Robbins_Geller_-_Evidence_of_Insurance_-_WC_Certificate.pdf

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Attached to
Master Agreement AZ|CTR067443
Contract number
CTR067443
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by Aon Risk Services Central, Inc. on 04/15/2025, with Robbins Geller Rudman & Dowd LLP listed as the insured. The insurance is provided by Vigilant Ins Co (NAIC #20397), covering a Workers Compensation policy for the period from 05/01/2024 to 05/01/2025.

The certificate provides evidence of insurance with key coverage details, including Workers Compensation with statutory limits and Employers' Liability coverage. The policy includes $1,000,000 for each accident, $1,000,000 for disease coverage per employee, and $1,000,000 for total disease policy limit. The document explicitly states this is issued as a matter of information only and does not constitute a contract or confer rights to the certificate holder, serving primarily as proof of existing insurance coverage for the named insured.

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Text version

H o ld e r

Id e n ti fi e r

77777 77707 07070 00777 61616 04557 11107 44525 02623 55740 07462 00577 27253 00072 57177 70451 12010 73605 75510 67442 10747 66271 76577 73507 72505 32357 33302 07004 00357 63215 64071 62112 56222 77110 76727 24203 57720 00777 77770 70007 07007

77777 77707 07070 00735 25677 11545 60007 32011 51346 70474 07221 11413 52611 31077 61154 43422 21370 70222 76216 42315 10756 23377 52463 44107 06633 32574 27510 07022 37621 64221 51071 23336 24306 21110 77756 16335 17655 40777 77770 70007 07007

C e rt if ic a te

N o

CERTIFICATE OF LIABILITY INSURANCE

DATE(MM/DD/YYYY)

04/15/2025

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.

PRODUCER

Aon Risk Services Central, Inc.

Chicago IL Office 200 East Randolph Chicago IL 60601 USA

PHONE

(A/C. No. Ext):

E-MAIL

ADDRESS:

INSURER(S) AFFORDING COVERAGE NAIC #

(312) 381-1000

INSURED 20397Vigilant Ins CoINSURER A:

INSURER B:

INSURER C:

INSURER D:

INSURER E:

INSURER F:

FAX

(A/C. No.):

CONTACT

NAME:

Robbins Geller Rudman & Dowd LLP 655 West Broadway Suite 1900 San Diego CA 92101 USA

COVERAGES CERTIFICATE NUMBER: 570112120935 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. Limits shown are as requested

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

(MM/DD/YYYY)

SUBR

WVD

INSR

LTR

ADDL

INSD POLICY NUMBER TYPE OF INSURANCE LIMITS

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

POLICY LOC

EACH OCCURRENCE

DAMAGE TO RENTED

PREMISES (Ea occurrence)

MED EXP (Any one person)

PERSONAL & ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGG

GEN'L AGGREGATE LIMIT APPLIES PER:

PRO-

JECT

OTHER:

AUTOMOBILE LIABILITY

ANY AUTO

OWNED

AUTOS ONLY

SCHEDULED

AUTOS

HIRED AUTOS

ONLY

NON-OWNED

AUTOS ONLY

BODILY INJURY ( Per person)

PROPERTY DAMAGE

(Per accident)

BODILY INJURY (Per accident)

COMBINED SINGLE LIMIT

(Ea accident)

EXCESS LIAB

OCCUR

CLAIMS-MADE AGGREGATE

EACH OCCURRENCE

DED

UMBRELLA LIAB

RETENTION

E.L. DISEASE-EA EMPLOYEE

E.L. DISEASE-POLICY LIMIT

E.L. EACH ACCIDENT $1,000,000

X OTH-

ER

PER STATUTEA 05/01/2024 05/01/2025

Workers Compensation

$1,000,000

Y / N

(Mandatory in NH)

ANY PROPRIETOR / PARTNER / EXECUTIVE

OFFICER/MEMBER EXCLUDED? N / AN

WORKERS COMPENSATION AND

EMPLOYERS' LIABILITY

If yes, describe under DESCRIPTION OF OPERATIONS below

$1,000,000

2571839019

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

Evidence of Insurance

CANCELLATIONCERTIFICATE HOLDER

AUTHORIZED REPRESENTATIVERobbins Geller Rudman & Dowd LLP 655 West Broadway Suite 1900 San Diego CA 92101 USA

ACORD 25 (2016/03)

©1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE

EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE

POLICY PROVISIONS.

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