State_of_Arizona_6458975_49.pdf
PDF 633 KB Posted
- Attached to
- Master Agreement AZ|CTR072685
- Contract number
- CTR072685
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance for Allied Universal Electronic Monitoring, a company located in Odessa, FL. The certificate is issued by Marsh USA LLC and involves multiple insurance carriers, including Indian Harbor Insurance Company, Greenwich Insurance Company, XL Insurance America, and others. The primary certificate holder is the State of Arizona, specifically the Arizona Department of Administration, located in Phoenix, AZ. The insurance coverage spans multiple policy types, including commercial general liability, automobile liability, umbrella liability, and workers' compensation, with policy periods effective from 01/01/2025 to 01/01/2026.
The insurance policies provide comprehensive coverage with significant limits, including $30,000,000 for commercial general liability, $5,000,000 for automobile liability, and $10,000,000 for umbrella liability. The policies include additional details such as contractual liability, self-insured retention of $1,750,000, and specific provisions for the State of Arizona. The State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as additional insured where required by written contract. The policies also include provisions for primary and non-contributory liability coverage and waiver of subrogation as specified in written contracts.
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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
E 01/01/2025
01/01/2026
X
D
24554
55,000,000
XL Specialty Insurance Company
RWR300120409 (WI)
SIR $1,750,000
36940
RES943799405
10,000,000
A
C
2,000,000
01/01/2026 X
Indemnity Insurance Company of North America
X
Professional Liability
01/01/2025
CN118025105-Atten-CASPC-25-26
1,000,000
22322
Marsh | U.S. Operations
01/01/2026
CLE-006458975-49
01/01/2025
X
55,000,000
01/03/2025
X
X
01/01/2026
1,750,000
01/01/2026
30,000,000
X
SIR
X
1,000,000 1,000,000
B
Philadelphia.Certs@marsh.com
01/01/2026
01/01/2025
01/01/2025
Auto Liability, and Workers' Comp
43575
RAD943781808
Limit
01/01/2025
RWD300120309 (AOS)
RWE943548209 (CA, OH)
XSM G72500027 005
30,000,000
State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees is/are included as additional insured (except workers’ compensation and crime) where required by written contract. Liability coverage shall be primary and non-contributory where required by written contract. Waiver of subrogation is applicable where required by written contract.
RE: ADSP013-00003094
XL Insurance America U.S, Inc.
Allied Universal Electronic Monitoring
Odessa, FL 33556 1838 Gunn Hwy
30,000,000
Indian Harbor Insurance Company
X
30 South 17th Street
MARSH USA LLC
Attn: Philadelphia.certs@marsh.com / Fax: (212) 948-0360 Philadelphia, PA 19103
RES943799405
Greenwich Insurance Company
N
1802 W. Jackson, #100
Phoenix, AZ 85007
State of Arizona
Arizona Department of Administration
01/01/2025
D
37885
5,000,000
866-966-4664
CONTRACTUAL LIABILITY
X
Excess of General Liability, A
10,000,000
01/01/2026
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:
MARSH USA LLC�
Policy No.: 01-468-22-46� Crime �
Limit: $10,000,000 Each Occurrence/Aggregate Limit.� Effective Dates: 10/29/2024 - 10/29/2025�
Self-Insured Retention: $2,500,000�
Cyber Risk�
Policy No.: 01-708-49-58�
Employee Theft or Dishonesty: $2,000,000�
Insurer: National Union Fire Insurance Co. �
Philadelphia
Certificate of Liability Insurance
Clients' Property: $2,000,000�
Effective Dates: 08/15/2024 - 08/15/2025�
Insurer: AIG Specialty Insurance Company�
Deductible: $750,000
Limit:�
U.S, Inc.� Allied Universal Electronic Monitoring�
1838 Gunn Hwy�
CN118025105
Odessa, FL 33556
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