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Risk Management Information
On-line Services

Phoenix
100 N. 15th Avenue
Suite 301
Phoenix, Arizona 85007
Phone: (602) 542-2182

Tucson
400 W. Congress #250
Tucson, Arizona, 85701
Phone (520) 628-6700

The major responsibilities within the Insurance Section:

Purchasing Excess and Catastrophe insurance to supplement funded self-insurance;

Agency Support / Customer Service:

  • We assist your State agency with the process of approving Certificates of Insurance when your agency needs to show evidence of State coverage to an outside entity (such as a landlord);
     
  • We answer Procurement Officer’s questions relating to Insurance Modules 

    Insurance Analysts are assigned to agencies for customer support:

  • Insurance Analysts will answer questions from state agencies on Who Is Covered by the self-insurance law (ARS 41-621), and Who Is Not Covered.

  • Insurance Analysts will advise your agency of the DOA rules that may affect Agreements of Indemnity that your agency may be asked to sign.

  • Insurance Analyst will advise on volunteer coverage questions. Refer to the section below called Volunteering to the State for details.

If you are: Then link with:
   
A Procurement Officer: Procurement Officer Insurance Modules
   
Traveling outside the USA:

Overview - Mexico and other Foreign Travel

  Bulletins - War
  Bulletins - Rentals Vehicles - Collision
  Defense Base Act - Handbook
 

Mexico

  Students, Chaperones & Volunteers
  Travel Warnings
  Travel Assistance
   
Requesting evidence of state coverage: Requesting Certificate Of Insurance
   
Volunteering to the State: Risk Management has purchased a policy specifically for Volunteers working for and on behalf of the State of Arizona and Students traveling to and from an approved function of the school in an authorized mode of transportation. Should you have any questions on this program call Chontel Hounjet at (602) 542-1445.
 

Volunteer Registration Form

Under 18 Volunteer Registration Form

 

Summary

  Instructions & Claims Form
   
   
Providing care in a program for Foster Parents, Independent Living, Respite Sitters, or Developmental Disabilities:

Provider Indemnity Program

   
 Flying on behalf of your Agency

 Pilot Application - MS Word fillable.doc
                                        

 Pilot Qualifications
Arizona Administrative Code - R-10-107

   

 

Insurance Forms -

Agency Analyst Assignment List

Assistance - Foreign Travel

Arizona Workers' Compensation Law - Notice to Employees (Bilingual)

Certificate of Insurance (ACORD form tutorial-coverage from Vendor)

Certificates of Insurance (Request from Agency to show ADOA coverage)

Indemnification Language - Commentary

Independent Contractor Agreement

Insurance and Indemnity Modules

Pilot Applications

Provider Indemnity Program (PIP) Brochure

Sole Proprietor Waiver form

Statutory Exclusions of Coverages

Submitting Request for Contract Exception
Instructions and Request Form

*Note: Form functionality may vary if using a program other than Acrobat or Adobe Reader 7.0.5 or later

Volunteer Registration Form

Volunteer Registration Form - UNDER 18 years old

   

 

 

 
 
 

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