State_of_AZ_ACORD_Form_CLI.pdf
PDF 19 KB Posted
- Attached to
- Master Agreement AZ|CTR049738
- Contract number
- CTR049738
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by ABD Insurance & Financial Services on 04/27/2020 for Pageup People Inc, with Twin City Fire Insurance Company as the primary insurer. The certificate is addressed to the Arizona Department of Administration's State Procurement Office in Phoenix, Arizona. The insurance covers Pageup People Inc for various liability categories, including commercial general liability, automobile liability, umbrella liability, and technology errors & omissions/cyber coverage.
The insurance policy provides multiple coverage limits, including $1,000,000 for commercial general liability per occurrence, $1,000,000 combined single limit for automobile liability, $5,000,000 for umbrella liability, and $2,000,000 for technology E&O/cyber coverage. The policy is effective from 03/31/2020 to 03/31/2021, with a waiver of subrogation and the Arizona Department of Administration included as an additional insured. The policy includes standard protections for general aggregate, personal and advertising injury, and provides coverage across multiple insurance categories to protect the insured's business operations.
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Text version
04/27/2020
ABD Insurance & Financial Services 777 Mariners Island Blvd.
Suite 250 San Mateo CA 94404
Kimber Gasca
(650) 437-0593 (650) 437-0593 kimber.gasca@theabdteam.com
Pageup People Inc 260 Madison Ave Fl 8
New York NY 10016
Twin city Fire Insurance Company 29459
CL2031343755
A Y Y 57SBABL6774 03/31/2020 03/31/2021
1,000,000 1,000,000 10,000 1,000,000 2,000,000 2,000,000
A 57SBABL6774 03/31/2020 03/31/2021
1,000,000
A 10,000
57SBABL6774 03/31/2020 03/31/2021
5,000,000 5,000,000
A Technology E&O Cyber Coverage 57SBABL6774 03/31/2020 03/31/2021 Aggregate Limit $2,000,000
The Certificate Holder shown below is included as an Additiona Insured per the attached policy forms. Waiver of Subrogation applies.
Arizona Department of Administration State Procurement Office 100 North 15th Avenue #402 Phoenix AZ 85007
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
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