COI_thru_10.1.24_Kingman.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

Willis Towers Watson Southeast, Inc.

c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA

The GEO Group Inc and All Subsidiaries 4955 Technology Way Boca Raton, FL 33431

Contract #AD9-010-A3

General Liability: Contractual Liability is provided per form CG0001 - Commercial General Liability. Coverage includes Severability of interest and Cross Suits. Sexual Molestation - Physical Abuse is not excluded under the General Liability policy. Blanket Additional Insured is included to Certificate Holder as respects General Liability

SEE ATTACHED

State of Arizona Department of Corrections 1601 West Jefferson Street, M/C 55303 Phoenix, AZ 85007-3002

10/02/2023

1-877-945-7378 1-888-467-2378 certificates@willis.com

National Union Fire Insurance Company of P 19445

ACE Property & Casualty Insurance Company

AIU Insurance Company

20699

19399

Ironshore Specialty Insurance Company 25445

Berkley National Insurance Company 38911

W30494910

A

5,000,000

5,000,000

0Civil Rights

5,000,000

25,000,000

5,000,000

Y Y 1729003 10/01/2023 10/01/2024

A

5,000,000

10/01/202410/01/2023

Deductible

Y Y 4594443

1,000,000

B 10,000,000

XOOG72597631 002 10/01/2023 10/01/2024 10,000,000

049154398 C Y

2,000,000 No 10/01/2023 10/01/2024

2,000,000

2,000,000

D Pollution Liability Each IncidentISPILLSCV0Y3001 10/01/2023 10/01/2026

Policy Aggregate

Retention

315091224740543SR ID: BATCH:

$100,000

$10,000,000

$10,000,000

Willis Towers Watson Certificate Center

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:

The GEO Group Inc and All Subsidiaries 4955 Technology Way Boca Raton, FL 33431 if required by written contract. Insurance is Primary and Non Contributory. Blanket Waiver of Subrogation is provided as respects General Liability as required by written contract.

Blanket Additional Insured is included to Certificate Holder as respect Automobile Liability if required by written contract. Blanket Waiver of Subrogation is provided as respects Automobile Liability as required by written contract.

Blanket Waiver of Subrogation is provided as respects Workers Compensation as required by written contract, as permitted by law.

The State of Arizona, its Department of Corrections, agencies, boards, commissions, universities and its officers, officials, agents and employees shall be named as additional insured with respect to liability arising out of the activiites performed by on on behalf of the Contractor, involving automobiles owned, leased, hired or borrowed by the Contractor.

Policy shall contain a waiver of subrogation against The State of Arizona, its Department of Corrections, agencies, boards, commissions, universities and its officers, officials, agents and employees for losses arising from work perfomed by or on behalf of the Contractor.

The Contractor's insurance coverage shall be primary insurance with respect to all other available sources.

The Umbrella sits excess the General Liability, Auto Liability, Employers Liability and Professional Liability policies.

INSURER AFFORDING COVERAGE: National Union Fire Insurance Company of Pittsburgh NAIC#: 19445

POLICY NUMBER: 6547191 EFF DATE: 10/01/2023 EXP DATE: 10/01/2024

ADDITIONAL INSURED: Y

SUBROGATION WAIVED: Y

TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT:

Medical Malpractice Limit 5,000,000 ������������������� Agg 25,000,000

ADDITIONAL REMARKS:

Certificate Holder is included as an Additional Insured as respects to Medical Malpractice. Waiver of Subrogation applies in favor of Certificate Holder with respects to Medical Malpractice.

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Willis Towers Watson Southeast, Inc.

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25 Certificate of Liability Insurance

W30494910CERT:3150912BATCH:24740543SR ID:

© 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:

The GEO Group Inc and All Subsidiaries 4955 Technology Way Boca Raton, FL 33431

INSURER AFFORDING COVERAGE: AIU Insurance Company NAIC#: 19399

POLICY NUMBER: 049154399 EFF DATE: 10/01/2023 EXP DATE: 10/01/2024

SUBROGATION WAIVED: Y

TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT:

Workers Compensation - CA Each Accident $2,000,000 Per Statute Disease Each Empl $2,000,000 ����������� Disease Pol Limit $2,000,000

INSURER AFFORDING COVERAGE: AIU Insurance Company NAIC#: 19399

POLICY NUMBER: 049154397 EFF DATE: 10/01/2023 EXP DATE: 10/01/2024

SUBROGATION WAIVED: Y

TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT:

Workers Compensation - WI Each Accident $2,000,000 Per Statute Disease Each Empl $2,000,000 ����������� Disease Pol Limit $2,000,000

INSURER AFFORDING COVERAGE: National Union Fire Insurance Company of Pittsburgh NAIC#: 19445

POLICY NUMBER: 4594444 EFF DATE: 10/01/2023 EXP DATE: 10/01/2024

ADDITIONAL INSURED: Y

SUBROGATION WAIVED: Y

TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT:

Automobile Liability - MA Only Combined Single Limit $5,000,000 Any Auto including Hired & Non-Owned

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Willis Towers Watson Southeast, Inc.

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© 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:

The GEO Group Inc and All Subsidiaries 4955 Technology Way Boca Raton, FL 33431

INSURER AFFORDING COVERAGE: National Union Fire Insurance Company of Pittsburgh NAIC#: 19445

POLICY NUMBER: 25060203 EFF DATE: 10/01/2023 EXP DATE: 10/01/2024

TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT:

Excess Liability Limit $10M x $10M

INSURER AFFORDING COVERAGE: Berkley National Insurance Company NAIC#: 38911

POLICY NUMBER: CEX09602890-05 EFF DATE: 10/01/2023 EXP DATE: 10/01/2024

TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT:

Excess Liability Limit $5M x $20M

4 4

Willis Towers Watson Southeast, Inc.

See Page 1

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10.0.2.20120224.1.869952

c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA

4955 Technology Way Boca Raton, FL 33431

General Liability: Contractual Liability is provided per form CG0001 - Commercial General Liability. Coverage includes Severability of interest and Cross Suits. Sexual Molestation - Physical Abuse is not excluded under the General Liability policy. Blanket Additional Insured is included to Certificate Holder as respects General Liability

SEE ATTACHED

INSURED:

State of Arizona Department of Corrections 1601 West Jefferson Street, M/C 55303 Phoenix, AZ 85007-3002