APPROVED GL,AL,WC,PROFESSIONAL 05.12.20-05.12.21.pdf

02/22/21

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. NAVIGATORS INSURANCE COMPANY 42307

10605 N. HAYDEN ROAD

BUILDING G, SUITE 140

SCOTTSDALE, ARIZONA 85260

COVERAGES: CERTIFICATE NUMBER: 392 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.

CO

LTR LIMITS

A X COMMERCIAL GENERAL LIABILITY $ 1,000,000

CLAIMS MADE X X X PSB0001543 05/12/20 05/12/21 $ 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

AUTOMOBILE LIABILITY $

ANY AUTO SCHEDULED

AUTOS $

NON $

OWNED $

AUTOS

A X UMBRELLA LAB X X PSE0001351 05/12/20 05/12/21 EACH OCCURRENCE $ 4,000,000

X AGGREGATE $ 4,000,000

DED RETENTION $ $

A N/A X PSW0001441 05/12/20 05/12/21

Y/N

N $ 1,000,000

$ 1,000,000

$ 1,000,000

OTHER EACH CLAIM / AGGREGATE

B X PROFESSIONAL LIABILITY X 08/29/20 08/29/21 2,000,000 / 2,000,000

A X VALUABLE PAPERS PSB0001543 05/12/20 05/12/21 $100,000

Project: On Call Transit and Rail

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 Liability coverages; blanket endorsement form PPB3040212 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.

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.

CM20DPL091494IV

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.

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

X 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)

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)

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:

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

CONTACT

NAME:

PHONE

(A/C.No. Ext):

FAX (A/C

No)

ACCEPTED

ADOT Risk Management

Insured Full Copy

648757198

POLICY NUMBER COMMERCIAL AUTO

AA CW 40 10 11

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

AA CW 40 10 11 Allstate Insurance Company Page 1 of 1

WAIVER OF THE

TRANSFER OF RECOVERY AGAINST OTHERS TO US

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

GARAGE COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

TRUCKERS COVERAGE FORM

SCHEDULE

Designated Person or Organization:

Contract Number:

Description of Project:

Location of Project:

The following is added to the Transfer of Rights of Recovery Against Others To Us Condition:

We waive any right of recovery we may have against the person or organization designated in the above

Schedule because of payments we make for injury or damage arising out of work you perform under a contract with the above designated person or organization. The waiver applies only to the above designated person or organization and the work you perform must be under the contract, and for the project and location designated in the above Schedule.