ASRS_CERT_on_behalf_of_RCLCO.pdf

PDF 2 MB Posted

Attached to
Master Agreement AZ|CTR057208
Contract number
CTR057208
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance for Robert Charles Lesser & Co., LLC and RCLCO Fund Advisors, LLC, located in Bethesda, Maryland. The insurance certificate involves multiple insurance carriers including Great Northern Insurance Company, Federal Insurance Company, Chubb Indemnity Insurance Company, and ACE Fire Underwriters Insurance Company. The certificate holder is the Arizona State Retirement System (ASRS), with a specific contract reference number CTR052269. The policy covers the period from January 1, 2025 to January 1, 2026.

The insurance coverage includes multiple liability types with significant financial protections: Commercial General Liability with a $1,000,000 per occurrence limit, Automobile Liability, Umbrella Liability with a $7,000,000 limit, Workers' Compensation, Professional Liability with a $3,000,000 per claim and aggregate limit, and additional Cyber Liability Coverage with a $2,000,000 limit. The policy also includes Directors & Officers (D&O), Employment Practices Liability Insurance (EPLI), and Fiduciary Liability, each with $1,000,000 aggregate coverage limits. The Arizona State Retirement System is included as an additional insured with primary, non-contributory wording and a waiver of subrogation for General Liability coverage.

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ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

INSR ADDL SUBR

LTR INSD WVD

PRODUCER CONTACT

NAME:

FAXPHONE

(A/C, No):(A/C, No, Ext):

E-MAIL

ADDRESS:

INSURER A :

INSURED INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)

AUTOMOBILE LIABILITY

UMBRELLA LIAB

EXCESS LIAB

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

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

AUTHORIZED REPRESENTATIVE

EACH OCCURRENCE $

DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT

OTHER: $

COMBINED SINGLE LIMIT

$(Ea accident)

ANY AUTO BODILY INJURY (Per person) $

OWNED SCHEDULED

BODILY INJURY (Per accident) $AUTOS ONLY AUTOS

HIRED NON-OWNED PROPERTY DAMAGE

$AUTOS ONLY AUTOS ONLY (Per accident)

OCCUR EACH OCCURRENCE

CLAIMS-MADE AGGREGATE $

DED RETENTION $

PER OTH-

STATUTE ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE $

If yes, describe under

E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below

INSURER(S) AFFORDING COVERAGE NAIC #

COMMERCIAL GENERAL LIABILITY

Y / N N / A

(Mandatory in NH)

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

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).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

CERTIFICATE HOLDER CANCELLATION

© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)

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

The ACORD name and logo are registered marks of ACORD

4/14/2025

License # L100460

(323) 550-7900 (323) 256-0800

20303

Robert Charles Lesser & Co., LLC RCLCO Fund Advisors, LLC 4800 Hampden Lane, Suite 710 Bethesda, MD 20814

20281 12777 20702

A 1,000,000

X X 36053073 1/1/2025 1/1/2026 1,000,000 No GL Deductible 10,000

1,000,000 2,000,000 2,000,000

1,000,000A 73601142 1/1/2025 1/1/2026

7,000,000B 78187448 1/1/2025 1/1/2026 7,000,000

C

71765147 1/1/2025 1/1/2026 1,000,000 1,000,000 1,000,000

D Prof. Liability G28286685 007 1/1/2025 Per Claim 3,000,000 D Prof. Liability G28286685 007 1/1/2025 1/1/2026 Aggregate 3,000,000

Includes Cyber Liability Coverage - (CLAIMS MADE FORM)

Carrier - Houston Casualty Company Policy# H24NGP21018403 Effective 8/23/2024 to 8/23/2025 $2,000,0000 coverage limit - Each Claim $2,000,000 coverage limit - Aggregate

SEE ATTACHED ACORD 101

Arizona State Retirement System 3300 N. Central Avenue Suite 1400 Phoenix, AZ 85012-0250

ROBERTC-01 DOLDENBERG

Knauf Maxwell Insurance Services 2900 W. Broadway Los Angeles, CA 90041 knaufreception@kmins.com

Great Northern Insurance Company Federal Insurance Company Chubb Indemnity Insurance Company ACE Fire Underwriters Insurance Company

X

1/1/2026

X X

X

X X

X X

X

X

X

FORM NUMBER:

EFFECTIVE DATE:

The ACORD name and logo are registered marks of ACORD

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE

FORM TITLE:

Page of

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

ACORD 101 (2008/01)

AGENCY CUSTOMER ID:

LOC #:

AGENCY NAMED INSURED

POLICY NUMBER

CARRIER NAIC CODE

© 2008 ACORD CORPORATION. All rights reserved.

Knauf Maxwell Insurance Services

ROBERTC-01

SEE PAGE 1

SEE PAGE 1

ACORD 25 Certificate of Liability Insurance

License # L100460

SEE P 1

Robert Charles Lesser & Co., LLC RCLCO Fund Advisors, LLC 4800 Hampden Lane, Suite 710 Bethesda, MD 20814

SEE PAGE 1

DOLDENBERG

Description of Operations/Locations/Vehicles:

$10,000 deductible - Each Claim $30,000 deductible - Aggregate

Retroactive Date - Full Prior Acts

Includes D&O, EPLI and Fiduciary Liability Coverage - (CLAIMS MADE FORM)

Carrier - Scottsdale Indemnity Company Policy# EKI3554863 Effective 1/01/2025 to 1/01/2026 D&O (Directors & Officers Liability) $1,000,0000 coverage limit - aggregate for loss $2,000,000 coverage limit - maximum aggregate for this coverage $25,000 Retention (Each Claim) Continuity Date - 1/01/2018

EPLI (Employment Practices Liability) $1,000,0000 coverage limit - aggregate for loss $2,000,000 coverage limit - maximum aggregate for this coverage $25,000 Retention (Each Claim) Continuity Date - 1/01/2014

Fiduciary Liability $1,000,0000 coverage limit - aggregate for loss and maximum aggregate for this coverage $25,000 Retention (Each Claim) Continuity Date - 1/01/2018

ASRS Contract CTR052269 Arizona State Retirement System is included as additional insured, including primary, non-contributory wording and waiver of subrogation as respects General Liability coverage; only as per attached endorsements.

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