CTR062834_-_COI__3_.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

2/26/2025

Crest Insurance Group, LLC 5285 E. Williams Circle Suite 4500 Tucson AZ 85711

Martin Hastings 928-202-4027 520-325-3757 mhastings@crestins.com

License#: 967026 Philadelphia Insurance Company 419 VERDVAL-14 AmGUARD Insurance Company 42390

Verde Valley Homeless Coalition P.O. Box 2893 Cottonwood AZ 86326

United Financial Casualty Co. 11770

1874005850

A X 1,000,000 X 100,000

5,000

1,000,000

3,000,000 X

Y Y PHPK2643102-003 2/24/2025 2/24/2026

3,000,000

C 1,000,000

X X X

Y Y 02780966 10/30/2024 10/30/2025

A X X 1,000,000PHUB896550-003 2/24/2025 2/24/2026

1,000,000 X 10,000

B XY R2WC573143 8/26/2024 8/26/2025

1,000,000

1,000,000

1,000,000 A A

Professional Liability Sexual Abuse & Molestation

PHPK2643102-003

PHPK2643102-003

2/24/2025 2/24/2025

2/24/2026 2/24/2026

Occ/Agg Occ/Agg

$1M/$3M $500k/$500k

For Policy PHPK2643102 - The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are added as Additional Insureds with respect to the liability arising out of the Ongoing Operations and Completed Operations performed by or on behalf of the Contractor per Form #'s: CG 20 10 04 13 & CG 20 37 0413 respectively

For Policy 02780966 - The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as Additional Insureds with respect to liability arising out of the activities performed by, or on behalf of, the Contractor involving automobiles per Form: 1198 (07/16)

See Attached...

The State of Arizona and Dept of Economic Security C/O: myCOI 1075 Broad Ripple Ave Suite 313 Indianapolis IN 46220

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:

VERDVAL-14

1 1

Crest Insurance Group, LLC Verde Valley Homeless Coalition P.O. Box 2893 Cottonwood AZ 86326

25 CERTIFICATE OF LIABILITY INSURANCE

A Waiver of subrogation is written in force 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 for Policies PHPK2643102 (Form #: CG 24 04 05 09), 02780966 (Form #: 8610 02/19), & R2WC573143 (Form #: WC 00 03 13).

Policy 02780966 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.

Policy PHPK2643102 is Primary and Non-Contributory to any other insurance held by the Certificate Holder and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees per Form #: PI-GL-005 (07/12)

No proprietor/partner/executive/officer/member is excluded from Workers Compensation Policy R2WC573143

Sexual Abuse and Molestation coverage is included in Philadelphia Indemnity Insurance Company Policy PHPK2643102

Umbrella Policy PHUB896550 is supplemental and in addition to the Professional Liability Occurrence limit for a total of $2M per Occurrence and $4M Aggregate.

Certificate Holder is added to be notified within 30 days of any pending cancellation notice of any policy.

Philadelphia Indemnity Insurance Company| NAIC #: 18058 | AM Best Rating: A++ (Superior)

United Financial Casualty Company | NAIC #: 11770 | AM Best Rating: A+ (Superior)

AmGUARD Insurance Company | NAIC #: 42390 | AM Best Rating: A+ (Superior)

Solicitation #: CTR062834