CTR070879_COI_3.1.26.pdf
PDF 16 KB Posted
- Attached to
- Master Agreement AZ|CTR070879
- Contract number
- CTR070879
- Issued by
- Arizona
About this file
This Certificate of Liability Insurance, issued on February 24, 2025, documents coverage for M A Rulon LLC, a contractor based in Phoenix, Arizona, under Arizona State Procurement Office Contract Number CTR070879. The certificate is issued by Hub International Florida on behalf of the insured and names the State of Arizona, its departments, agencies, boards, commissions, universities, and their officers, officials, agents, and employees as additional insureds. Three insurance carriers provide coverage: Ohio Casualty Insurance Company (NAIC #24074), Great Divide Insurance Company (NAIC #25224), and Arch Specialty Insurance Company (NAIC #21199).
The insurance coverage includes Commercial General Liability with limits of $2,000,000 per occurrence and $4,000,000 aggregate, Automobile Liability with $1,000,000 combined single limit, Professional Liability with $2,000,000 aggregate and $2,500 deductible, and Cyber/Privacy/Network coverage with $2,000,000 aggregate and $2,500 deductible. All policies are effective March 1, 2025, through March 1, 2026. The contractor has provided a waiver of subrogation applicable to General Liability, Auto Liability, Professional Liability, and Cyber coverage, with all policies serving as primary and non-contributory in favor of the State of Arizona and its entities. Medical expense coverage is limited to $15,000 per person.
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Other files
| File | Type | Posted |
|---|---|---|
| BMP005616Solicitation_RequirementsFinal.pdf | ||
| CTR070879_A1.pdf | ||
| BPM005616_Price_Sheet.xlsx | XLSX spreadsheet | |
| Offer_and_Acceptance_MARulon.pdf |
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Text version
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
PRODUCER CONTACT
NAME:
FAXPHONE
(A/C, No):(A/C, No, Ext):
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $
DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT
OTHER: $
COMBINED SINGLE LIMIT
$(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED
BODILY INJURY (Per accident) $AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
$AUTOS ONLY AUTOS ONLY (Per accident)
OCCUR EACH OCCURRENCE
CLAIMS-MADE AGGREGATE $
DED RETENTION $
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below
INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N N / A
(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
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.
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.
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).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
The ACORD name and logo are registered marks of ACORD
2/24/2025
(904) 446-3151 (904) 396-7432
24074
M A Rulon LLC 2722 E Evans Dr Phoenix, AZ 85032
25224 21199
A 2,000,000
X X BZS59601944 3/1/2025 3/1/2026 2,000,000
15,000
2,000,000 4,000,000 4,000,000
1,000,000A
X X BZS59601944 3/1/2025 3/1/2026
B Professional Liabili X X KYSMPLG000602 3/1/2025 $2M agg/$2,500 ded 2,000,000 C Cyber/Privacy/Networ X X C4LZQ021889CYBER 2025A 3/1/2025 3/1/2026 $2M agg/$2,500 ded 2,000,000
The State of Arizona its Departments Agencies Boards Commissions Universities and its Officers Officials Agents and Employees shall be named as additional insured with respect to General Liability, Auto Liability, Professional Liability and Cyber arising out of the activities performed by on or on behalf of Contractor. Waiver of Subrogation applied with Respects to General Liability, Auto Liability, Profesisonal Liability and Cyber . General Liability, Professional Liability & Auto Policies are primary & non-contributory in favor of The State of Arizona its Departments Agencies Boards Commissions Universities and its Officers Officials Agents and Employees.
Contract number CTR070879
State of Arizona, Arizona Dept of Admin, State Procurement Office 100 N 15th Ave Ste 402 Phoenix, AZ 85007
MARULON-01 NBUTLER
Hub International Florida 10739 Deerwood Park Blvd Suite 200 Jacksonville, FL 32256
Nita Butler
Nita.Butler@HUBinternational.com
Ohio Casualty Insurance Company Great Divide Insurance Company Arch Specialty Insurance Company
3/1/2026
X X
X X
File details come from the government source that posted it. Updated .