Salibas_COI_EXP_9.30.2023.pdf
PDF 104 KB Posted
- Attached to
- Master Agreement AZ|CTR061131
- Contract number
- CTR061131
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance for Guardian Pharmacy of Arizona, LLC (dba Saliba's Extended Care Pharmacy), issued by USI Insurance Services LLC on behalf of multiple insurers including TDC Specialty Insurance Company, Sompo America Insurance Company, and Capitol Specialty Insurance Corporation. The certificate is specifically related to RFP BPM004543 and is issued for the Arizona Department of Veterans' Services, located in Phoenix, Arizona.
The insurance coverage includes Commercial General Liability with a $1,000,000 per occurrence limit, Automobile Liability with $2,000 comprehensive and collision coverage, Umbrella Liability with a $5,000,000 primary limit, Workers' Compensation coverage, and Professional Liability with $1 million per incident and $3 million aggregate limits. The policy period runs from 09/30/2022 to 09/30/2023, with a retroactive date of 09/30/2021. The certificate extends coverage to the State of Arizona, its departments, agencies, boards, commissions, universities, officers, and employees as additional insureds, subject to policy terms and conditions.
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RE: RFP BPM004543
The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as additional insureds on General and Auto Liability as respects liability arising out of the operations of the named insured, subject to policy terms, conditions and exclusions. Waiver applies in favor of the same including Workers' Compensation if required by written contract, subject to policy's terms, conditions and exclusions.
GUARDPHA
9/30/2022
Gail Rapa Commercial Lines - (404) 923-3700 470.875.0345 USI Insurance Services LLC gail.rapa@usi.com 1 Concourse Parkway NE, Suite 700
Atlanta, GA 30328 TDC Specialty Insurance Company 34487
Sompo America Insurance Company 11126 Guardian Pharmacy of Arizona, LLC Capitol Specialty Insurance Corporation 10328 dba Saliba's Extended Care Pharmacy
925 E. Covey Lane
Phoenix, AZ 85024
15611048
XA MFP010312203 1,000,00009/30/2022 09/30/2023
X 100,000
X Retro Date: 09/30/2021 5,000
1,000,000
3,000,000
X 1,000,000 sex abuse/molestation included
B LAL30025618900 09/30/2022 09/30/2023 1,000,000
$2,000 Comp X $2,000 Coll
X X C MM2014218908 ($5mil prim) 09/30/2022 09/30/2023 5,000,000
5,000,000
B WCDS1149X0 (AOS) 09/30/2022 09/30/2023 X
1,000,000WCNS1383F0 (WI)
1,000,000
1,000,000
A Professional Liability MFP010312203 09/30/202209/30/2022 09/30/2023 $1M Per Incident / $3M Aggregate
Arizona Department of Veterans’ Services
Procurement Unit
3839 N. 3rd St., Suite 209 Phoenix, AZ 85012
File details come from the government source that posted it. Updated .