COI 2025-10-23 GL AL WC PL.pdf

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

11/6/2024

(623) 594-7531

20443

United Civil Group, Inc.

2803 N 7th Ave Ste. 16 Phoenix, AZ 85007

35289 29459

A 2,000,000

X X 4031101115 10/23/2024 10/23/2025 1,000,000 10,000

2,000,000 4,000,000 4,000,000

1,000,000B

X X 4031101132 10/23/2024 10/23/2025

2,000,000A 6072730510 10/23/2024 10/23/2025 2,000,000

10,000 C

X 59WECAC1SK0 10/23/2024 10/23/2025 1,000,000

1,000,000 1,000,000

A Technology E&O 6025072816 10/23/2024 See Description 1,000,000 A Prof/Pollution Liab. MCH288361955 10/23/2024 10/23/2025 See Description 3,000,000

Technology Errors & Omissions - Claims Made - Policy Number 6025072816 - Policy Effective Dates 10/23/24 to 10/23/25. Each Claim Limit $1,000,000 - Aggregate Limit $1,000,000 Deductible - $5,000 - Retroactive Date - 1/2/2019.

Professional Liability and Pollution Incident Liabiltiy - Claims Made - Policy Number 288361955 - Policy Effective Dates 10/23/24 to 10/23/25. Each Claim Limit $3,000,000 (Including claims expenses) - Aggregate Limit $3,000,000 per year (Including claims expenses). Each Design Defect Circumstance Limit $3,000,000. Aggregate Design Defect Circumstance Limit $3,000,000 per year. Each claim death or disability and non-practicing extended reporting period

SEE ATTACHED ACORD 101

State of Arizona/ADOT 206 S. 17th Ave Phoenix, AZ 85007

UNITCIV-01 GURUSAIYADAV

NFP Property & Casualty Services, Inc.

8777 North Gainey Center Drive Suite 260 Scottsdale, AZ 85258

Carol Miller carol.miller@nfp.com

Continental Casualty Company Continental Insurance Company Twin City Fire Insurance Company

X

10/23/2025

X X

X

X

X

X

X

G0171 Accepted

G0171 Highlight

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.

NFP Property & Casualty Services, Inc.

UNITCIV-01

SEE PAGE 1

SEE PAGE 1

ACORD 25 Certificate of Liability Insurance

SEE P 1

United Civil Group, Inc.

2803 N 7th Ave Ste. 16 Phoenix, AZ 85007

SEE PAGE 1

GURUSAIYADAV

Description of Operations/Locations/Vehicles:

Limit $3,000,000 (Including claims expenses). Aggregate death or disability and non-practicing extended reporting period Limit $3,000,000 (Including claims expenses). Deductible - $5,000. Inception Date - 10/23/2011.

Certificate holder is additional insured with respect to general liability per endorsement SB146932G Ed. 10-19 including completed operations per endorsement SB146968C Ed. 10-19 attached. General liability coverage is primary and non-contributory per endorsement SB146932G Ed. 10-19. Waiver of subrogation applies with respect to general liability per endorsement SB146932G Ed.

10-19 attached.

Certificate holder is additional insured with respect to automobile liability per endorsement CA2048 10 13 attached. Waiver of subrogation applies with respect to automobile liability per endorsement CA0444 04 13 attached.

Certificate holder is additional insured with respect to umbrella liability per endorsement G-15057-C and schedule of underlying insurance attached.

Waiver of subrogation applies with respect to workers' compensation per endorsement WC 00 03 13 attached.

State of Arizona/ADOT is Additional Insured with respects to General Liability per endorsement SB146932G (10-19) attached. General Liability Coverage is Primary and Non-Contributory per endorsement SB146932G (10-19) attached. Waiver of Subrogation applies to General Liability per endorsement SB146932G (10-19) attached.

State of Arizona/ADOT is Additional insured with respects to Automobile Liability per endorsement CA2048 10 13 attached. Waiver of Subrogation applies to Automobile Liability per endorsement CA0444 10 13 attached.

Waiver of subrogation applies to Workers Compensation per endorsement WC00 03 13 attached.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

Countersigned by Authorized Representative

Form WC 00 03 13 Printed in U.S.A.

Process Date: 09/12/24 Policy Expiration Date: 10/23/25

WAIVER OF OUR RIGHT TO RECOVER

FROM OTHERS ENDORSEMENT

Policy Number: 59 WEC AC1SK0 Endorsement Number:

Effective Date: 10/23/24 Effective hour is the same as stated on the Information Page of the policy.

Named Insured and Address: United Civil Group Inc.

2803 N 7TH AVE

PHOENIX AZ 85007

We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule.

This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.

SCHEDULE

Any person or organization for whom you are required by contract or agreement to obtain this waiver from us.

Endorsement is not applicable in KY, NH, NJ or for any MO construction risk