2023-12-01_COI.pdf

Certificate of Insurance Certificate No. 135523

Rev. Date: 11/10/2022

This is to certify that the policy(ies) of insurance as described below have been issued to the Insured for whom this Certificate is executed and is/are in force at this time. This Certificate is issued for information only and confers no rights upon the holder. This Certificate neither affirmatively nor negatively amends, extends or alters the coverage afforded by such policy(ies) or binder(s) stated herein. This certificate cancels and supersedes all previously issued certificates.

Certificate Holder: Arizona Game and Fish Department Purchasing Office 5000 W. Carefree Highway Phoenix, AZ 85086

Named Insured: Papillon Airways, Inc.

1265 Airport Road Boulder City, NV 89005

Policy Type: Aircraft Hull & Liability and Aviation General Liability Policy

Policy Period: December 01, 2022 to December 01, 2023 both days at 12:01am Local Standard Time at the address of the Named Insured shown above

Insurer(s): Company Policy No(s).

Member Companies of United States Aircraft Insurance Group (USAIG) through United States Aviation Underwriters (USAU) and following markets as on file.

SIHL1-K093

Contract No.: AGFD18-00007731, Helicopter Flight Services

Aircraft Covered: All aircraft owned and/or operated by the Named Insured.

Territory: Worldwide

Premises Covered: All premises necessary and incidental to the aviation operations of the Named Insured.

Aircraft Liability Coverage Limit Combined Single Limit Bodily Injury and Property Damage including Passengers

$30,000,000 each occurrence including Passenger Liability.

Aircraft Physical Damage Coverage Limit All Risks $As Agreed Per Schedule, Subject to applicable deductibles.

Aviation General Liability Coverage Limit Combined Single Limit Bodily Injury and Property Damage $30,000,000 Combined Single Limit Bodily Injury and Property

Damage each occurrence including Premises Liability, On Premises Automobile Liability, Contractual Liability and Mobile Equipment Liability. $25,00,000 each occurrence for Personal and Advertising Injury. In the aggregate as respects Personal and Advertising Injury and Contractual Liability.

Coverage & Limits

Additional Insured With respect to Liability, it is understood and agreed the Certificate Holder(s), the State of Arizona, and its departments, agencies, boards, commission, universities, officer, officials, agents and employees shall be included as Additional Insured(s) hereunder solely with respect to the operations of the Named Insured. It is specifically agreed the inclusion of more than one Insured hereunder shall not operate to increase the Limits of Liability and is limited to those coverages provided by these policies.

Waiver of Subrogation With respect to coverage provided by this policy the Company hereby waives its rights of Subrogation against the State of Arizona, and its departments, agencies, boards, commission, universities, officer, officials, agents and employees, excluding gross negligence and/or willful misconduct by the State of Arizona, and its departments, agencies, boards, commission, universities, officer, officials, agents and employees.

Primary Insurers agree that this insurance shall be primary insurance without any right of contribution from any other insurance which may be carried by the State of Arizona, and its departments, agencies, boards, commission, universities, officer, officials, agents and employees.

Certificate Provisions

3535 Factoria Blvd SE, Suite 510, Bellevue, WA 98006 Phone: (206) 232-9870 - Fax: (206) 232-9515

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Notice of Cancellation The Insurer(s) listed above will provide for a 30 day notice to you, except ten (10) days as respects non-payment of premium and seven (7) days or less as respects war risks and other perils, in the even in the event of cancellation of the above described policies.

Except as otherwise stated in this certificate, the Insurer(s) assume(s) no legal responsibility for any failure to do so.

Manufacturers Exclusion The policy does not provide coverage for the Additional Insured(s) with respect to claims arising out of their legal liability as manufacturers, repairers, suppliers or servicing agents and shall not operate to prejudice Underwriters rights of recourse against the Additional Insured as manufacturers, repairers, suppliers or servicing agents where such rights of recourse would have existed had this endorsement not been effected under this policy.

3535 Factoria Blvd SE, Suite 510, Bellevue, WA 98006

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Certificate of Insurance Certificate No. 137425

Rev. Date: 1/5/2023

This is to certify that the policy(ies) of insurance as described below have been issued to the Insured for whom this Certificate is executed and is/are in force at this time. This Certificate is issued for information only and confers no rights upon the holder. This Certificate neither affirmatively nor negatively amends, extends or alters the coverage afforded by such policy(ies) or binder(s) stated herein. This certificate cancels and supersedes all previously issued certificates.

Certificate Holder: Arizona Game and Fish Department Purchasing Office 5000 W. Carefree Highway Phoenix, AZ 85086

Named Insured: Papillon Group 1265 Airport Road

Boulder City, NV 89005

Policy Type: Workers' Compensation & Employers' Liability Policy

Policy Period: January 01, 2023 to January 01, 2024 both days at 12:01am Local Standard Time at the address of the Named Insured shown above

Insurer(s): Company Policy No(s).

Starr Indemnity & Liability Company through Starr Aviation 1000003127

Contract No.: AGFD18-00007731, Helicopter Flight Services

Workers' Compensation Insurance Coverage Limit State of AZ & NV Statutory

Other States Coverage Coverage Limit All States except ND, OH, WA, WY and states listed under Workers Compensation Insurance above

Statutory

Workers Compensation and Employers' Liability Coverage Limit Workers Compensation Employers' Liability Statutory Limits E.L. Each Accident: $1,000,000. E.L. Disease-

Each Employee: $1,000,000. E.L. Disease-Policy Limit:

$1,000,000.

Coverage & Limits

Waiver of Subrogation With respect to Workers Compensation coverage provided by this policy the Company hereby waives its rights of Subrogation against the State of Arizona, and its departments, agencies, boards, commission, universities, officer, officials, agents and employees, excluding gross negligence and/or willful misconduct by the State of Arizona, and its departments, agencies, boards, commission, universities, officer, officials, agents and employees.

Certificate Provisions

3535 Factoria Blvd SE, Suite 510, Bellevue, WA 98006

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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.

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 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).

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

CERTIFICATE HOLDER

© 1988-2015 ACORD CORPORATION. All rights reserved.

ACORD 25 (2016/03)

AUTHORIZED REPRESENTATIVE

CANCELLATION

DATE (MM/DD/YYYY)

CERTIFICATE OF LIABILITY INSURANCE

OTHER:

LOCJECT

PRO-

POLICY

GEN'L AGGREGATE LIMIT APPLIES PER:

OCCURCLAIMS-MADE

COMMERCIAL GENERAL LIABILITY

PREMISES (Ea occurrence) $

DAMAGE TO RENTED

EACH OCCURRENCE $

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GENERAL AGGREGATE $

PRODUCTS - COMP/OP AGG $

$RETENTIONDED

CLAIMS-MADE

OCCUR

AGGREGATE $

EACH OCCURRENCE $UMBRELLA LIAB

EXCESS LIAB

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

INSR

LTR TYPE OF INSURANCE POLICY NUMBER

POLICY EFF

(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY) LIMITS

PER

STATUTE

OTH-

ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE

E.L. DISEASE - POLICY LIMIT

ANY PROPRIETOR/PARTNER/EXECUTIVE

If yes, describe under DESCRIPTION OF OPERATIONS below

(Mandatory in NH)

OFFICER/MEMBER EXCLUDED?

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY Y / N

AUTOMOBILE LIABILITY

ANY AUTO

OWNED SCHEDULED

HIRED NON-OWNED

AUTOS ONLY AUTOS

AUTOS ONLY AUTOS ONLY

COMBINED SINGLE LIMIT

BODILY INJURY (Per person)

BODILY INJURY (Per accident)

PROPERTY DAMAGE $

INSD

ADDL

WVD

SUBR

N / A

(Ea accident)

(Per accident)

The ACORD name and logo are registered marks of ACORD

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

INSURED

PHONE

(A/C, No, Ext):

PRODUCER

ADDRESS:

E-MAIL

FAX

(A/C, No):

CONTACT

NAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

INSURER(S) AFFORDING COVERAGE

W7SHZGLS

05/01/2023

Arizona Game and Fish Dept.

Attn: Purchasing 5000 W Carefree Hwy Phoenix, AZ 85086

1,000,000

206-232-9870

New Hampshire Insurance Company Ltd {23841}

Nicole.Barreto@mcgriff.com

Nicole Barreto

A

McGriff Insurance Services, LLC 3535 Factoria Blvd SE, Suite 510 Bellevue, WA 98006

Papillon Airways, Inc. et al 1265 Airport Road Boulder City, NV 89005-0000

04/12/2023

05/01/2022

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as Additional Insured on a Primary & Non-Contributory basis and provided a Waiver of Subrogation as required by written contract per attached endorsement.

01-CA-016691977-10

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