CTR072685_-_COI_-_State_of_Arizona_-_AUEMUS_COI_W_ADDITIONAL_INSURED.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)

© 1988-2016 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

E 01/01/2024

01/01/2025

X

C

43575

55,000,000

XL Specialty Insurance Company

RWR300120408 (WI)

SIR $1,750,000

36940

RES943799404

10,000,000

A

D

2,000,000

01/01/2025 X

XL Insurance America

X

Professional Liability

01/01/2024

CN118025105-ALL-STAND-24-25

1,000,000

22322

Marsh | U.S. Operations

01/01/2025

CLE-006458975-44

01/01/2024

X

55,000,000

07/01/2024

X

X

01/01/2025

2,000,000

01/01/2025

30,000,000

X

Aggregate

X

1,000,000 1,000,000

B

Philadelphia.Certs@marsh.com

01/01/2025

01/01/2024

01/01/2024

Auto Liability, and Workers' Comp

24554

RAD943781807

Claim

01/01/2024

RWD300120308 (AOS)

RWE943548208 (CA, OH)

XSM G72500027 004

SIR: $1,750,000

30,000,000

State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees is/are included as additional insured (except workers’ compensation and crime) where required by written contract. Liability coverage shall be primary and non-contributory where required by written contract. Waiver of subrogation is applicable where required by written contract.

RE: ADSP013-00003094

Indemnity Insurance Company of North America (See Attached for Additional Named Insureds)

Allied Universal Topco, LLC

Conshohocken, PA 19428 161 Washington Street, Suite 600

30,000,000

Indian Harbor Insurance Company

X

30 South 17th Street

MARSH USA LLC

Attn: Philadelphia.certs@marsh.com / Fax: (212) 948-0360 Philadelphia, PA 19103

RES943799404

Greenwich Insurance Company

N

1802 W. Jackson, #100

Phoenix, AZ 85007

State of Arizona

Arizona Department of Administration

01/01/2024

C

37885

5,000,000

866-966-4664

CONTRACTUAL LIABILITY

X

Excess of General Liability, A

10,000,000

01/01/2025

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:

MARSH USA LLC�

Policy No.: CPO13303734 �

SIR: $1,000,000�

Employers Liability Disease-Each Employee: $1,000,000 �

Limit:� Effective Dates: 1/1/2024 - 1/1/2025�

Employers Liability Disease-Policy Limit: $1,000,000 � Employers Liability Each Accident: $1,000,000 �

Excess Workers' Compensation�

Policy No.: RWE943548208 �

Employee Theft or Dishonesty: $2,000,000�

Insurer: National Union Fire Insurance Co. �

Effective Dates: 01/01/2024 - 01/01/2026�

Contractors Pollution Liability�

Insurer: Commerce and Industry Insurance Company�

Philadelphia

Certificate of Liability Insurance

Clients' Property: $2,000,000�

Effective Dates: 08/15/2023 - 08/15/2024�

The General Liability and Professional Liability policies evidenced above share in the limits shown. The limits do not apply separately to the individual coverages�

Limit: $5,000,000 �

Crime �

Deductible: $750,000�

Insurer: XL Specialty Insurance Company �

Limit:�

Policy No.: 03-824-02-02 �

(See Attached for Additional Named Insureds)� Allied Universal Topco, LLC�

161 Washington Street, Suite 600�

CN118025105

Conshohocken, PA 19428

Deductible: $250,000�