2024-DES.pdf

CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)

01/12/2024

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).

PRODUCER

Trust Risk Management Services, Inc.

1791 Paysphere Circle Chicago, IL 60674

CONTACT

NAME: Trust Risk Management Services, Inc

PHONE

(A/C, No, Ext): 877.637.9700

FAX

(A/C, No): 877.251.5111

EMAIL

ADDRESS: info@trustrms.com

INSURER(S) AFFORDING COVERAGE NAIC #

INSURER A: ACE American Insurance Company 22667

INSURED

Jennifer Jones-Greenspon 1930 S Alma School RdSuite C 108 Mesa, AZ 85210

INSURER B:

INSURER C:

INSURER D:

INSURER E:

INSURER F:

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

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.

INSR

LTR TYPE OF INSURANCE

ADDL

INSR

SUBR

WVD POLICY NUMBER

POLICY EFF

(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY) LIMITS

COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $

CLAIMS MADE OCCUR

DAMAGE TO RENTED

PREMISES (Ea occurrence)

___________________________________ MED EXP (Any one person)

___________________________________ PERSONAL & ADV INJURY

GEN’L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

POLICY

PRO-

JECT LOC PRODUCTS–COMP/OP AGG

OTHER:

AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT

(Ea accident)

ANY AUTO BODILY INJURY (Per Person) $

ALL OWNED

AUTOS

SCHEDULED

AUTOS BODILY INJURY (Per accident)

HIRED AUTOS

NON-OWNED

AUTOS

PROPERTY DAMAGE

(Per accident)

UMBRELLA LIAB OCCUR EACH OCCURRENCE $

EXCESS LIAB CLAIMS-MADE AGGREGATE $

DED RETENTION $

WORKERS COMPENSATION

AND EMPLOYERS LIABILITY

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below

Y / N N / A

PER

STATUTE

OTH-

ER

E.L.EACH ACCIDENT $

E.L. DISEASE-EA EMPLOYEE $

E.L. DISEASE - POLICY LIMIT

A Psychologist's Professional Liability Retroactive Date: 01/30/2012

Y 58G26275179 01/30/2024 01/30/2025 Each Incident Annual Aggregate

$2,000,000 $4,000,000

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

CERTIFICATE HOLDER CANCELLATION

Additional Insured The State of Arizona, Arizona Department of Economic Security 1789 W. Jefferson St. Site Code 805Z Phoenix, AZ, 85007

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED

BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE

DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE

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