STATEOFARIZONA_W41693438.pdf
PDF 54 KB Posted
- Attached to
- Master Agreement AZ|CTR079348
- Contract number
- CTR079348
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance for QTC Commercial Services, LLC, a subsidiary of Leidos Holdings, Inc., with coverage issued by Underwriters at Lloyd's London. The certificate is addressed to the State of Arizona, Arizona Department of Administration, Office of Special Events, located in Phoenix, AZ, and is associated with Contract Number CTR079348.
The insurance policy provides Professional Liability coverage, including Contractors Pollution Legal Liability and Cyber Liability, with policy limits of $25,000,000 per each claim and in the aggregate. The policy includes a $10M aggregate sublimit for Privacy Notification Costs. The coverage is effective from 10/26/2025 to 10/12/2026, with the insurance certificate issued on 11/06/2025. The policy is administered by Willis Towers Watson Southeast, Inc., based in Nashville, TN, and serves as a certification of insurance for the specified contract between QTC Commercial Services and the State of Arizona.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| STATEOFARIZONA_W41693439.pdf | ||
| CTR079348_Pricing.xlsx | XLSX spreadsheet | |
| STATEOFARIZONA_W41693437.pdf | ||
| STATEOFARIZONA_W41693440.pdf | ||
| CTR079348_Contract_Summary_Document.pdf |
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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
Willis Towers Watson Southeast, Inc.
c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA
QTC Commercial Services, LLC a wholly owned subsidiary of Leidos Holdings, Inc.
1750 Presidents Street Reston, VA 20190
Note:
Professional Liability inclusive of a $10M Aggregate Sublimit for Privacy Notification Costs.
Contract Number: CTR079348
STATE OF ARIZONA,
ARIZONA DEPARTMENT OF ADMINISTRATION,
OFFICE OF SPECIAL EVENTS
100 N. 15111Avenue, Suite 202 Phoenix, AZ 85007
11/06/2025
1-877-945-7378 1-888-467-2378 certificates@wtwco.com
Underwriters at Lloyd's London 15792
W41693438
A Professional Liability including
Contractors Pollution Legal Liab
Each ClaimB080130966P25 10/26/2025 10/12/2026
Aggregate and Cyber Liability
419643228827140SR ID: BATCH:
$25,000,000
$25,000,000
WTW Certificate Center
10.0.2.20120224.1.869952
| DATE (MM/DD/YYYY): 11/06/2025 |
| PRODUCER: Willis Towers Watson Southeast, Inc. |
c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA
| FAX (A/C, No):: 1-877-945-7378 |
| FAX (A/C, No):: 1-888-467-2378 |
| FAX (A/C, No):: certificates@wtwco.com |
| NAIC #_INSURER A :: Underwriters at Lloyd's London |
| NAIC #_INSURER A :: 15792 |
| INSURED: QTC Commercial Services, LLC |
a wholly owned subsidiary of Leidos Holdings, Inc.
1750 Presidents Street Reston, VA 20190
| NAIC #_INSURER B :: |
| NAIC #_INSURER C :: |
| NAIC #_INSURER B :: |
| NAIC #_INSURER C :: |
| NAIC #_INSURER D :: |
| NAIC #_INSURER D :: |
| NAIC #_INSURER E :: |
| NAIC #_INSURER E :: |
| NAIC #_INSURER F :: |
| NAIC #_INSURER F :: |
| CERT_NUMBER: W41693438 |
| GL INSR LETTER: |
| CGL_checkbox: Off |
| Clams_Made_checkbox: Off |
| Occur_checkbox: Off |
| OTHER 1 checkbox: Off |
| OTHER 1 checkbox: Off |
| undefined: |
| undefined: |
| undefined: |
| GL_OTHER_1_TYPE_OF_INS: |
| GL_OTHER_2_TYPE_OF_INS: |
| undefined: |
| undefined: |
| undefined: |
| Gen_Agg_Policy_checkbox: Off |
| Gen_Agg_Project_checkbox: Off |
| Gen_Agg_Location_checkbox: Off |
| INSR ADDL_Row_1: |
| WVD SUBR_Row_1: |
| POLICY NUMBER_Row_1: |
| POLICY EFF (MM/DD/YYYY)_Row_1: |
| POLICY EXP (MM/DD/YYYY)_Row_1: |
| OTHER_LIMIT_DESC: |
| undefined: |
| ANY_AUTO_checkbox: Off |
| AL INSR LETTER: |
| undefined: |
| NON-OWNED_AUTOS_checkbox: Off |
| SCHEDULED_AUTOS_checkbox: Off |
| ALL_OWNED_AUTOS_checkbox: Off |
| HIRED_AUTO_checkbox: Off |
| POLICY EXP (MM/DD/YYYY)_Row_1: |
| undefined: |
| POLICY EFF (MM/DD/YYYY)_Row_1: |
| undefined: |
| undefined: |
| AL_OTHER_1_checkbox: Off |
| AL_OTHER_1_DESC: |
| PROPERTY DAMAGE (Per accident)_Row_1: |
| AL_OTHER_2_checkbox: Off |
| AL_OTHER_2_DESC: |
| INSR ADDL_Row_2: |
| WVD SUBR_Row_2: |
| POLICY NUMBER_Row_2: |
| undefined: |
| UMB_LIAB: Off |
| UMB_EX_OCC: Off |
| UMB INSR LETTER: |
| undefined: |
| EX_LIAB_checkbox: Off |
| CLAIMS_MADE_checkbox: Off |
| RET_checkbox: Off |
| DED_checkbox: Off |
| DED_RET_AMOUNT: |
| INSR ADDL_Row_3: |
| WVD SUBR_Row_3: |
| POLICY NUMBER_Row_3: |
| POLICY EFF (MM/DD/YYYY)_Row_3: |
| POLICY EXP (MM/DD/YYYY)_Row_3: |
| undefined: |
| AGGREGATE_Row_1: |
| undefined: |
| POLICY NUMBER_N / A: |
| STATUTORY: Off |
| OTHER: Off |
| WC_OTHER_DESC: |
| WC INSR LETTER: |
| WVD SUBR_N / A: |
| undefined: |
| Y / N: |
| POLICY EFF (MM/DD/YYYY)_Row_3: |
| POLICY EXP (MM/DD/YYYY)_Row_3: |
| undefined: |
| undefined: |
| OTHER 1 INSR LETTER: A |
| OTHER_1_TYPE_OF_INS: Professional Liability including |
| OTHER_2_TYPE_OF_INS: Contractors Pollution Legal Liab |
| N / A_Row_1: |
| WVD SUBR_Row_5: |
| N / A_Row_1: |
| OTHER_1_LIMIT_OF_INS: Each Claim |
| OTHER 2 INSR LETTER: |
| POLICY NUMBER_Row_5: B080130966P25 |
| POLICY NUMBER_Row_5: |
| POLICY EFF (MM/DD/YYYY)_Row_5: 10/26/2025 |
| POLICY EFF (MM/DD/YYYY)_Row_5: |
| POLICY EXP (MM/DD/YYYY)_Row_5: 10/12/2026 |
| POLICY EXP (MM/DD/YYYY)_Row_5: |
| OTHER_2_LIMIT_OF_INS: Aggregate |
| WVD SUBR_Row_5: |
| OTHER 3 INSR LETTER: |
| WVD SUBR_Row_5: |
| POLICY NUMBER_Row_5: |
| POLICY EFF (MM/DD/YYYY)_Row_5: |
| OTHER_3_TYPE_OF_INS: and Cyber Liability |
| N / A_Row_1: |
| POLICY EXP (MM/DD/YYYY)_Row_5: |
| OTHER_3_LIMIT_OF_INS: |
| DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required): Note: |
Professional Liability inclusive of a $10M Aggregate Sublimit for Privacy Notification Costs.
Contract Number: CTR079348
INSURED:
STATE OF ARIZONA,
ARIZONA DEPARTMENT OF ADMINISTRATION,
OFFICE OF SPECIAL EVENTS
100 N. 15111Avenue, Suite 202 Phoenix, AZ 85007
| AUTHORIZED REPRESENTATIVE: |
| BATCH_NUMBER: 4196432 |
| SR_NUMBER: 28827140 |
| SRID_label: SR ID: |
| Batch_label: BATCH: |
| GL_Agg_applies_per_Other_checkbox: Off |
| GL_Agg_applies_per_Other: |
| OTHER_3_LIMIT_OF_INS_AMT3: |
| OTHER_2_LIMIT_OF_INS_AMT_2: $25,000,000 |
| OTHER_1_LIMIT_OF_INS_AMT_1: $25,000,000 |
| Contact_Name: WTW Certificate Center |
| DATE (MM/DD/YYYY): Page 1 of 1 |
File details come from the government source that posted it. Updated .