CTR079466_COI_2026-04-01_AL_GL_WC.pdf
PDF 99 KB Posted
- Attached to
- Master Agreement AZ|CTR079466
- Contract number
- CTR079466
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance for RecoveryTrek, LLC, located in Norfolk, Virginia. The certificate involves multiple insurers including Sentinel Insurance Company Ltd, Hartford Accident and Indemnity Company, and Gemini Insurance Company. The primary certificate holder is the Arizona Department of Health Services, Office of Procurement, located in Phoenix, Arizona. The insurance coverage is set to run from July 1, 2025 to July 1, 2026, with a certificate issuance date of November 24, 2025.
The insurance policy provides comprehensive coverage including Commercial General Liability (with $2,000,000 each occurrence and $4,000,000 aggregate limits), Automobile Liability, Umbrella Liability, Workers' Compensation, and Technology Errors & Omissions (Tech E&O) coverage with $2,000,000 limits for each wrongful act and in aggregate. The State of Arizona and Arizona Department of Health Services are included as additional insureds when required by written contract, with a waiver of subrogation for General Liability and Workers Compensation policies. The Errors & Omissions policy is specified as primary and non-contributory, with all standard policy terms, conditions, definitions, and exclusions applying.
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Other files
| File | Type | Posted |
|---|---|---|
| CTR079466_Contract_Administration.pdf | ||
| CTR079466_Pricing.pdf | ||
| CTR079466_Contractor_Quote.pdf | ||
| CTR079466_Contract_Documents.pdf |
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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
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
11/24/2025
Arthur J. Gallagher Risk Management Services, LLC 115 Federal Street Boston MA 02110
617-261-6700 617-531-7777
Sentinel Insurance Company Ltd 11000 RECOLLC-04 Hartford Accident and Indemnity Company 22357
RecoveryTrek, LLC 440 Monticello Avenue, Suite 100 Norfolk VA 23510
Gemini Insurance Company 10833
1807763557
A X 2,000,000 X 1,000,000
10,000
2,000,000
4,000,000 X
Y 08SBAIX5338 7/1/2025 7/1/2026
4,000,000
A 2,000,000
X X
08SBAIX5338 7/1/2025 7/1/2026
A X X 1,000,00008SBAIX5338 7/1/2025 7/1/2026
1,000,000 X 10,000
B X08WECAK2P73 4/1/2025 4/1/2026
1,000,000
1,000,000
1,000,000 C Tech E&O VNPL019933 9/22/2025 9/22/2026 Each Wrongful Act
Aggregate $2,000,000 $2,000,000
The State of Arizona and the Arizona Department of Health is included as additional insured when required by written contract or agreement with a waiver of subrogation with regard to General Liability and Workers Compensation policies, per form SS 00 08 04 05. The Errors & Omissions policy is primary and non-contributory per form FS 00 H335 00 1016. All policy terms, conditions, definitions, and exclusions apply.
Arizona Department of Health Services Office of Procurement 150 N 18th Avenue, Suite 530 Phoenix AZ 85007
USA
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