State_of_Arizona_Arizona__005_.pdf

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.

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).

PRODUCER

Sentry Insurance

1800 North Point Drive

Stevens Point, WI 54481

CONTACT

NAME: Sentry Customer Service

PHONE

(A/C, No, Ext): 800-473-6879

FAX

(A/C, No): 800-514-7191

EMAIL

ADDRESS: businessproducts_direct@sentry.com

INSURER(S) AFFORDING COVERAGE NAIC#

INSURER A : Sentry Insurance Company 24988

INSURED

US Computers Inc 181 W Orangethorpe Ave Ste C Placentia, CA 92870-6931

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

COVERAGES CERTIFICATE NUMBER: 1028677 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.

INSR

LTR TYPE OF INSURANCE ADDL

INSR

SUBR

WVD POLICY NUMBER POLICY EFF

(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY)

LIMITS

A

X BUSINESS OWNERS LIABILITY

CLAIMS-MADE X OCCUR

GEN'L AGGREGATE LIMIT APPLIES PER:

X POLICY PRO-

JECT LOC

OTHER:

X X 2557758001 04/15/2025 04/15/2026

EACH OCCURRENCE $ 1,000,000

DAMAGE TO RENTED

PREMISES (Ea occurrence) $ 300,000

MED EXP (Any one person) $ 10,000

PERSONAL & ADV INJURY $ 1,000,000

GENERAL AGGREGATE $ 3,000,000

PRODUCTS - COMP/OP AGG $ 3,000,000

A

AUTOMOBILE LIABILITY

ANY AUTO

OWNED

AUTOS ONLY

SCHEDULED

AUTOS

X HIRED

AUTOS ONLY X NON-OWNED

AUTOS ONLY

X X 2557758001 04/15/2025 04/15/2026

COMBINED SINGLE LIMIT

(Ea accident) $ 1,000,000

BODILY INJURY (Per person) $

BODILY INJURY (Per accident) $

PROPERTY DAMAGE

(Per accident) $

UMBRELLA LIAB OCCUR

EXCESS LIAB CLAIMS-MADE

DED RETENTION $

EACH OCCURRENCE $

AGGREGATE $

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below

Y / N

N / A

PER

STATUTE

OTH-

ER

E.L. EACH ACCIDENT $

E.L. DISEASE - EA EMPLOYEE $

E.L. DISEASE - POLICY LIMIT $

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

Refer to attached

DATE (MM/DD/YYYY)

07/08/2025CERTIFICATE OF LIABILITY INSURANCE

CERTIFICATE HOLDER CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE

ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD2557758 Sentry Insurance Company a1e6944d-e9b6-43a1-99b5-e9d895e17142

07/08/2025

Arizona Department of Administration State Procurement Office 1802 W Jackson St #100 Phoenix, AZ 85007-3202

2557758 Sentry Insurance Company a1e6944d-e9b6-43a1-99b5-e9d895e17142

07/08/2025The ACORD name and logo are registered marks of ACORD

ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.

AGENCY CUSTOMER ID: XXXXXX4132

LOC #:

Page 2 of 2ADDITIONAL REMARKS SCHEDULE

AGENCY NAMED INSURED

Scott Deaver US Computers Inc

POLICY NUMBER

2557758001

CARRIER NAIC CODE

Sentry Insurance Company 24988 EFFECTIVE DATE: 04/15/2025

ADDITIONAL REMARKS

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: ACORD 25 Certificate of Liability InsuranceFORM TITLE:

Businessowners

RE: Contract # CTR073467 The Certificate Holder, State of Arizona,and its departments,agencies, boards,commissions, universities,officers, officials,agents,and employees

2557758001

Computers

2557758 Sentry Insurance Company

07/08/2025

Change effective 07/07/2025 BP 04 47 07 13 Page 1 of 2

4bd31212-1e8e-4391-8c7f-3b9f1e68d844

POLICY NUMBER:

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Your Products:

SCHEDULE

BUSINESSOWNERS

BP 04 47 07 13

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED - VENDORS

This endorsement modifies insurance provided under the following:

BUSINESSOWNERS COVERAGE FORM

Section II - Liability is amended as follows:

A. The following is added to Paragraph C. Who Is An Insured:

3. Any person(s) or organization(s) (referred to throughout this endorsement as vendor) shown in the Schedule is also an additional insured, but only with respect to "bodily injury" or "property damage" arising out of "your products" shown in the Schedule which are distributed or sold in the regular course of the vendor's business.

However:

a. The insurance afforded to such vendor only applies to the extent permitted by law; and

b. If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor.

B. With respect to the insurance afforded to these vendors, the following additional exclusions apply:

1. The insurance afforded the vendor does not apply to:

a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement;

b. Any express warranty unauthorized by you;

c. Any physical or chemical change in the product made intentionally by the vendor;

d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container;

e. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products;

© Insurance Services Office, Inc., 2012

Name Of Additional Insured Person(s) Or Organization(s) (Vendor):

Arizona Department of Administration State Procurement Office

STATE OF ARIZONA AND ITS DEPARTMENTS, AGENTS, BOARDS, COMMISSIONS, UNIVERSITIES,

OFFICERS, OFFICIALS, AGENTS AND EMPLOYEES AS ADDITIONAL INSURED WITH RESPECT TO

LIABILITY ARISING FROM WORK PERFORMED BY OR ON BEHALF OF THE CONTRACTOR.

2557758 Sentry Insurance Company

07/08/2025

Change effective 07/07/2025 BP 04 47 07 13Page 2 of 2

4bd31212-1e8e-4391-8c7f-3b9f1e68d844

f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product;

g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or

h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to:

(1) The exceptions contained in Subparagraph d. or f.; or

(2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products.

2. This insurance does not apply to any insured person or organization from whom you have acquired such products, or any ingredient, part or container entering into, accompanying or containing such products.

C. With respect to the insurance afforded to these vendors, the following is added to Paragraph D.

Liability And Medical Expenses Limits Of Insurance:

If coverage provided to the vendor is required by a contract or agreement, the most we will pay on behalf of the vendor is the amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable Limits Of Insurance shown in the Declarations;

whichever is less.

This endorsement shall not increase the applicable Limits Of Insurance shown in the Declarations.

© Insurance Services Office, Inc., 2012

2557758001

STATE OF ARIZONA AND ITS DEPARTMENTS, AGENTS, BOARDS, COMMISSIONS, UNIVERSITIES,

OFFICERS, OFFICIALS, AGENTS AND EMPLOYEES AS ADDITIONAL INSURED WITH RESPECT TO

LIABILITY ARISING FROM WORK PERFORMED BY OR ON BEHALF OF THE CONTRACTOR.

SCHEDULE

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Name Of Person Or Organization:

POLICY NUMBER: BUSINESSOWNERS

BP 04 97 01 06

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US

This endorsement modifies insurance provided under the following:

BUSINESSOWNERS COVERAGE FORM

Paragraph K. Transfer Of Rights Of Recovery Against Others To Us in Section III - Common Policy Conditions is amended by the addition of the following:

We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above.

© ISO Properties, Inc., 2004 2557758 Sentry Insurance Company

07/08/2025

Change effective 07/07/2025 BP 04 97 01 06 Page 1 of 1 f72ae88d-e723-40d1-b73b-377e9f880ff8

Arizona Department of Administration State Procurement Office

All other terms and conditions of this policy remain unchanged.

Change effective 07/07/2025 Page 1 of 1IL 70 58 02 14

07/08/20252557758 Sentry Insurance Company cee5168d-2694-460c-85f0-eb4765c6a40dcee5168d-2694-460c-85f0-eb4765c6a40d

IL 70 58 02 14

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NOTICE OF CANCELLATION - CERTIFICATE HOLDERS

This endorsement modifies insurance provided under the following:

BUSINESSOWNERS COVERAGE FORM

COMMERCIAL AUTOMOBILE COVERAGE PARTS

COMMERCIAL PROPERTY COVERAGE PART

CRIME AND FIDELITY COVERAGE PART

COMMERCIAL INLAND MARINE COVERAGE PART

COMMERCIAL GENERAL LIABILITY COVERAGE PARTS

COMMERCIAL EXCESS/UMBRELLA LIABILITY COVERAGE FORM

EMPLOYMENT RELATED PRACTICES LIABILITY

POLLUTION LIABILITY COVERAGE

ERRORS AND OMISSIONS COVERAGE FORM

In the event we cancel this policy, we shall endeavor to also mail to the person(s) or organization(s) listed in the Schedule for this endorsement advance written notice of cancellation.

This notification of cancellation of the policy is intended as a courtesy only. Our failure to provide such notification to the person(s) or organization(s) shown in the Schedule will not extend any policy cancellation date nor impact or negate any cancellation of the policy. This endorsement does not entitle the person(s) or organization(s) listed or described in the Schedule below to any benefit, rights or protection under this policy.

Failure by us to provide this notice of cancellation to the person(s) or organization(s) listed or described in the Schedule below will not impose liability of any kind upon us.

Any of these provisions that conflict with a law that controls the notice of cancellation of the insurance in this endorsement is changed by this statement to comply with the law.

Schedule

Person(s) or Organization(s) including mailing address:

Arizona Department of Administration State Procurement Office

STATE OF ARIZONA AND ITS DEPARTMENTS, AGENTS, BOARDS, COMMISSIONS, UNIVERSITIES,

OFFICERS, OFFICIALS, AGENTS AND EMPLOYEES AS ADDITIONAL INSURED WITH RESPECT TO LIABILITY

ARISING FROM WORK PERFORMED BY OR ON BEHALF OF THE CONTRACTOR.

1802 W Jackson St #100 Phoenix, AZ 85007-3202