Wellomy_Tech_-_COI.pdf
PDF 197 KB Posted
- Attached to
- Master Agreement AZ|CTR078127
- Contract number
- CTR078127
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance for Wellomy Inc., located in Corona, California. The certificate involves multiple insurance providers including ACE Property and Casualty Insurance Company, Federal Insurance Company, and ACE American Insurance Company. The certificate holder is Banner Health, located in Phoenix, Arizona, and the insurance is issued by Coverdash Agents in New York.
The insurance coverage includes Commercial General Liability, Automobile Liability, Workers Compensation, and Errors & Omissions/Cyber insurance. The policies are effective from 04/11/2025 to 04/11/2026, with various coverage limits. General Liability has a $2,000,000 per occurrence limit and a $4,000,000 aggregate limit. Automobile Liability covers hired and owned autos. The E&O/Cyber policy has a $3,000,000 per occurrence and aggregate limit with a $5,000 retention. Banner Health is listed as an Additional Insured via endorsement on these policies. The certificate emphasizes that it is issued for informational purposes only and does not constitute a contract or confer specific rights to the certificate holder.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| WellomyTech_BPM006672_-_Pricing_Document_-_Amendment_1_-_REVISED.xlsx | XLSX spreadsheet | |
| CTR078127_Wellomy_Tech-_Contract.pdf | ||
| Data_Management_Services_-_Supplier_Award_and_Category_Matrix.pdf |
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Text version
CERTIFICATE HOLDER
© 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05)
AUTHORIZED REPRESENTATIVE
CANCELLATION
DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE
GENERAL LIABILITY
UMBRELLA LIAB
EXCESS LIAB
INSR
LTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY) LIMITS
(Mandatory in NH)
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
AUTOMOBILE LIABILITY
INSR
ADDL
WVD
SUBR
N / A
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 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).
The ACORD name and logo are registered marks of ACORD
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSURED
PHONE
(A/C, No, Ext):
PRODUCER
ADDRESS:
FAX
(A/C, No):
CONTACT
NAME:
NAIC #
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
INSURER(S) AFFORDING COVERAGE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
04/11/2025
20699 20281 22667
A Y D02927743 2025- 04-11 2026- 04-11
2,000,000 1,000,000 5,000 2,000,000 4,000,000 4,000,000
1,000,000 1,000,000 1,000,000
ACE Property And Casualty Insurance Company Federal Insurance Company ACE American Insurance CompanyWELLOMY INC.
11350 Hutton Rd
Corona 92883
B
C
7181- 74-61
D02927755
2025- 04-11 2026- 04-11
2025- 04-11 2026- 04-11
Y
CA
Banner Health
2901 N Central Ave Ste 160
Phoenix 85012AZ
E&O / Cyber
Per Occurrence Aggregate
$3,000,000 $3,000,000
Retention $5,000
Y
Y
Banner Health is listed as Additional Insured via Endorsement
Y Y D02927743 2025-04-11 2026-04-11
1,000,000
A
File details come from the government source that posted it. Updated .