COI_EXP_10-23-25.pdf

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

04/21/2025

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).

PRODUCER CONTACT

NAME: Southwest Professional Insurance Consultants

Southwest Professional Insurance Consultants 7689 E. Paradise Lane, Suite 5 Scottsdale AZ 85260

PHONE

(A/C, No. Ext): (480) 368-1800 FAX

(A/C, No): (480) 368-1702

E-MAIL

ADDRESS

INSURER(S) AFFORDING COVERAGE NAIC #

INSURED

INSURER A:

INSURER B: RLI Insurance Company

RLI Insurance Company 13056 13056

J2 ENGINEERING & ENVIRONMENTAL DESIGN, LLC

4649 E. COTTON GIN LOOP, SUITE B2

PHOENIX AZ 85040-8889

INSURER C: RLI Insurance Company 13056 INSURER D: RLI Insurance Company 13056 INSURER E: Arch Insurance Company 11150

INSURER F:

COVERAGES CERTIFICATE NUMBER: 20791 REVISION NUMBER:1 SUPERCEDES PREVIOUS REVISIONS

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.

INSR

LTR TYPE OF INSURANCE

ADDL

INSRD

SUBR

WVD

POLICY EFF

DATE (MM/DD/YY)

POLICY EXP

DATE (MM/DD/YY)

X

POLICY NUMBER

EACH OCCURRENCE

LIMITS

$ 1,000,000

A

COMMERCIAL GENERAL LIABILITY

X X

PSB0010401 10/23/24 10/23/25

DAMAGE TO RENTED

PREMISES (Ea occurence) $ 1,000,000CLAIMS MADE X OCCUR

10,000MED EXP (Any one person) $

1,000,000PERSONAL & ADV INJURY $

2,000,000GEN'L AGGREGATE LIMIT APPLIES PER:

PRO-

JECT

GENERAL AGGREGATE $

2,000,000

A POLICY LOC

PSB0010401 10/23/25

PRODUCTS-COMP/OP AGG $

500,000X OTHER: YES

PSA0003363

10/23/24

10/23/25 COMBINED SINGLE LIMIT

(Ea accident)

B AUTOMOBILE LIABILITY X X 10/23/24 $ 1,000,000

X ANY AUTO BODILY INJURY (Per person) $

OWNED

AUTOS ONLY

SCHEDULED

AUTOS

BODILY INJURY (Per accident) $

HIRED

AUTOS ONLY

NON-OWNED

AUTOS ONLY

PROPERTY DAMAGE

$(Per accident)

C UMBRELLA LIAB X OCCUR X X PSE0005099 10/23/24 10/23/25 EACH OCCURRENCE $ 4,000,000

X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 4,000,000

DED RETENTION $ $

D

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY X

PSW0005631 10/23/24 10/23/25 X PER

STATUTE

OTH-

ER

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH)

Y/N N/A E.L. EACH ACCIDENT $ 1,000,000

E.L. DISEASE-EA EMPLOYEE $ 1,000,000

If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $ 1,000,000

E Professional Liability PAAEP0151802 10/23/24 10/23/25 $5,000,000 / $5,000,000

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

CERTIFICATE HOLDER CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

Arizona Department of Administration 1400 West Washington Street Phoenix, AZ 85007

Attention: Kevin Query Dan Hardesty Lic # 43395 ACORD 25 (2016/03) Certificate # 20791 Revision # 1 © 1988-2015 ACORD CORPORATION. All right reserved.

The ACORD name and logo are registered marks of ACORD

SUPPLEMENT TO CERTIFICATE OF LIABILITY INS #20791 DATE

APR 21 2025

DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS

Professional Liability - Claims Made and Reported - Retroactive Date 09/01/2002 Arizona Department of Administration is added as additional insured on a primary and non-contributary basis as required by written contract as respects to general liability only for ongoing work per form PPB 304 02 12. Waiver of Subrogation applies as respects general liability as required by written contract per form PPB 304 02 12. Blanket Waiver of Subrogation applies to Workers Compensation per form WC 00 03 13. Arizona Department of Administration is added as additional insured on a primary and non-contributary basis as required by written contract as respects auto liability only for ongoing work per form PPA 300 03

13. Blanket Waiver of Subrogation for auto liability per form PPA 300 03 13. Project: ADOA Contract BPM006827 On Call Landscape Architectural Services. J2 Project 25.1758

Certificate # 20791