FCC_NPP_SENSE_Contract_COI_-__BPM003267_4-9-25.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

4/8/2025

OAKLEY INSURANCE GROUP

7040 N Oracle Rd.

Tucson AZ 85704

Jessica Richards-Finley

(520) 887-5555 certificates@oakleyinsurancegroup.com

LIFETRAN CORP

3430 N 1st Ave

TUCSON AZ 85719

MANUFACTURERS ALLIANCE INS CO 36897

COAST NATL INS CO 25089

PENNSYLVANIA MANUFACTURERS ASSOC INS 12262

VALLEY FORGE INS CO 20508

A

✘ Hired/Non-Owned Auto

Y Y 822501-14-44-66-0 03/04/2025 03/04/2026

1,000,000

100,000

5,000

1,000,000

3,000,000

3,000,000

Hired/Non-Owned Auto 1,000,000

B

Y Y M00-0050764-01 08/01/2024 08/01/2026

500,000

C ✘

Y Y 602501-14-44-66-0 03/04/2025 03/04/2026

1,000,000

1,000,000

D Y Y 6025027472 11/28/2024 11/28/2026 1,000,000

1,000,000

1,000,000

A Professional Liability with $2500 ded

Sexual Abuse and Molestation 3825011444660 03/04/2025 03/04/2026

Each Occurrence 1,000,000

General Aggregate 3,000,000

SA & M 500,000

Contract #BPM0032 (Family Connections, Nurturing Parenting and SENSE) Certificate holder and The State of Arizona, its departments, agencies, boards, commissions, universities, and its officers, officials, agents and employees for losses arising from work performed by or on behalf of the contractor is named as an additional insured with respect to the General Liability and Business Auto Policy. Wavier of Subrogation applies to General Liability, Business Auto, and Workers Compensation policies. Primary and non-contributory applies to General Liability Policy. Sexual Abuse and Molestation Coverage is included.

With respects to Workers Compensation Idorenyin K Umoh/Owner is excluded from coverage.

State of Arizona Department of Child Safety Office of Procurement &

Contracts

3003 N Central, Suite 2000

Site Code CH010-20

Phoenix AZ 85012