE ISSUING INSURER(S1 AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certifie.ate holder is an ADDmONAL INSURED, the policy(ies) must !'\ave ADDmONAL 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 ceftificate does not confer rights to the ceftifieate holder in lieu of such endorsement(s).
PRODUCER Lock.ton Compa.uies Sll0E. Union Avenue Suite 700
Denver CO 80237
(303) 414-6000 j428315 Catholic Charities Commuorty Semces, Inc.
5151 N 19th Ave Pboemx,AZ 85015
COVERAGES CERTIFICATE NUMBER·
CONTACT
MAME:
�NE
••- If�-"
UOAOC
AOORE&t:
tNWRER'*' AFFOROINO COVERAGE
IN8UR£.RA Social Sen.-i.c.e Contractor's Indemnity Pool 0 tNltRat:8 ConnorPoint American Insurance Com•-..... , 13751 tNtuRERC:
all-I.RE.RO:
IN&t.MERE:
tN&URERF:
199374<61 REVISION NUMBER· xxxxxxx THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTEO BELOW HAVE SEEN ISSUED TO lHE INSURED NA.MED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG NlY REOOREMENT. TERM OR CONCmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIACATE MAY BE ISSUED OR r#.Y PERTAIN. THE INSURAfK:E AFFORDED SY 1HE POUCIES DESCRIBED !£REIN IS SUBJECT TO ALL lHE TERMS, EXCUISKlNSAND CONDITIONS OF SUCH POUC IES . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID Q.AIMS.
1'YPE OE INlURAHCE
""'" lUB� POt.lCYU-f ��-�- UM,n "" ... ,, wvo POUCY lfUMBER
A X COIQIERCIAL OElfERAL t.lASLITY y y 6000569 711/2023 711/2024 EACKOCCURRENCE • 1.000 000
-tJ Cl.A.1M3-tMDE [x] OCCUR . • 1000 000
- MEO EXP t/VIY Oflt Ot1'$011) • 10 000
PER30HM.. & N>V IMJUR'I' - • 1.000.000
xi
GEN'LAGGREGATE LN'T N=PUE3 PER: GEMEAAl. AGGREGATE • 3.000.000
POI.ICY□ �A8; □ LOC PROOUCT3 • COMP/OP AGG • 3.000 000
OTHER: •
A AUTOII081L£ UA8LITY y y - 6000569 71112023 7/1/2024 COM81NEO 3!KGI..E LIMrT • 1.000.000
X N<Y AUTO 8001L Y INJURY (!>ff penon) • xxxxxxx"'"""' - SCH:OULEO 8001L Y INJURY (!>ff «clOent,) • xxxxxxx- NJT030N.Y
HIRED �WNEO "P
ROf'ERTY DAMAS: • xxxxxxx- NJT03()(1l.Y -AUT080NLY Pel'a«IC!Cflli
X $500·- X $500coll • xxxxxxx
A UMBRELLAUU �OCCUR N N 6000570 7/112023 7/1/2024 EACH OCCURRENCE • 5 000000-
X EXCUlUA8 CLAMS·MAOE AGGREGATE • 5.000.000 OED I I RETENT10N J • xxxxxxx
B WCM'l:KERl COIIPEN lATION y 1019020 71112023 7/1/2024 x1reTVTE I l�nt-
AHO EMPLOY'EIU' UA8LITY
v,.
ANY MOPRIETOR.IPAATMER.IEXECOTfVE llil
E.L EACH ACCl.)ENT • 1.000 000Q;,FlCER'El.t&R EltCUJOEO? .,.
(ll.lmdll!OfY In NH) E.L 013EA8E • EA EMPLOYU J 1 000 000 lfYtS,Ot"M� WJClet OE3CRP'l'IOH 0� OPERATIONS bdoW E.L OC8EASe • POUC'Y LM!T • 1.000.000
A SeeAmdled N N 6000569 711/2023 711/2024 SeeAtt3clM!d
OElCFll"OON Of' Of'ERA1l0Nl/ LOCl.110Nl /VEHICLEl (AOORO 101, Addlbonfil R•m«k• ktledUS., IN)'tt.� If-.--�ndl B..:Diviiioit. Nam,: ADES, CocUW: fCTJI.U90$4. i!CTB.0408$2, CTR.Os+tH, CTR066282,C'l'R.061944, CTR.062399,C'l'R.06763l, C'l'R.06773+ & CTB.066190 To. S.i.�• o!Amou ud � &p1-"Ul1QG.1,, uQCM'-bod,, co:am.iu3olll. llllh� ofEc•n. of5ciat1o, b .a:d -rJoT'" au iDc.lud� "' Add..'tictw hluJ,..-.d witll. r.tp,Kt ,o tiltbility ioi:1oiq out of th.t KC\iliie1, pado:mtd by
OJ OG W»lf of' lh.t Nac;d m,u....t ., :.sptet Gt:ie:al Lulaility ud AtilO Liab· • •. Ull.-olriDg:
lt:Tcc:.obi.lt, on$d.. bit.cl ud.'or -� by cbA Co:ottfC;b:!r, wb.r. �d by'll'ritM:i co:otnct. Wai-.woiSubroptioo �&\ ill b\'OJ oith.t Sw. of Ariz.cm ud itt dapatl::lf:m, <lg$CK� t,c-a:,h.
CERTIFICATE HOLDER
19937461 The State of Arizona and Dept of Economic Security C/0:myCOI 1075 Broad Ripple Ave Suite 313 In olis IN 46220
CANCELLATION SeeAttachment
SHOULD AJ4Y Of THE A.BOVE OESCftlBED POLtclE$ BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISION$.
©1988-2 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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