cert_CLE_Arizona_Department_of_Administration_6306313_41.pdf

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)

© 1988-2016 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

D

30,000,000

01/01/2024

RES943799403

RWE943548207 (CA, OH)

CLE-006306313-41

X

1,000,000

10,000,000

RWR300120407 (WI)

X

X

22322

10,000,000

AggregateSIR: $1,750,000

Attn: Philadelphia.certs@marsh.com / Fax: (212) 948-0360

N

X

CONTRACTUAL LIABILITY

01/01/2023

XL Specialty Insurance Company

01/01/2024

01/01/2023

43575

01/01/2024

Philadelphia.Certs@marsh.com

RAD943781806

Professional Liability

C

55,000,000

30,000,000

24554 Greenwich Insurance Company

1,000,000

X

A

X

X

10/31/2023

2,000,000

01/01/2023

2,000,000

01/01/2023

RE: BPM004732.

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as additional insured (except workers’ compensation and crime)

SIR $1,750,000

X

01/01/2023

100 N 15th Ave., Suite 402

Phoenix, AZ 85007

Arizona Department of Administration

Indemnity Insurance Company of North America where required by written contract. Liability coverage shall be primary and non-contributory where required by written contract. Waiver of subrogation is applicable where required by written contract.

X

A

E

XL Insurance America

CN118025105-ALL-STAND-23-24

Claim

01/01/2024

5,000,000

XSM G72500027 003

Auto Liability, and Workers' Comp

C

55,000,000

36940

30,000,000

1,000,000

01/01/2024

RWD300120307 (AOS)

Excess of General Liability, 1717 Arch Street

MARSH USA LLC

X

Philadelphia, PA 19103

(See Attached for Additional Named Insureds)

Allied Universal Topco, LLC

Conshohocken, PA 19428 161 Washington Street, Suite 600

RES943799403

01/01/2023

State Procurement Office

01/01/2023

B

Marsh | U.S. Operations

01/01/2024

37885

01/01/2024

866-966-4664

Indian Harbor Insurance Company

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: FORM TITLE:

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE Page of

AGENCY CUSTOMER ID:

LOC #:

AGENCY

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSURED

EFFECTIVE DATE:

Insurer: National Union Fire Insurance Co. �

Limit:�

Clients' Property: $2,000,000�

Deductible: $250,000 �

The General Liability and Professional Liability policies evidenced above share in the limits shown. The limits do not apply separately to the individual coverages�

Contractors Pollution Liability �

SIR: $1,000,000�

Employers Liability Disease-Each Employee: $1,000,000 �

Philadelphia

Limit:� Effective Dates: 1/1/2023 - 1/1/2024�

Employers Liability Disease-Policy Limit: $1,000,000 � Employers Liability Each Accident: $1,000,000 �

Excess Workers' Compensation�

Insurer: XL Specialty Insurance Company � Policy No.: RWE943548207�

Certificate of Liability Insurance

Insurer: Commerce and Industry Insurance Company �

CN118025105

Policy No.: 03-824-02-02 �

Effective Dates: 08/15/2023 - 08/15/2024�

Deductible: $750,000�

Employee Theft or Dishonesty: $2,000,000�

Policy No.: CPO13303734 �

Effective Dates: 11/01/2021 - 11/01/2023�

MARSH USA LLC�

(See Attached for Additional Named Insureds)� Allied Universal Topco, LLC�

Conshohocken, PA 19428 161 Washington Street, Suite 600�

Limit: $5,000,000�

Crime �