COI_3.4.2026.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)

© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

9/16/2025

OAKLEY INSURANCE GROUP

7040 N Oracle Rd.

Tucson AZ 85704

Shawn Hellebuyck

(520) 887-5555 certificates@oakleyinsurancegroup.com

LifeNest LLC

3430 N 1ST AVE

TUCSON AZ 85719-1803

CFC Underwriting for Lloyds 32727

GEICO 25089

PENNSYLVANIA MANUFACTURERS ASSOC INS 12262

TRANSPORTATION INS CO 20494

A Y Y 822501-14-44-66-0 03/04/2025 03/04/2026

1,000,000

100,000

5,000

1,000,000

3,000,000

3,000,000

B Y Y 9300177247 07/08/2025 07/08/2026

1,000,000

C 6524011444660 03/04/2025 03/04/2026

1,000,000

1,000,000

D Y Y 8035640213 08/30/2025 08/30/2026 1,000,000

1,000,000

1,000,000

A Professional Liability

Y 210880276 09/01/2025 09/01/2026

Each Occurrence 2,000,000

General Aggregate 2,000,000

S.A.M 2,000,000

Division Name: ADES.

- Contract ID: CTR076898

Waiver of Subrogation applies in favor of: State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees.

Additional Insured: State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees.

Additional Insured applies to General Liability.

Additional Insured for Ongoing and and Completed Operations applies to this policy.

The State of Arizona and Dept of Economic Security C/O: myCOI

C/O: myCOI P.O. Box# 501970

8710 Bash Street

Indianapolis IN 46256

9300177247

POLICY NUMBER: 822501-14-44-66-0 COMMERCIAL GENERAL LIABILITY

CG 24 041219

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US (WAIVER OF SUBROGATION)

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

ELECTRONIC DATA LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES

POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

RAILROAD PROTECTIVE LIABILITY COVERAGE PART

UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS

SCHEDULE

Name Of Person(s) Or Organization(s):

ARIZONA DEPARTMENT OF ECONOMIC SECURITY REHABILITATION SERVICE

State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions:

We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above.

CG 24 041219 © Insurance Services Office, Inc., 2018

INSURED COPY

POLICY NUMBER: 822501-14-44-66-0 COMMERCIAL GENERAL LIABILITY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US (WAIVER OF SUBROGATION)

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

ELECTRONIC DATA LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES

POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

RAILROAD PROTECTIVE LIABILITY COVERAGE PART

UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS

SCHEDULE

Name Of Person(s) Or Organization(s):

ARIZONA DEPARTMENT OF ECONOMIC SECURITY

State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions:

We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above.

Page 2 of 2 © Insurance Services Office, Inc., 2018

INSURED COPY

/012�34567238349�8651:132�142;7<4=3�>76?1535�;4537�903��;214322�@;96��6?37<A3�B678�<45�;4537�903��68837=1<C� D3437<C��1<E1C19F��4567238349�G034�<99<=035�9037396H�

I190�732>3=9�96�=6?37<A3�>76?1535�EF�9012�34567238349J�903�>76?121642�6:�903��;214322�@;96��6?37<A3�B678�<45�903� �68837=1<C�D3437<C��1<E1C19F��4567238349�<>>CF�;4C322�8651:135�EF�9012�34567238349H�

/012�34567238349�153491:132�>37264K2L�67�67A<41M<9164K2L�G06�<73�N142;7352N�;4537�903�I06��2�@4��42;735�>76?12164�6:�903� �;214322�@;96��6?37<A3�B678�<45�;4537�903�53:1419164�6:�N�42;735N�14�903��68837=1<C�D3437<C��1<E1C19F��4567238349H� /012�34567238349�5632�469�<C937�=6?37<A3�>76?1535�14�903��;214322�@;96��6?37<A3�B678�67�903��68837=1<C�D3437<C� �1<E1C19F��4567238349H�

/012�34567238349�=0<4A32�903�>6C1=F�3::3=91?3�64�903�14=3>9164�5<93�6:�903�>6C1=F�;4C322�<469037�5<93�12�1451=<935�

E3C6GH�

K�:�46�3497F�<>>3<72�<E6?3J�14:678<9164�73O;1735�96�=68>C393�9012�34567238349�G1CC�E3�206G4�14�903�P3=C<7<91642�<2�

<>>C1=<EC3�96�903�34567238349HL�

�<=0�>37264�67�67A<41M<9164�206G4�14�903�Q=035;C3�12�<4�N142;735N�:67��6?3735�@;962��1<E1C19F��6?37<A3J�E;9�64CF� 96�903�3R9349�90<9�>37264�67�67A<41M<9164�O;<C1:132�<2�<4�N142;735N�;4537�903�I06��2�@4��42;735��76?12164� =649<1435�14�'STUVWX����6:�903��;214322�@;96��6?37<A3�B678H�Q;=0�>37264�67�67A<41M<9164�<C26�O;<C1:132�<2�<4� N142;735N�;4537�903��68837=1<C�D3437<C��1<E1C19F��4567238349�G034�<99<=035�96�903�>6C1=FH�

I034�73O;1735�EF�<�G719934�=6497<=9�67�G719934�<A7338349�F6;�34937�>7167�96�903�NC622NJ�9012�142;7<4=3�12�>718<7F�96� <45�G1CC�469�233Y�=64971E;9164�:768�<4F�69037�142;7<4=3�<?<1C<EC3�96�<4�@5519164<C��42;735�C12935�14�903�Q=035;C3� >76?1535�90<9�� �H� �H� /03�@5519164<C��42;735�12�<��<835��42;735�;4537�2;=0�69037�142;7<4=3Z� �6;�0<?3�<A7335�14�G71914A�14�2;=0�=6497<=9�67�<A7338349�90<9�9012�142;7<4=3�G6;C5�E3�>718<7F�<45�G6;C5�469� 233Y�=64971E;9164�:768�<4F�69037�142;7<4=3�<?<1C<EC3�96�903�@5519164<C��42;735Z�<45�

/03�@5519164<C��42;735�12�469�26C3CF�C1<EC3�:67�903�NC622NH��H�

��!"�#$�"%�!#� �4=C;532�=6>F71A0935�8<9371<C�6:��42;7<4=3�Q37?1=32��::1=3J��4=HJ�

G190�192�>378122164H� +[\S�]�Ŵ�]�

([_S�Ŵ�+S̀aWXbac�Ẁ��̀\[XVd[UVWXbace�

�/03�Q9<93�6:�@71M64<�<45�P3>9�6:��=64681=�Q3=;719F�

�4567238349��::3=91?3����f��f���g� �6;493721A435��F��

K@;90671M35� 3>732349<91?3L�

�<835��42;735�� �1:3�329��67>67<9164�