CTR062834-AutoCOI.pdf

Form_SCTNID_CTGRY.XX0316ACORD25_ACORD

<docindex><index>ACORD</index></docindex> BDF_PCA

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

PRODUCER CONTACT

NAME:

PHONE

(A/C, No, Ext):

FAX

(A/C, No):

E-MAIL

ADDRESS:

INSURER(S) AFFORDING COVERAGE NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

INSR

LTR

ADDL

INSD

SUBR

WVDTYPE OF INSURANCE

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY

OTHER:

PRO-

JECT LOC

AUTOMOBILE LIABILITY

ANY AUTO

OWNED

AUTOS ONLY

HIRED

AUTOS ONLY

SCHEDULED

AUTOS

NON-OWNED

AUTOS ONLY

UMBRELLA LIAB

EXCESS LIAB

OCCUR

CLAIMS-MADE

DED RETENTION $

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

ANYPROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBEREXCLUDED?

(Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below

Y/N

N / A

POLICY NUMBER

POLICY EFF POLICY EXP

(MM/DD/YYYY) (MM/DD/YYYY) LIMITS

EACH OCCURRENCE

DAMAGE TO RENTED

MED EXP (Any one person)

PERSONAL & ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGG

PREMISES (Ea occurrence)

COMBINED SINGLE LIMIT

PROPERTY DAMAGE

BODILY INJURY (Per person)

(Ea accident)

BODILY INJURY (Per accident)

AGGREGATE

EACH OCCURRENCE

E.L. EACH ACCIDENT

INSURED

$E.L. DISEASE - POLICY LIMIT

E.L. DISEASE - EA EMPLOYEE

PER

STATUTE

OTH-

ER

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

CERTIFICATE HOLDER CANCELLATION

AUTHORIZED REPRESENTATIVE

(Per accident)

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.

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.

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

progressivecommercial@email.progressive.com

1-800-444-4487

Progressive Commercial Lines Customer and Agent Servicing

CREST INS GROUP LLC

5285 E WMS CR #4500, TUCSON, AZ 85711

United Financial Casualty Company 11770

1,000,000

VERDE VALLEY HOMELESS COALITION

PO BOX 2893

COTTONWOOD, AZ 86326

The State of Arizona Its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees 1789 W. Jefferson Street Phoenix, AZ 85007

© 1988-2015 ACORD CORPORATION. All rights reserved.

ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD

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).

A X Y Y 02780966 10/30/2023 10/30/2024

10/23/2023

See ACORD 101 for additional coverage details. $

A Y Y 02780966 10/30/2023 10/30/2024

56915T9060274094215 mailto:progressivecommercial@email.progressive.com

Form_SCTNID_CTGRY.XX0108ACORD101_ACORD

<docindex><index>ACORD</index></docindex> BDF_PCA

CREST INS GROUP LLC

02780966

United Financial Casualty Company 11770

VERDE VALLEY HOMELESS

PO BOX 2893

COTTONWOOD, AZ 86326

AGENCY CUSTOMER ID:

LOC #:

ADDITIONAL REMARKS SCHEDULE Page of

AGENCY

POLICY NUMBER

CARRIER NAIC CODE

NAMED INSURED

EFFECTIVE DATE:

ADDITIONAL REMARKS

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance

1 1

Additional Coverages Insurance coverage(s) Limits…………………………………………………………………………………………………………………………………………………………………………………… Uninsured Motorist Bodily Injury $1,000,000 Combined Single Limit …………………………………………………………………………………………………………………………………………………………………………………… Underinsured Motorist Bodily Injury $1,000,000 Combined Single Limit

Description of Location/Vehicles/Special Items Scheduled autos only

2006 FORD 1FBNE31L96DA61693ECONO/CLUB WGN

Collision $1,000 Ded

Comprehensive $1,000 Ded

Medical Payments $5,000

Liability coverage may not apply to all scheduled vehicles.

Additional Information

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

Progressive Insurance Company and United Financial Casualty Company does not offer Symbol #2 coverage for "All Owned Autos" on any commercial auto policy.

This policy is primary and non-contributory as to The State of Arizona its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees regardless of whether Holder is a named insured of any other policy.

10/30/2023