CTR066205_-_COI.pdf

DATE (MM/DD/YYYY

12/27/2023

NFP Property & Casualty Services, Inc 420 N Humphreys St

Flagstaff AZ 86001

Bunny Alderete

(928) 774-3345 (928) 779-4561 bunny.alderete@nfp.com

Tohdenasshai Committee Against Family Abuse Inc.

P O Box 1510

Kayenta AZ 86033

PHILADELPHIA INSURANCE CO

CERTIFICATE NUMBER:

A Y Y

1,000,000 100,000 1,000 1,000,000 2,000,000 2,000,000

A Y Y

1,000,000

Medical payments 5,000

A

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

The State of Arizona, it's departments, agencies, boards, commissions, universities, officers, officials, agents and employees are hereby listed as Additional Insured as respects General Liability per form CG2026 (04/13) and Commercial Auto per form CA2048(10/13)with respect to liability arising out of the activities performed by or on behalf of the Contractor. Waiver of Subrogation is endorsed in favor of The State of Arizona, it's departments agencies, boards, commissions, universities, officers, officials, agents and employees as respects General Liability per form CG2404 (05/09) and Commercial Auto per form CA 0444 (03/10) for losses arising from work performed by or on behalf of the Contractor. This insurance is Primary and any insurance carried by the Department,it's agents officials or employees ot the State shall be excess and not contributory.

Contract # 066205

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: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

EXCESS LIAB

UMBRELLA LIAB $EACH OCCURRENCE

$AGGREGATE

OCCUR

CLAIMS-MADE

DED RETENTION $

$PRODUCTS - COMP/OP AGG

$GENERAL AGGREGATE

$PHPK2596941 08/29/2023 08/29/2024 PERSONAL & ADV INJUR

$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

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

PHPK2596941 08/29/2023 08/29/2024

PHPK2596941 08/29/2022 08/29/2023 $1,000,000/Occurence $2,000,000 Agg Professional Liability-Claims Made

Sexual Abuse & Molestation $ 500,000/Occurence $ 500,000 Agg

A X X

X 10,000

PHUB879625 08/29/2023 8/29/2024

1,000,000 1,000,000

The State of Arizona Arizona Department of Economic Security c/o My COI 1075 Broad Ripple Ave Ste 313 Indianapolis IN 46220 bunny.alderete Highlight

DATE (MM/DD/YYYY

01/23/2023 NFP Property & Casualty Services, Inc 420 N Humphreys St Flagstaff AZ 86001 Bunny Alderete

(928) 774-3345 (928) 779-4561 bunny.alderete@nfp.com Tohdenasshai Committee Against Family Abuse Inc.

P O Box 1510 Kayenta AZ 86033

PHILADELPHIA INSURANCE CO

CERTIFICATE NUMBER:

A Y Y 1,000,000 100,000 1,000 1,000,000 2,000,000 2,000,000 A Y Y 1,000,000 Medical payments 5,000 A DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The State of Arizona, it's departments, agencies, boards, commissions, universities, officers, officials, agents and employees are hereby listed as Additional Insured as respects General Liability per form CG2026 (04/13) and Commercial Auto per form CA2048(10/13)with respect to liability arising out of the activities performed by or on behalf of the Contractor. Waiver of Subrogation is endorsed in favor of The State of Arizona, it's departments agencies, boards, commissions, universities, officers, officials, agents and employees as respects General Liability per form CG2404 (05/09) and Commercial Auto per form CA 0444 (03/10) for losses arising from work performed by or on behalf of the Contractor. This insurance is Primary and any insurance carried by the Department,it's agents officials or employees ot the State shall be excess and not contributory.

Contract # CTR062161