Southstar_COI.pdf
PDF 248 KB Posted
- Solicitation number
- BPM005633
- Issued by
- Arizona
About this file
This is a Certificate of Liability Insurance issued by Continental Casualty Company on behalf of SouthStar Translation & Interpretation Services for a contract with the State of Arizona, Office of Procurement (Contract Number: ADSPO18-212881). The certificate documents insurance coverage for the contractor's translation and interpretation services to be provided to the State of Arizona and its departments, agencies, boards, commissions, universities, and their officers, officials, agents, and employees. The State of Arizona is named as an additional insured with respect to liability arising from activities performed by or on behalf of the contractor. The certificate was issued on September 19, 2023, with an expiration date of September 19, 2024.
The insurance coverage includes commercial general liability with limits of $2,000,000 aggregate and $1,000,000 per occurrence, professional liability coverage of $1,000,000, and data breach coverage of $4,000,000 aggregate and $2,000,000 per occurrence with a $1,000 deductible. An excess/umbrella liability policy is maintained with a $2,500 retention and $2,000,000 aggregate limit. The certificate holder contact is Brian Bogard at Old Pueblo Insurance (520-742-0682), representing SouthStar Translation & Interpretation Services. Insurance company contact information is listed as bwbogard@gmail.com. All coverage is subject to the terms, exclusions, and conditions of the underlying policies.
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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
Phoenix, AZ 85007
100 N 15th Ave Suite 201
Office of Procurement
State of Arizona
$2500 Retention
2,000,000Aggregate
2,000,000
6024961696 Professional Liability
A
1,000,000
1,000,000
1,000,000
6024961729A
1,000,000
6024961696Y
A
$2M/$2M/$200KData Breach
4,000,000
4,000,000
2,000,000
10,000
300,000
2,000,000
6024961696Y
Data Breach $1000 ded✘
A
20443CONTINENTAL CAS CO
85652AZCortaro
Po Box 9
SouthStar Translation & Interpretaion Services bwbogard@gmail.com
520-742-0682
Brian Bogard
Old Pueblo Insurance
Brian Bogard
Per policy terms, conditions and exclusions General Liability The State of Arizona, it's departments, agencies, boards, commissions, universities and it's officers, officials, agents and employees shall be named as Additional Insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor.
Contract number: ADSPO18-212881
Bogard Typewritten text 10/20/2023
Bogard Typewritten text 09/19/2023
Bogard Typewritten text 09/19/2024
Bogard Typewritten text 09/19/2023
Bogard Typewritten text 09/192024
Bogard Typewritten text 09/19/2023
Bogard Typewritten text 09/19/2024
Bogard Typewritten text 09/19/2023
Bogard Typewritten text 09/19/2024
File details come from the government source that posted it. Updated .