CTR066205_COI_WC_Exp_2025.4.16.pdf

This document is a Certificate of Liability Insurance and Workers' Compensation Endorsement issued by Service American Indemnity Company for the Tohdenasshai Committee Against Family Abuse, Inc., located in Kayenta, Arizona. The insurance certificate, dated 3/28/2024, includes a waiver of subrogation that applies to the State of Arizona, its departments, agencies, boards, commissions, officers, and employees, with the Arizona Department of Economic Security listed as the certificate holder.

The insurance policy provides workers' compensation coverage with effective dates from 4/16/2024 to 4/16/2025. The workers' compensation policy includes limits of $1,000,000 for each accident, employee disease, and disease policy limit. The certificate includes a broad waiver of subrogation that allows the insurer to waive its right to recover payments from parties named in the schedule, specifically extending to the State of Arizona and its associated entities, with the primary location listed as 1789 W Jefferson St, mail drop 1541, Phoenix, AZ 85007.