ACCEPTED CTR053898 GL,AL,WC,PROFESSIONAL 08.29.23-08.29.24.pdf

08/29/23

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).

PRODUCER: WENDI S REED

PROFESSIONAL INSURANCE BROKERS, INC. 623 465-5300 623 465-5933

PMB 857, 515 E. CAREFREE HWY

wendi@pibinc.com

PHOENIX, ARIZONA 85085-8839

R L I INSURANCE COMPANY, INC. 13056

CIVTECH, INC. NUTMEG INSURANCE COMPANY 39608

10605 N. HAYDEN ROAD HARTFORD ACCIDENT & INDEMNITY CO 22357

BUILDING G, SUITE 140 HARTFORD FIRE INSURANCE COMPANY 19682

SCOTTSDALE, ARIZONA 85260

COVERAGES: CERTIFICATE NUMBER: 392 REVISION NUMBER: 1-8/18/23

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.

CO

LTR LIMITS

A X COMMERCIAL GENERAL LIABILITY $ 1,000,000

CLAIMS MADE X X X PSB0001543 08/29/23 08/29/24 $ 1,000,000

X $ 10,000

X CONTRACTUAL LIABILITY $ 1,000,000

GEN'L AGGREGATE LIMIT APPLIES PER: $ 2,000,000

X LOC $ 2,000,000

OTHER

B AUTOMOBILE LIABILITY $ 1,000,000

X ANY AUTO SCHEDULED X X 59UECBC6952 08/29/23 08/29/24

AUTOS $

NON $

OWNED $

AUTOS

A X UMBRELLA LAB X X PSE0001351 08/29/23 08/29/24 EACH OCCURRENCE $ 4,000,000

X AGGREGATE $ 4,000,000

DED RETENTION $ $

C

Y/N

N N/A X 59WECAS5XPV 08/29/23 08/29/24 $ 1,000,000

$ 1,000,000

$ 1,000,000

OTHER EACH CLAIM / AGGREGATE

D X PROFESSIONAL LIABILITY X 08/29/23 08/29/24 2,000,000 / 2,000,000

A X VALUABLE PAPERS PSB0001543 08/29/23 08/29/24 $100,000

Project: On Call Transit and Rail - CTR053898

As per written contract, the State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents and employees are

Additional Insured, on a primary and noncontributory basis, as respects the General and Automobile Liability coverages; blanket endorsement forms PPB3040212 and HA99161221 attached. Umbrella follows form. Waiver of Subrogation applies to all policies per the written contract.

Workers Compensation blanket waiver form WC000313 attached. CGL exclusions attached. 30 day notice of cancellation applies.

CERTIFICATE HOLDER CANCELLATION

Arizona Dept of Transportation 1739 W Jackson Street, MD 100P Phoenix AZ 85007

© 1988-2014 ACORD CORPORATION. All rights reserved.

ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD.

AUTHORIZED REPRESENTATIVE

E.L. DISEASE - POLICY LIMIT

OH 03987192301

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

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

X PER STATUTE

OTHER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE

EXCESS LIAB OCCUR

CLAIMS-MADE

WORKERS COMPENSATION AND

EMPLOYERS’ LIABILITY ANY

PROPRIETOR/PARTNER EXECUTIVE

OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION

OF OPERATIONS BELOW

COMBINED SINGLE LIMIT (Ec

Accident)

ALL

OWNED

AUTOS

BODILY INJURY (Per person)

X

BODILY INJURY (Per accident)

X

HIRED

AUTOS

PROPERTY DAMAGE (Per accident)

BROAD FORM PROPERTY DAMAGE MED EXP (Any one person)

PERSONAL & ADV INJURY

GENERAL AGGREGATE

POLICY PROJECT PRODUCTS.COMP/OP AGG

POLICY EXP.

DATE(MM/DD/YY) DATE(MM/DD/YY)

EACH OCCURRENCE

OCCUR DAMAGE TO RENTED PREMISES

(Ec occurrence)

TYPE OF INSURANCE

ADDL

INSR

SUBR

WVO

POLICY NUMBER

POLICY EFF.

INSURER B:

INSURER C:

INSURER D:

INSURER E:

INSURER F:

EMAIL

ADDRESS:

PRODUCER

CUSTOMER ID:

INSURER(S) AFFORDING COVERAGE NAIC #

INSURED: INSURER A:

A C O RD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)

CONTACT

NAME:

PHONE

(A/C.No. Ext):

FAX (A/C

No) a8812 Accepted