BETTER_TOGETHER_-_COL_AZ_DCS_060625_Redacted.pdf

PDF 51 KB Posted

Attached to
Master Agreement AZ|CTR071409
Contract number
CTR071409
Issued by
Arizona

About this file

This document is an ACORD Certificate of Liability Insurance for Better Together Mesa LLC, issued by Independence Insurance Group, PLLC in Phoenix, Arizona. The certificate involves multiple insurers, including The PIE Insurance Co and GEICO Marine Insurance Co, with the certificate holder being the Arizona Department of Child Safety located in Phoenix. The insurance is dated 6/6/2025 and covers multiple types of insurance.

The insurance policy provides coverage across several areas, including commercial general liability, automobile liability, and workers' compensation, with policy periods from 03/28/2025 to 03/28/2026. The general liability policy has a $1,000,000 per occurrence limit and a $3,000,000 general aggregate limit. The professional liability coverage also includes $1,000,000 per occurrence and $3,000,000 general aggregate. Automobile liability and workers' compensation are similarly structured with $1,000,000 limits. The policy is comprehensive, covering potential risks for Better Together Mesa LLC across multiple operational domains.

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Text version

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE

INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #

NAME:

CONTACT

(A/C, No):

FAX

E-MAIL

ADDRESS:

PRODUCER

(A/C, No, Ext):

PHONE

INSURED

REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES

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).

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.

OTHER:

(Per accident)

(Ea accident)

N / A

SUBR

WVD

ADDL

INSD

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.

$PROPERTY DAMAGE

BODILY INJURY (Per accident)

BODILY INJURY (Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY

Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH)

DESCRIPTION OF OPERATIONS below If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE

E.L. DISEASE - POLICY LIMIT

E.L. DISEASE - EA EMPLOYEE

E.L. EACH ACCIDENT

ER

OTH-

STATUTE

PER

LIMITS(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR

INSR

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

EXCESS LIAB

UMBRELLA LIAB $EACH OCCURRENCE

$AGGREGATE

OCCUR

CLAIMS-MADE

DED RETENTION $

$PRODUCTS - COMP/OP AGG

$GENERAL AGGREGATE

$PERSONAL & ADV INJURY

$MED EXP (Any one person)

$EACH OCCURRENCE

DAMAGE TO RENTED

$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY

PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE

ACORD 25 (2016/03)

© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

6/6/2025

Independence Insurance Group, PLLC

10210 N 32nd St #C-3

Phoenix AZ 85028

IRENE PLOSKI

(480) 656-1036 (480) 656-1046 info@indieinsurance.com

BETTER TOGETHER MESA LLC

THE PIE INS CO 21857

GEICO MARINE INS CO 37923

THE PIE INS CO 21857

A

Y Y 6002726-3 03/28/2025 03/28/2026

1,000,000

1,000,000

10,000

1,000,000

1,000,000

3,000,000

B Y Y 9300132294 03/28/2025 03/28/2026

1,000,000

C Y Y WC PI 1043179-001 03/28/2025 03/28/2026

1,000,000

1,000,000

1,000,000

A Professional Liability

6002726-3 03/28/2025 03/28/2026

Each Occurrence 1,000,000

General Aggregate 3,000,000

Arizona Department Of Child Safety

3003 N Central Ave#2000Ch010-2

Phoenix AZ 85012

File details come from the government source that posted it. Updated .