MCA_-_gl_wc__ADHS-BPM000334__041025.pdf

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Attached to
Master Agreement AZ|CTR056041
Contract number
CTR056041
Issued by
Arizona

About this file

This document is a Certificate of Insurance issued by Mayo Clinic Arizona on April 10, 2025, addressed to the Arizona Department of Health Services' Office of Procurement. The certificate relates to a solicitation with RFGA Number BPM000334 and provides details about Mayo Clinic Arizona's insurance coverage. The document involves Mayo Clinic Arizona, Mayo Insurance Company Limited, the State of Arizona, and the Arizona Industrial Commission.

The certificate confirms Mayo Clinic Arizona's general liability coverage through Mayo Insurance Company Limited, with a policy providing $5,000,000 per occurrence on an occurrence basis. The policy includes additional insured status for the State of Arizona and its associated entities, with a waiver of subrogation. Additionally, Mayo Clinic Arizona has workers' compensation and employer's liability coverage through a self-insured authority certified by the Industrial Commission of Arizona, which also includes a waiver of subrogation for the State of Arizona and its associated entities.

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Text version

April 10, 2025

CERTIFICATE OF INSURANCE

Certificate Holder Arizona Department of Health Services Office of Procurement 150 North 18th Avenue, Suite 260 Phoenix, AZ 85007

RE: Mayo Clinic Arizona (RFGA Number: BPM000334)

General Liability Coverage Worker’ Compensation Coverage

To Whom It May Concern:

Mayo Clinic Arizona is covered for its General Liability exposure through a policy issued by Mayo Insurance Company Limited, under policy No. 272-1-05011. Coverage is on an occurrence basis with limits $5,000,000 per occurrence. The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are listed as additional insureds with respect to liability arising out of the activities performed by or on behalf of Mayo Clinic Arizona.

The policy contains a waiver of subrogation 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 Mayo Clinic Arizona.

Mayo Clinic Arizona is provided with workers’ compensation and employer’s liability coverage through a self-insured authority certified by the Industrial Commission of Arizona. The policy includes a waiver of subrogation against the State of Arizona, its department, agencies, boards, commissions, universities and its officers, officials, agents, and employees for losses arising from work performed by or on behalf of Mayo Clinic Arizona.

Sincerely, Dawn M. Schieffer Director, Risk Management

CERTIFICATE OF INSURANCE

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