CTR072042_-_COI_WC_Exp._1.01.2026.pdf

PDF 177 KB Posted

Attached to
Master Agreement AZ|CTR072042
Contract number
CTR072042
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by Lovitt-Touche, a Marsh & McLennan Agency LLC Co, for Child & Family Resources, Inc. The insurance policy is underwritten by CopperPoint Indemnity Insurance Company and is specifically a Workers' Compensation policy. The certificate holder is the Arizona Department of Economic Security, located in Indianapolis, Indiana. The policy provides coverage for the period from January 1, 2025, to January 1, 2026, with a policy number WC1041478.

The insurance includes a Waiver of Subrogation in favor of the State of Arizona, its departments, agencies, boards, commissions, universities, and its officers, officials, agents, and employees for losses arising from work performed by or on behalf of the contractor. The policy has workers' compensation limits of $1,000,000 for each accident, each employee, and policy limit. The endorsement specifically relates to a contract (CTR072042) for Child Care Resource & Referral services, with the waiver of subrogation extending to losses arising from the contractor's work. The premium for this endorsement is $500.00, with an effective date of January 1, 2025.

View the file

Other files

File Type Posted
1-ATTACHMENT - 2 Questionnaire_Child & Family Resourcecs.docx DOCX document
BAFO2 Attachment_14_Itemized_Service_Budget Child & Family Resources.xlsx XLSX spreadsheet
Boycott_Disclosure_Child___Family_Resources.pdf PDF
CTR072042_COI_CGL_Auto_PL_02.17.25_WC_01.01.25.pdf PDF
CTR072042_COI_WC_Exp_1.01.26_GL_AL_Exp_2.17.26.pdf PDF
CTR072042_Contract_Amendment_2.pdf PDF
Certification_Regarding_Exclusions_Child___Family_Resources.pdf PDF
Certification_of_Insurability_Child___Family_Resouces.pdf PDF
Designation_of_Confidentity_Child___Family_Resources.pdf PDF
Force_Labor_Child___Family_Resources.pdf PDF
Offer_and_Acceptance_Child___Family_Resources.pdf PDF
BAFO2 ATTACHMENT - 2 Questionnaire_Child Family Resources.pdf PDF
BAFO_Attachment_14_Itemized_Service_Budget_Child___Family_Resources.xlsx XLSX spreadsheet
CTR072042_Amendment_1.pdf PDF
CTR072042_Attachment_13_Data_Sharing_Agreement__-_signed.pdf PDF
CTR072042_Exhibit_C_Invoice.docx DOCX document
CTR072042_Pricing.xlsx XLSX spreadsheet
Certifcation_Lobbying_Child___Family_Resources.pdf PDF
Deviations_and_Exceptions_Child___Family_Resources.pdf PDF
BAFO_ATTACHMENT_-_2_Questionnaire_Child___Family_Resourcecs.docx DOCX document
CTR072042_Contract_Documents.pdf PDF
CTR072042_Debarment_Checks.pdf PDF
Proposed_Subcontractors_Child___Family_Resources.pdf PDF
References_Child___Family_Resources.pdf PDF
Show all 24

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

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

E-MAIL

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

12/26/2024

Lovitt-Touche A Marsh & McLennan Agency LLC Co 4703 E Camp Lowell Drive, #101 Tucson AZ 85712

Jordyn Even 520-722-3000 520-722-7245 jeven@lovitt-touche.com

CopperPoint Indemnity Insurance Company 13928

CHIL&FA-C1

Child & Family Resources, Inc.

Connie Curnett 2800 E. Broadway Blvd Tucson AZ 85716

87912362

A XY WC1041478 1/1/2025 1/1/2026

1,000,000

1,000,000

1,000,000

Waiver of Subrogation in favor of the Certificate Holder

(WC) Re: CTR072042 – Child Care Resource & Referral Workers Compensation: Waiver of subrogation provided to the State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor.

Arizona Department of Economic Security C/O: myCOI 1075 Broad Ripple Ave, Suite 313 Indianapolis IN 46220

File details come from the government source that posted it. Updated .