CTR055086_2021-10-01_COI.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

9/16/2020

Lovitt & Touché, a Marsh & McLennan Agency, LLC 7202 E Rosewood Drive, Suite 200 Tucson AZ 85710

Mary Schlimgen 520-722-3000 520-722-7245 mschlimgen@lovitt-touche.com

CopperPoint Indemnity Insurance Company 13928 ARIZCHI-C2 Capitol Indemnity Corporation 10472

Arizona's Children Association (AZCA) c/o Kenneth Goranson 3716 E. Columbia Tucson AZ 85714

1901695338

B X 1,000,000 X 1,000,000

5,000

1,000,000

3,000,000 X

HS029138200203 10/1/2020 10/1/2021

3,000,000

B 1,000,000

X

X X

HS029138200203 10/1/2020 10/1/2021

B X 7,000,000HS029138200203 10/1/2020 10/1/2021

7,000,000 X 10,000

A X1003483 7/1/2020 7/1/2021

1,000,000

1,000,000

1,000,000 B

Sexual Molestation Professional Liability

HS029138200203 10/1/2020 10/1/2021 Each Claim $1,000,000 $1,000,000

Policy Aggregate $3,000,000 $3,000,000

Sexual Abuse and Molestation coverage is included

General & Professional The policy ,as required by this written agreement, includes the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insured with respect to liability arising out of the activities performed by or on behalf of the Contractor.

Policy contains a waiver of subrogation endorsement, as required by written agreement, in favor of the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor.

See Attached...

Evidence of Insurance

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:

ARIZCHI-C2

1 1

Lovitt & Touché, a Marsh & McLennan Agency, LLC Arizona's Children Association (AZCA) c/o Kenneth Goranson 3716 E. Columbia Tucson AZ 85714

25 CERTIFICATE OF LIABILITY INSURANCE

Coverage provided to the additional insured above is primary insurance.

Auto Policy is endorsed, as required by this written agreement, to include the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insured with respect to liability arising out of the activities performed by, or on behalf of, the Contractor involving automobiles owned, hired and/or non-owned by the Contractor. Auto policy contains a waiver of subrogation endorsement as required by this written agreement in favor of the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor.

Coverage provided to the additional insured above is primary insurance.

Workers Compensation policy contains a waiver of subrogation endorsement, as required by this written agreement, in favor of the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor

All locations are insured for Professional Liability.

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13

(Ed. 4-84)

WC 00 03 13

(Ed. 4-84)

© 1983 National Council on Compensation Insurance.

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

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 applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)

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

Schedule State Blanket/Schedule/State

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

This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.

(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)

07/01/2020Endorsement Effective 1003483Policy No. 17Endorsement No.

Arizonas Children AssociationInsured 100 Premium $

CopperPoint Indemnity Insurance CompanyInsurance Company Countersigned by

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 89 06 00 B

(Version 7/01)

This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.

(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)

07/01/2020Endorsement Effective 1003483Policy No. 18Endorsement No.

Arizonas Children AssociationInsured $100Premium Cost Change

CopperPoint Indemnity Insurance CompanyInsurance Company Countersigned by

WC 89 06 00 B

(Version 7/01)

© Copyright 2009 National Council on Compensation Insurance, Inc. All Rights Reserved.

POLICY INFORMATION PAGE ENDORSEMENT

The following item(s)

Insured’s Name (WC 89 06 01) Expiration Date (WC 89 06 04) Insured’s Mailing Address (WC 89 06 05) Experience Modification (WC 89 04 06) Producer’s Name (WC 89 06 07) Change in Workplace of Insured (WC 89 06 08) Insured’s Legal Status (WC 89 06 10) Item 3.A. States (WC 89 06 11)

Item 3.B. Limits (WC 89 06 12) Item 3 .C. States (WC 89 06 13)

✔ Item 3.D. Endorsement Numbers (WC 89 06 14) Item 4.* Class, Rate, Other (WC 89 04 15)

✔ Interim Adjustment of Premium (WC 89 04 16) Interstate/Intrastate Risk ID Number (WC 89 06 18) Issuing Agency/Producer Office Address (WC 89 06 25)

Is changed to read:

Total Estimated Annual Premium: $144,993

CGE 512 (07-15) Page 1 of 3 © 2015 CapSpecialty, Inc. All rights reserved.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY

ADDITIONAL INSURED – STATE OF ARIZONA

This endorsement modifies Insurance provided under the following:

ARIZONA CHANGES – CANCELLATION AND NONRENEWAL

BUSINESS AUTO COVERAGE FORM

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

HUMAN SERVICES SEXUAL ABUSE OR PHYSICAL ABUSE OR MOLESTATION LIABILITY OCCURRENCE

POLICY

HUMAN SERVICES SEXUAL ABUSE OR PHYSICAL ABUSE OR MOLESTATION LIABILITY CLAIMS-MADE

POLICY

HUMAN SERVICES PROFESSIONAL LIABILITY POLICY

HUMAN SERVICES PROFESSIONAL LIABILITY POLICY CLAIMS-MADE

Schedule

Description of State of Arizona Department:

A. Paragraph A.7.h.b. of the ARIZONA CHANGES – CANCELLATION AND NONRENEWAL IL 02 58 has been deleted and replaced by the following:

b. 60 days before the effective date of cancellation if we cancel for any of the other reasons.

B. Paragraph B.g.(2) of the ARIZONA CHANGES – CANCELLATION AND NONRENEWAL IL 02 58 has been deleted and replaced by the following:

(2) 60 days before the effective date of cancellation, if we cancel for any other reasons.

C. Paragraph A.1. Who Is An Insured under Section II – COVERED AUTOS LIABILITY COVERAGE of the

BUSINESS AUTO COVERAGE FORM has been amended to add the following as an additional insured:

The State of Arizona, the specific State of Arizona department listed in the Schedule above (if any is so listed) its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees shall be named as additional insureds but only with respect to liability arising out of the activities performed by or on behalf of the “insured”, involving automobiles owned, leased or hired or borrowed by the “insured”.

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

Including Arizona Department of Child Safety, Arizona Department of Economic Security, Arizona Department of Development Disabilities, Arizona Department of Transportation, Arizona Criminal Justice System, Arizona Department of Development Disabilities, Arizona Department of Education, Arizona Supreme Court, Arizona Supreme Court, Arizona Supreme Court Juvenile Court System, Cartwright School District No. 83, Casa de los Ninos, Child and Family Resource Center, Community Partnership of Southern Arizona, Dillion International Inc., Eastern Arizona College,First Things First , Gila River Behavioral Health Services, La Frontera Center, Inc., Marana Health Center, Inc. Behavioral Health Services, Mercy Maricopa Integrated Care, Northern Arizona Behavioral Health Authority, Pascua Yaqui Centered Spirit Behavioral Health Program, People of Color Network Southwest Network, Pima County c/o Pima County Community Development Kino Service Center, Pima County Community Development and Neighborhood Conservation, Pima County Juvenile Court Center, Pima County Community Development Kind Service Center, Providence of Arizona, Inc., Southwest Network , Pima Council on Aging Advocacy, Action Assistance, Town of Gilbert,Trips for Kids, Tucson Medical Center, Tucson Police Department, Tucson Unified School District, Wellington Court, LLC, Cenpatico of Arizona, Inc.

CGE 512 (07-15) Page 2 of 3

D. Paragraph A.1. Who Is An Insured under Section II – Who Is An Insured of the COMMERCIAL GENERAL

LIABILITY COVERAGE FORM CG 00 01; Section II – Who Is An Insured of the HUMAN SERVICES

SEXUAL ABUSE OR PHYSICAL ABUSE OR MOLESTATION LIABILITY OCCURRENCE POLICY HSA 004 and HUMAN SERVICES SEXUAL ABUSE OR PHYSICAL ABUSE OR MOLESTATION LIABILITY CLAIMS-

MADE POLICY HSA 005 and Section II – Who Is An Insured of the HUMAN SERVICES PROFESSIONAL

LIABILITY POLICY HSP 004 and HUMAN SERVICES PROFESSIONAL LIABILITY POLICY CLAIMS-MADE

HSP 005 are all amended to add the following as an additional insured:

The State of Arizona, the specific State of Arizona department listed in the Schedule above (if any is so listed), its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees shall be named as additional insureds but only with respect to liability arising out of the activities performed by or on behalf of the ‘insured”.

E. Paragraph 5. Other Insurance under SECTION IV – BUSINESS AUTO CONDITIONS of the BUSINES

AUTO COVERAGE FORM CA 00 01; Paragraph 4. Other Insurance under SECTION IV – COMMERCIAL

GENERAL LIABILITY CONDITIONS CG 00 01; Paragraph E. Other Insurance under Section IV.

CONDITIONS of the HUMAN SERVICES SEXUAL ABUSE OR PHYSICAL ABUSE OR MOLESTATION

LIABILITY OCCURRENCE POLICY HSA 004; HUMAN SERVICES SEXUAL ABUSE OR PHYSICAL ABUSE

OR MOLESTATION LIABILITY CLAIMS-MADE POLICY HSA 005; HUMAN SERVICES PROFESSIONAL

LIABILITY POLICY HSP 004 and HUMAN SERVICES PROFESSIONAL LIABILITY POLICY CLAIMS-MADE

HSP 005 are all amended to add the following

However, the “insured” has agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the State of Arizona.

F. The Transfer Of Rights Of Recovery Against Others To Us condition in the BUSINESS AUTO COVERAGE

FORM CA 00 01 does not apply to the State of Arizona or the State of Arizona department listed in the

Schedule above if applicable, but only to the extent that subrogation is waived prior to the “accident” or “loss” under a contract with that person or organization.

G. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section

IV – CONDITIONS of the COMMERCIAL GENERAL LIABLIITY COVERAGE FORM CG 00 01:

We waive any right of recovery we may have against the State of Arizona or State of Arizona department listed in the Schedule above (if any is so listed), because of payments we make for injury or damage arising out of your ongoing operations or “your work” done under a contract with that person or organization and included in the “products-completed operations hazard”. This waiver applies only to the State of Arizona or State of Arizona department shown in the Schedule above if applicable.

H. The following is added to Paragraph M. Transfer of Rights Recovery Against Others To Us of Section IV.

CONDITIONS of the HUMAN SERVICES SEXUAL ABUSE OR PHYSICAL ABUSE OR MOLESTATION

LIABILITY OCCURRENCE POLICY HSA 004 and HUMAN SERVICES SEXUAL ABUSE OR PHYSICAL

ABUSE OR MOLESTATION LIABILITY CLAIMS-MADE POLICY HSA 005:

We waive any right of recovery we may have against the State of Arizona or State of Arizona department listed in the Schedule above if applicable because of payments we make for injury or damage arising out of

“abusive conduct”. This waiver applies only to the State of Arizona or State of Arizona department shown in the Schedule above (if any is so listed).

CGE 512 (07-15) Page 3 of 3

I. The following is added to Paragraph N. Transfer of Rights Recovery Against Others to Us of Section IV.

CONDITIONS of the HUMAN SERVICES PROFESSIONAL LIABILITY POLICY HSP 004 and HUMAN

SERVICES PROFESSIONAL LIABILITY POLICY CLAIMS-MADE HSP 005

We waive any right of recovery we may have against the State of Arizona or State of Arizona department listed in the Schedule above (if any is so listed), if applicable because of payments we make for injury or damage arising out of a “professional incident“. This waiver applies only to the State of Arizona or State of

Arizona department shown in the Schedule above if applicable.

All Other Terms, Conditions And Exclusions Remain Unchanged.