D_Smith_Technology_and_Consulting_-_COI.pdf

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Attached to
Master Agreement AZ|CTR078084
Contract number
CTR078084
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by The Hartford on August 18, 2025, for D. Smith Technology and Consulting, LLC (DBA DSTC, LLC), with the State of Arizona's Department of Administration and State Procurement Office as the certificate holder. The insurance is provided through multiple insurers, including Hartford Underwriters Insurance Company, Hartford Fire Insurance Company, and Twin City Fire Insurance Company, and was produced by Nutmeg Insurance Agency.

The insurance covers commercial general liability, automobile liability, workers' compensation, and technology errors and omissions with policy periods from 08/10/2025 to 08/10/2026. The policy is associated with contract number CTR078084 for Data Management Services. Coverage limits include $1,000,000 for each occurrence in general liability, with an aggregate limit of $2,000,000, and similar structured limits for other policy types. The policy specifically references services to be performed at 643 Tory Pines Dr, Red Oak, TX, and includes provisions for additional insured status and waiver of subrogation in favor of the certificate holder.

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Text version

WLTR005

THE HARTFORD

BUSINESS SERVICE CENTER

3600 WISEMAN BLVD

SAN ANTONIO TX 78251 August 18, 2025

State of Arizona Arizona Department of Administration State Procurement Office

1802 W JACKSON ST # 100

PHOENIX AZ 85007-3221

Account Information:

Policy Holder Details : D. Smith Technology and Consulting, LLC DBA DSTC, LLC

Contact Us Need Help?

Chat online or call us at

(866) 467-8730.

We're here Monday - Friday.

Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any questions or concerns.

Sincerely, Your Hartford Service Team

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)

08/18/2025 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 be endorsed. If SUBROGATIONIS 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).

PRODUCER

NUTMEG INS AGENCY INC/PHS

76210775 The Hartford Business Service Center 3600 Wiseman Blvd San Antonio, TX 78251

CONTACT

NAME:

PHONE

(A/C, No, Ext):

(888) 925-3137 FAX

(A/C, No):

E-MAIL

ADDRESS:

INSURER(S) AFFORDING COVERAGE NAIC#

INSURED

D. Smith Technology and Consulting, LLC DBA DSTC, LLC

643 TORY PINES DR

RED OAK TX 75154-2748

INSURER A : Hartford Underwriters Insurance Company 30104 INSURER B : Hartford Fire Insurance Company 19682 INSURER C : Twin City Fire Insurance Company 29459

INSURER D :

INSURER E :

INSURER F :

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

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.

INSR

LTR

TYPE OF INSURANCE ADDL

INSR

SUBR

WVD

POLICY NUMBER POLICY EFF

(MM/DD/YYYY)

POLICY EXP

(MM/DD/Y YYY)

LIMITS

A

COMMERCIAL GENERAL LIABILITY

X X 76 SBW AZ4FXH 08/10/2025 08/10/2026

EACH OCCURRENCE $1,000,000

CLAIMS-MADE X OCCUR DAMAGE TO RENTED

PREMISES (Ea occurrence) $1,000,000

X General Liability MED EXP (Any one person) $10,000

PERSONAL & ADV INJURY $1,000,000

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000

X POLICY PRO-

JECT

LOC PRODUCTS - COMP/OP AGG $2,000,000

OTHER:

A

AUTOMOBILE LIABILITY

76 SBW AZ4FXH 08/10/2025 08/10/2026

COMBINED SINGLE LIMIT

(Ea accident)

$1,000,000 ANY AUTO BODILY INJURY (Per person)

ALL OWNED

AUTOS

SCHEDULED

AUTOS BODILY INJURY (Per accident)

X HIRED

AUTOS X NON-OWNED

AUTOS

PROPERTY DAMAGE

(Per accident)

UMBRELLA LIAB

EXCESS LIAB

OCCUR

CLAIMS-

MADE

EACH OCCURRENCE

AGGREGATE

DED RETENTION $

C

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

ANY

PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below

N/ A X 76 WEG AZ4FXJ 08/10/2025 08/10/2026

X PER

STATUTE

OTH-

ER

Y/N E.L. EACH ACCIDENT $1,000,000

E.L. DISEASE -EA EMPLOYEE $1,000,000

E.L. DISEASE - POLICY LIMIT $1,000,000

B FailSafe Technology Errors or Omissions Liability

76 SBW AZ4FXH 08/10/2025 08/10/2026 Each Wrongful Act Aggregate Limit

$1,000,000 $1,000,000

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

Those usual to the Insured's Operations. RE: Job Description/Contract Number: CTR078084 - Data Mgmt. Services - 643 TORY PINES DR, RED OAK, TX 75154-2748 .

CERTIFICATE HOLDER CANCELLATION

State of Arizona Arizona Department of Administration State Procurement Office

1802 W JACKSON ST # 100

PHOENIX AZ 85007-3221

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED

BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED

IN ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE

© 1988-2015 ACORD CORPORATION. All rights reserved.

ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD

ACORD 101 (2014/01) © 2014 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

AGENCY CUSTOMER ID:

LOC# :

ADDITIONAL REMARKS SCHEDULE Page 2 of 2

AGENCY

NUTMEG INS AGENCY INC/PHS

NAMED INSURED

D. SMITH TECHNOLOGY AND CONSULTING, LLC DBA DSTC,

LLC

643 TORY PINES DR

RED OAK TX 75154-2748

POLICY NUMBER

SEE ACORD 25

CARRIER

SEE ACORD 25

NAIC CODE

EFFECTIVE DATE: SEE ACORD 25

ADDITIONAL REMARKS

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM

FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE

Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SL 00 00, attached to this policy. The Business Liability Coverage Part includes a Blanket Additional Insured By Contract Endorsement, Form SL 30

32. Blanket Waiver of Subrogation applies in favor of the Certificate Holder per the Waiver of Our Right to Recover from Others Endorsement WC420304B, attached to this policy.

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