APPROVED CTR054971, CTR063646 PROFESSIONAL 01.24.23-01.24.24.pdf

01/19/2023

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 Reed

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

PMB 857, 515 E. CAREFREE HWY

wendi@pibinc.com

PHOENIX, ARIZONA 85085-8839

AIG SPECIALTY INSURANCE COMPANY 26883

ROBERT T HELMER/HELMER & ASSOCIATES

4409 E. FRIESS DRIVE

PHOENIX, ARIZONA 85032

COVERAGES: CERTIFICATE NUMBER: 2 REVISION NUMBER:1 01/11/2023

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 LIMITS

COMMERCIAL GENERAL LIABILITY $

CLAIMS MADE $

GEN'L AGGREGATE LIMIT APPLIES PER: $

LOC $

OTHER

AUTOMOBILE LIABILITY $

ANY AUTO SCHEDULED

AUTOS $

NON $

OWNED $

AUTOS

UMBRELLA LIAB EACH OCCURRENCE $

AGGREGATE $

DED RETENTION $ $

Y/N

N/A $

A EACH CLAIM / AGGREGATE

X PROFESSIONAL LIABILITY 035908521-03 01/24/2023 01/24/2024 2,000,000 / 2,000,000

CONTRACT # CTR054971; #CTR063646- Real Estate Appraisal and Valuation Services, Statewide for any and all work performed in ADOT's right-of-way

CERTIFICATE HOLDER CANCELLATION

ARIZONA DEPT OF TRANSPORTATION

1739 W JACKSON ST

STE A MD 100P

ATTN: SHARON TOHTSONI

PHOENIX, AZ 85007

stohtsoni@azdot.gov © 1988-2014 ACORD CORPORATION. All rights reserved.

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

DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached 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.

AUTHORIZED REPRESENTATIVE

WORKERS COMPENSATION AND

EMPLOYERS’ LIABILITY ANY

PROPRIETOR/PARTNER EXECUTIVE

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH) If yes, describe under

DESCRIPTION OF OPERATIONS BELOW

PER STATUTE

OTHER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE

E.L. DISEASE - POLICY LIMIT

HIRED

AUTOS

PROPERTY DAMAGE (Per accident)

EXCESS LIAB OCCUR

CLAIMS-MADE

COMBINED SINGLE LIMIT (Ec

Accident)

ALL

OWNED

AUTOS

BODILY INJURY (Per person)

BODILY INJURY (Per accident)

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)

INSURER B:

INSURER C:

INSURER D:

INSURER E:

INSURER F:

TYPE OF INSURANCE

ADDL

INSR

SUBR

WVO

POLICY NUMBER

POLICY EFF.

EMAIL

ADDRESS:

PRODUCER

CUSTOMER ID:

INSURER(S) AFFORDING COVERAGE NAIC #

INSURED: INSURER A:

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CONTACT

NAME:

PHONE

(A/C.No. Ext):

FAX (A/C

No)

DocuSign Envelope ID: 9C34F45B-434C-47F7-AE7A-EFA02ACD0552

ACCEPTED

ADOT Risk Management