LanguageLineHoldingsIIInc_-_Client_Pack_-_3001262_-_COI_6-5-2023.pdf
PDF 1 MB Posted
- Attached to
- Master Agreement AZ|CTR069864
- Contract number
- CTR069864
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by Willis Towers Watson Northeast, Inc. for Language Line Holdings II, Inc., with multiple insurers including Great Northern Insurance Company, Federal Insurance Company, Vigilant Insurance Company, Westchester Surplus Lines Insurance Company, and Chubb. The certificate covers insurance policies for the period of June 1, 2023 to June 1, 2024, with the State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, and agents listed as the certificate holder, referencing contract number ADSPO18-212895.
The insurance provides comprehensive coverage including Commercial General Liability, Automobile Liability, Umbrella/Excess Liability, Workers' Compensation, and Errors & Omissions policies. The professional liability coverage includes protection for contingent bodily injury, property damage, and wrongful acts such as disclosure of confidential information, with worldwide coverage. Specific policy limits include $1,000,000 for general liability, $1,000,000 for automobile liability, $20,000,000 for umbrella/excess liability, $1,000,000 for workers' compensation, and $10,000,000 for errors & omissions. The policies include additional insured provisions for the State of Arizona and include a waiver of subrogation for the listed entities.
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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)
© 1988-2016 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
Willis Towers Watson Northeast, Inc.
c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA
Language Line Holdings II, Inc.
One Lower Ragsdale Building Two Monterey, CA 93940
Re: ADSPO18-212895.
Professional Liability coverage includes coverage for contingent bodily injury, property damage and wrongful acts such as the disclosure of confidential information. Coverage is true worldwide.
State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and
State of Arizona ADOA - State Procurement Office 100 North 15th Avenue, Suite 305 Phoenix, AZ 85007
06/05/2023
1-877-945-7378 1-888-467-2378 certificates@willis.com
Great Northern Insurance Company 20303
Federal Insurance Company
Vigilant Insurance Company
20281
20397
Westchester Surplus Lines Insurance Compan 10172
W29242652
A
1,000,000
1,000,000
10,000
1,000,000
2,000,000
2,000,000
Y Y 3595-61-78 06/01/2023 06/01/2024
B
1,000,000
06/01/202406/01/2023Y Y (23)7357-61-09
B 20,000,000
Y Y 7987-71-21 06/01/2023 06/01/2024 20,000,000
7174-35-69 C Y
1,000,000 06/01/2023 06/01/2024
1,000,000
1,000,000
D Errors & Omissions Limit:G21654711 021 06/01/2023 06/01/2024
300126224237829SR ID: BATCH:
$10,000,000
Willis Towers Watson Certificate Center
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:
Language Line Holdings II, Inc.
One Lower Ragsdale Building Two Monterey, CA 93940 employees are included as Additional Insureds as respects to General Liability, Automobile Liability and Umbrella/Excess Liability.
Waiver of Subrogation applies in favor of Additional Insureds with respects to General Liability, Automobile Liability, Umbrella/Excess Liability and Workers Compensation, as permitted by law.
2 2
Willis Towers Watson Northeast, Inc.
See Page 1
See Page 1 See Page 1 See Page 1
25 Certificate of Liability Insurance
W29242652CERT:3001262BATCH:24237829SR ID:
Form: 16-02-0292 (Rev. 11-16) Page 3 of 3 "Includes copyrighted material of Insurance Services Office, Inc. with its permission"
Under Paragraph D. - DEDUCTIBLE – of
SECTION III – PHYSICAL DAMAGE COVERAGE
the following is added:
No deductible applies to glass damage if the glass is repaired rather than replaced.
11. TWO OR MORE DEDUCTIBLES
Paragraph D.- DEDUCTIBLE – of SECTION III – PHYSICAL DAMAGE COVERAGE is amended to add the following:
If this Coverage Form and any other Coverage Form or policy issued to you by us that is not an automobile policy or Coverage Form applies to the same “accident”, the following applies:
1. If the deductible under this Business Auto
Coverage Form is the smaller (or smallest) deductible, it will be waived; or
2. If the deductible under this Business Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible.
12. AMENDED DUTIES IN THE EVENT OF
ACCIDENT, CLAIM, SUIT OR LOSS
Paragraph A.2.a. - DUTIES IN THE EVENT OF AN ACCIDENT, CLAIM, SUIT OR LOSS of SECTION IV - BUSINESS AUTO CONDITIONS is deleted and replaced with the following:
a. In the event of “accident”, claim, “suit” or
“loss”, you must promptly notify us when the “accident” is known to:
(1) You or your authorized representative, if you are an individual;
(2) A partner, or any authorized representative, if you are a partnership;
(3) A member, if you are a limited liability company; or
(4) An executive officer, insurance manager, or authorized representative, if you are an organization other than a partnership or limited liability company.
Knowledge of an “accident”, claim, “suit” or “loss” by other persons does not imply that the persons listed above have such knowledge.
Notice to us should include:
(1) How, when and where the “accident” or
“loss” occurred;
(2) The “insured’s” name and address; and
(3) To the extent possible, the names and addresses of any injured persons or witnesses.
13. WAIVER OF SUBROGATION
Paragraph A.5. - TRANSFER OF RIGHTS OF
RECOVERY AGAINST OTHERS TO US of SECTION IV – BUSINESS AUTO CONDITIONS is deleted and replaced with the following:
5. We will waive the right of recovery we would otherwise have against another person or organization for “loss” to which this insurance applies, provided the “insured” has waived their rights of recovery against such person or organization under a contract or agreement that is entered into before such “loss”.
To the extent that the “insured’s” rights to recover damages for all or part of any payment made under this insurance has not been waived, those rights are transferred to
us. That person or organization must do everything necessary to secure our rights and must do nothing after “accident” or “loss” to impair them. At our request, the insured will bring suit or transfer those rights to us and help us enforce them.
14. UNINTENTIONAL FAILURE TO DISCLOSE
HAZARDS
Paragraph B.2. – CONCEALMENT, MISREPRESENTATION or FRAUD of SECTION IV – BUSINESS AUTO CONDITIONS - is deleted and replaced with the following:
If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not void coverage under this Coverage Form because of such failure.
15. AUTOS RENTED BY EMPLOYEES
Paragraph B.5. - OTHER INSURANCE of
SECTION IV – BUSINESS AUTO CONDITIONS -
is amended to add the following:
e. Any “auto” hired or rented by your “employee” on your behalf and at your direction will be considered an “auto” you hire. If an “employee’s” personal insurance also applies on an excess basis to a covered “auto” hired or rented by your “employee” on your behalf and at your direction, this insurance will be primary to the “employee’s” personal insurance.
16. HIRED AUTO – COVERAGE TERRITORY
Paragraph B.7.b.(5). - POLICY PERIOD, COVERAGE TERRITORY of SECTION IV – BUSINESS AUTO CONDITIONS is deleted and replaced with the following:
(5) A covered “auto” of the private passenger type is leased, hired, rented or borrowed without a driver for a period of 45 days or less; and
17. RESULTANT MENTAL ANGUISH COVERAGE
Paragraph C. of - SECTION V – DEFINITIONS is deleted and replaced by the following:
“Bodily injury” means bodily injury, sickness or disease sustained by any person, including mental anguish or death as a result of the “bodily injury” sustained by that person.
Liability Insurance
Endorsement
Policy Period
Effective Date
Policy Number 3595-61-78 DTO
Insured LANGUAGE LINE HOLDINGS D, INC
This Endorsement applies to the following forms:
GENERAL LIABILITY
Under Who Is An Insured, the following provision is added.
Who Is An Insured
Additional Insured - Scheduled Person Or Organization
Persons or organizations shown in the Schedule are Insureds; but they are Insureds only if you are obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by this policy.
However, the person or organization is an insured only:
• if and then only to the extent the person or organization is described in the Schedule;
• to the extent such contract or agreement requires the person or organization to be afforded status as an Insured;
• for activities that did not occur, in whole or in part, before the execution of the contract or agreement; and
• with respect to damages, loss, cost or expense for injury or damage to which this insurance applies.
No person or organization is an Insured under this provision:
• that is more specifically identified under any other provision of the Who Is An Insured section (regardless of any limitation applicable thereto).
• with respect to any assumption of liability (of another person or organization) by them in a contract or agreement. This limitation does not apply to the liability for damages, loss, cost or expensefor injury or damage, to which this insurance applies,that theperson or organization would have in the absence of such contract or agreement.
Liability Insurance Additional Insured - Scheduled Person Or Organization continued Form 80-02-2367 (Rev. 5-07) Page 1Endorsement
JUNE 1, 2023 TO JUNE 1, 2024
JUNE 1, 2023
Name of Company GREAT NORTHERN INSURANCE COMPANY
Date Issued JUNE 1, 2023
Liability Endorsement (continued)
Under Conditions, the following provision is added to the condition titled Other Insurance.
Conditions
Other Insurance- Primary, Noncontributory Insurance-Scheduled Person Or Organization
If you are obligated,pursuant to a contract or agreement, to provide the person or organization shown in the Schedule with primary insurance such as is afforded by this policy, then in such case this insurance is primary and we will not seek contribution from insurance available to such person or organization.
Schedule
Persons or organizations that you are obligated, pursuant to a contract or agreement, to provide with such insurance as is afforded by this policy.
All other terms and conditions remain unchanged.
Authorized Representative O
Liability Insurance Additional Insured - Scheduled Person Or Organization last page Form 80-02-2367 (Rev. 5-07) Page 2Endorsement
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement No.
Insured LANGUAGE LINE HOLDINGS II, INC Premium $ Incl.
Insurance Company Vigilant Insurance Company
Countersigned By
WC 00 03 13
(Ed. 4-84)
1983 National Council on Compensation Insurance.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
WHEN REQUIRED UNDER WRITTEN CONTRACT
OR AGREEMENT
Producer Copy
Policy No. (23) 7174-35-69Endorsement Effective 06-01-23
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