Supplement_7_-_COI_-_State_of_Arizona.pdf

PDF 555 KB Posted

Attached to
Master Agreement AZ|CTR071992
Contract number
CTR071992
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by Philadelphia Indemnity Insurance Company for AZ Language Solutions, Inc. (DBA: AZITA: AZ Interpretation and Translation Agency) located in Phoenix, Arizona. The certificate is associated with Contract #ADSPO18-00008136 and names the State of Arizona State Procurement Office as the certificate holder, with coverage effective from 10/5/2023 to 10/5/2024.

The insurance policy provides Commercial General Liability coverage with limits of $2,000,000 per occurrence, $4,000,000 general aggregate, and includes additional coverages such as Sexual Abuse or Molestation Liability (with $1,000,000 aggregate and $500,000 per abusive conduct) and Professional Liability with a $2,000,000 aggregate/occurrence limit. The policy includes Additional Insured status for the State of Arizona with a Waiver of Subrogation on the General Liability, ensuring comprehensive protection for the state agency in relation to the contracted services.

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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

E-MAIL

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

9/7/2023

Inszone Insurance Services, LLC 2721 Citrus Road, Suite A Rancho Cordova, CA 95742

Jeremie Strother

(480) 755-5233 jstrother@inszoneins.com

License#: 0F82764 Philadelphia Indemnity Insurance Company 18058

ZAHROMA-01

AZ Language Solutions, Inc.

DBA: AZITA: AZ Interpretation and Translation Agency 4739 E Culver Street Phoenix, AZ 85008

1536091200

A X 2,000,000 X 1,000,000

20,000

2,000,000

4,000,000 X

Y Y PHPK2593123 10/5/2023 10/5/2024

4,000,000

A 1,000,000

X X

PHPK2593123 10/5/2023 10/5/2024

A A A

Sexual Abuse or Molestation Liab.

Sexual Abuse or Molestation Liab.

Professional Liability

PHPK2593123

PHPK2593123

PHSD1737347

10/5/2023 10/5/2023 10/5/2022

10/5/2024 10/5/2024 10/5/2023

Aggregate Each Abusive Conduct Aggregate/Occurrence

$1000000 $500000 $2000000

RE: Contract #ADSPO18-00008136

Additional Insured with a Waiver of Subrogation on the General Liability.

The aforementioned coverage is provided to the extent in the attached forms for: State of Arizona

State of Arizona State Procurement Office 100 N. 16th Avenue, Ste. 201 Phoenix, AZ 86007

File details come from the government source that posted it. Updated .