Supplement_7_-_COI_-_State_of_Arizona.pdf
PDF 555 KB Posted
- Solicitation number
- BPM005633
- Issued by
- Arizona
About this file
This is a Certificate of Liability Insurance issued by Inszone Insurance Services, LLC on behalf of AZ Language Solutions, Inc. (DBA: AZITA: AZ Interpretation and Translation Agency) for the State of Arizona, specifically related to Contract #ADSPO18-00008136 managed by the State Procurement Office. The certificate documents insurance coverage effective October 5, 2023, through October 5, 2024, provided by Philadelphia Indemnity Insurance Company under policy number PHPK2593123 for general liability, sexual abuse or molestation liability, professional liability, and commercial general liability coverage.
The insurance coverage includes general liability limits of $2,000,000 per occurrence with a $4,000,000 aggregate, commercial general liability of $1,000,000 each occurrence, sexual abuse or molestation liability of $500,000 per occurrence with a $1,000,000 aggregate, and professional liability of $2,000,000 per claim. The State of Arizona is named as an additional insured with a waiver of subrogation on the general liability policy. The coverage is issued as a matter of information only and does not constitute a contract between the issuing insurer and certificate holder, with all coverage subject to the terms, exclusions, and conditions of the underlying policies.
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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)
© 1988-2015 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 .