2023_03_01_COI_CL_AL_UL_PL_SAM_WC.pdf

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

3/3/2022

Lovitt & Touché A Marsh and McLennan Agency, LLC 1050 W Washington Street, Suite 233 Tempe AZ 85281

Lindsey Brundage 602-385-0535 602-956-2258 lbrundage@lovitt-touche.com

CopperPoint Insurance Company 14216 ARIZBRI-C1 Great American Insurance Company 16691

Ability360, Inc.

5025 E Washington St, Ste 200 Phoenix AZ 85034

1610156411

B X 1,000,000 X 1,000,000

20,000

1,000,000

3,000,000 X

Y Y PAC435840000 3/1/2022 3/1/2023

3,000,000

B 1,000,000

X

Y Y CAP435840100 3/1/2022 3/1/2023

B X X 4,000,000UMB435840200 3/1/2022 3/1/2023

4,000,000 X 10,000

A XY 1013351 3/1/2022 3/1/2023

1,000,000

1,000,000

1,000,000 B

Professional Liability Sexual Abuse & Molestation

PAC435840000 3/1/2022 3/1/2023 Per Claim $1,000,000 $1,000,000

Per Aggregate $3,000,000 $3,000,000

The above-indicated Additional Insured and Waiver of Subrogation are provided with respects to General Liability when required in a written and executed contract. Such coverage afforded by these policies (or update as applicable) for the benefit of the additional insured(s) is primary and any other coverage maintained by such additional insured(s) shall be non-contributory when required in a written and executed contract.

The above-indicated Additional Insured is provided with respects to Automobile Liability when required in a written and executed contract.

Umbrella Liability, $4,000,000 is excess of General Liability, Automobile Liability, Employers Liability, Professional Liability and Sexual Abuse & Molestation.

See Attached...

Arizona Department of Economic Security Rehabilitation Services Administration 1789 West Jefferson Street, 2nd Floor NW Mail Drop 5112 Phoenix AZ 85007-3202

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: FORM TITLE:

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE Page of

AGENCY CUSTOMER ID:

LOC #:

AGENCY

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSURED

EFFECTIVE DATE:

ARIZBRI-C1

1 1

Lovitt & Touché A Marsh and McLennan Agency, LLC Ability360, Inc.

5025 E Washington St, Ste 200 Phoenix AZ 85034

25 CERTIFICATE OF LIABILITY INSURANCE

Re: Contract CTR056077

Insurance Services Office, Inc., 2018 CG 24 04 (Ed. 12/19) (Page 1 o f 1)

CG 24 04 (Ed. 12/19)

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US (WAIVER OF SUBROGATION)

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

ELECTRONIC DATA LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES

POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

RAILROAD PROTECTIVE LIABILITY COVERAGE PART

UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS

SCHEDULE

Name Of Person(s) Or Organization(s):

Information required to complete this Schedule, i f not shown above, will be shown in the Declarations.

The fol lowing is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us o f Section IV - Conditions:

We waive any right o f recovery against the person(s) or organization(s) shown in the Schedule above because o f payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right o f recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above.

The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents and employees for losses arising from work performed by or on behalf of the contractor.

Pol #PAC435840000

Copyright, ISO Properties, Inc., 2011 CA 04 44 (Ed. 10/13) (Page 1 o f 1)

CA 04 44 (Ed. 10 13)

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US

(WAIVER OF SUBROGATION)

This endorsement modifies insurance provided under the following:

AUTO DEALERS COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

With respect to coverage provided by this endorsement, the provisions o f the Coverage Form apply unless modified by the endorsement.

Schedule

Name(s) of Person(s) or Organization(s):

Information required to complete this Schedule, i f not shown above, will be shown in the Declarations.

The Transfer of Rights of Recovery Against Others to Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization.

The State of Arizona, its departments, agencies, boards, commissions, universities and officers, officials, agents and employees for losses arising from work performed by or on behalf of the contractor.

Pol #CAP435840100

Copyright, ISO Properties, Inc., 2011 CA 20 48 (Ed. 10/13) (Page 1 o f 1)

CA 20 48 (Ed. 10 13)

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE

This endorsement modifies insurance provided under the following:

AUTO DEALERS COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

With respect to coverage provided by this endorsement, the provisions o f the Coverage Form apply unless modified by this endorsement.

This endorsement identifies Person(s) or Organization(s) who are "Insureds" f o r Covered Autos Liability Coverage under the Who Is an Insured provision o f the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form.

Schedule

Name of Person(s) or Organization(s):

Information required to complete this Schedule, i f not shown above, will be shown in the Declarations.

Each person or organization shown in the Schedule is an "Insured" f o r Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "Insured" under the Who Is An Insured provision contained in paragraph A.1. o f SECTION II - COVERED AUTOS LIABILITY COVERAGE in the Business Auto and Motor Carrier Coverage Forms and paragraph D.2. o f SECTION I - COVERED AUTOS COVERAGES o f the Auto Dealers Coverage Form.

Pol #CAP435840100

State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds with respect to liability arising out of the activities performed by, or on behalf of, the Contractor involving automobiles owned, hired and/or non-owned by the Contractor.

CG 20 26 (Ed. 12/19) (Page 1 o f 2)

CG 20 26 (Ed. 12/19)

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED - DESIGNATED

PERSON OR ORGANIZATION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name Of Additional Insured Person(s) Or Organization(s):

Information required to complete this Schedule, i f not shown above, will be shown in the Declarations.

A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability f o r "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions o f those acting on your behalf:

1. In the performance o f your ongoing operations; or

2. In connection with your premises owned by or rented to you.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. I f coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide f o r such additional insured.

B. With respect to the insurance afforded to these additional insureds, the fol lowing is added to Section III - Limits Of Insurance:

I f coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf o f the Additional Insured is the amount o f insurance:

1. Required by the contract or agreement; or

The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents and employees are named additional insured with respect to liability arising out of the activities performed by or on behalf of the contractor.

Pol #PAC435840000

CG 20 26 (Ed. 12/19) (Page 2 o f 2)

2. Available under the applicable limits o f insurance;

whichever is less.

This endorsement shall not increase the applicable limits o f insurance.