GMI__COI_Part_1_-_Expires_7-1-2023.pdf
PDF 226 KB Posted
- Attached to
- Master Agreement AZ|CTR059871
- Contract number
- CTR059871
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by Crest Insurance Group, LLC for Global Market Innovators, Inc., with Hartford Underwriters Insurance Company as the primary insurer. The certificate is issued for the State of Arizona, specifically the State Procurement Office, and provides comprehensive liability coverage for the period from 7/1/2022 to 7/1/2023. The insurance policy covers the State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds.
The insurance policy includes Commercial General Liability with a $2,000,000 each occurrence limit, Automobile Liability, Umbrella Liability, Workers' Compensation, Technology Errors & Omissions (Tech E&O), and Employment Practices Liability Insurance (EPLI). The policy is primary, with any state-carried insurance being excess and non-contributory. The coverage includes a waiver of subrogation in favor of the State of Arizona and its entities. The policy provides protection for liability arising from activities performed by or on behalf of the named insured, with a 30-day cancellation notice required for the certificate holder.
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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
10/14/2022
Crest Insurance Group, LLC 5285 E. Williams Circle Suite 4500 Tucson AZ 85711
Marty Hastings 928-202-4027 520-325-3757 mhastings@crestins.com
License#: 967026 Hartford Underwriters Insurance Company 30104
GLOBMAR-01
Global Market Innovators, Inc 13430 N. Black Canyon Highway Phoenix AZ 85029
787112588
A X 2,000,000 X 1,000,000
10,000
2,000,000
4,000,000 X
59SBAAH1TNF 7/1/2022 7/1/2023
4,000,000
A 1,000,000
X X
59 UEC BC9141 7/1/2022 7/1/2023
A X X 1,000,00059SBAAH1TNF 7/1/2022 7/1/2023
1,000,000 X 25,000
The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds with respect to liability arising out of the activities performed by or on behalf of the named insured. Policy also contains a waiver of subrogation endorsement, in favor of the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Named Insured. Insurance provided by the Named Insured See Attached...
State of Arizona State Procurement Office 100 N 15th Ave Suite 104 Phoenix AZ 85007
A A
Tech E&O
EPLI
59SBAAH1TNF
59SBAAH1TNF
7/1/2022 7/1/2022
7/1/2023 7/1/2023
Occ/Agg Occ
5,000,000 25,000
Nicholas Hastings mhastings Typewritten text X X
ACORD 101 (2008/01)
The ACORD name and logo are registered marks of ACORD
© 2008 ACORD CORPORATION. All rights reserved.
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: FORM TITLE:
ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY CUSTOMER ID:
LOC #:
AGENCY
CARRIER NAIC CODE
POLICY NUMBER
NAMED INSURED
EFFECTIVE DATE:
GLOBMAR-01
1 1
Crest Insurance Group, LLC Global Market Innovators, Inc 13430 N. Black Canyon Highway Phoenix AZ 85029
25 CERTIFICATE OF LIABILITY INSURANCE
is primary and that any insurance carried by the Department, its agents, officials, employees or the State of Arizona shall be excess and not contributory insurance, as provided by A.R.S. § 41-621 (E). A 30 Day notice of cancellation will be provided to the certificate holder.
File details come from the government source that posted it. Updated .