Kutak_Rock_COI_for_PL_to_6-15-2023.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

8/19/2022

Alliant Insurance Services, Inc.

200 S Wacker Dr Ste 3030 Chicago IL 60606

Angela Fleege 312-246-0866 angelaf@proquestinsurance.com

License#: 0C36861 Scottsdale Insurance Company 41297 KUTAROC-01 Ironshore Specialty Insurance 25445

Kutak Rock LLP The Omaha Building 1650 Farnam Street Omaha NE 68102

QBE Specialty Insurance Compan 11515

467826384

A B C

Professional Liability Professional Liability Professional Liability

LWS0001017

LPL7CAB0U5U003

130002910

6/15/2022 6/15/2022 6/15/2022

6/15/2023 6/15/2023 6/15/2023

See Description See Description See Description

Limits of Liability in excess of: $2,000,000 per Claim/$4,000,000 Aggregate

Claims-made coverage

Insurers Affording Coverage schedule continued on Attachment A

Arizona State Retirement System 3300 North Central Ave Phoenix AZ 85012

Kutak Rock LLP

Certificate of Professional Liability Insurance

Policy Term: June 15, 2022 – June 15, 2023

Attachment A

Insurer Affording Coverage:

Policy Number: Policy Term: NAIC or AIIN#

Insurer D: Gotham Insurance Company PL2022LPL90070

PL202200002771

6/15/2022 – 6/15/2023 25569

Insurer E: Endurance American Specialty Insurance Co.

LPL30020804600 6/15/2022 – 6/15/2023 41718

Insurer F: National Fire and Marine Insurance Company

45-EPP-302670-07 6/15/2022 – 6/15/2023 20060

Insurer G: Travelers Excess and Surplus Lines Company

107106135 6/15/2022 – 6/15/2023 29696

Insurer H: SiriusPoint Specialty Ins Co LDUSA2205023 6/15/2022 – 6/15/2023 16820 Insurer I: Indian Harbor Insurance Co LPE 9038997-03 6/15/2022 – 6/15/2023 36940 Insurer J: HDI Global Specialty SE LDUSA2205023 6/15/2022 – 6/15/2023 AA1340041 Insurer K: Markel Bermuda Limited LDUSA2205023 6/15/2022 – 6/15/2023 AA3190829 Insurer L: Associated Industries

Insurance Company

AES121112802 6/15/2022 – 6/15/2023 23140

Insurer M: Peleus Insurance Company XPL409495-4 6/15/2022 – 6/15/2023 34118 Insurer N: Great American Fidelity

Insurance Company

LAXE558606 6/15/2022 – 6/15/2023 41858

Insurer O: Westfield Specialty Ins Co ELP-00013P2 6/15/2022 – 6/15/2023 16992 Insurer P: Starr Surplus Lines Insurance

Company 1000634755221 6/15/2022 – 6/15/2023 13604

Insurer Q: Aspen Specialty Insurance Company

LXA72GQ22

LX00MAG22

6/15/2022 – 6/15/2023 10717

Insurer R: Canopius Insurance Svcs;

Lloyd’s Syndicate 4444

CUAI0696-01

6/15/2022 – 6/15/2023 AA1122000

Insurer S: Underwriters at Lloyd’s LDUSA2205091 6/15/2022 – 6/15/2023 AA1122000 Insurer T: General Security Indemnity

Company of AZ

FA0022187-2002-1

FA0022187-2022-2

6/15/2022 – 6/15/2023 20559

Kutak Rock LLP

Certificate of Professional Liability Insurance

Policy Term: June 15, 2021 – June 15, 2022

Attachment A

Insurer Affording Coverage:

Policy Number: Policy Term: NAIC or AIIN#

Insurer D: Gotham Insurance Company PL2021LPL90070 6/15/2021 – 6/15/2022 25569 Insurer E: Endurance American

Specialty Insurance Co.

LPL10013153903 6/15/2021 – 6/15/2022 41718

Insurer F: National Fire and Marine Insurance Company

45-EPP-302670-06 6/15/2021 – 6/15/2022 20060

Insurer G: Travelers Excess and Surplus Lines Company

107106135 6/15/2021 – 6/15/2022 29696

Insurer H: Everest Indemnity Insurance Company

PL5EE00093-211 6/15/2021 – 6/15/2022 10851

Insurer I: Indian Harbor Insurance Co LPE 9038997-02 6/15/2021 – 6/15/2022 36940 Insurer J: HDI Global Specialty SE LDUSA2105023 6/15/2021 – 6/15/2022 AA1340041 Insurer K: Markel Bermuda Limited LDUSA2105023 6/15/2021 – 6/15/2022 AA3190829 Insurer L: Associated Industries

Insurance Company

AES121112800 6/15/2021 – 6/15/2022 23140

Insurer M: Peleus Insurance Company XPL409495-4 6/15/2021 – 6/15/2022 34118 Insurer N: Great American Fidelity

Insurance Company

LAXE558606 6/15/2021 – 6/15/2022 41858

Insurer O: Nautilus Insurance Company PLX_1000450_P-1 6/15/2021 – 6/15/2022 17370 Insurer P: Starr Surplus Lines Insurance

Company 1000634755211 6/15/2021 – 6/15/2022 13604

Insurer Q: Aspen Specialty Insurance Company

LXA72GQ21 &

LX00MAG21

6/15/2021 – 6/15/2022 10717

Insurer R: Canopius Insurance Svcs;

Lloyd’s Syndicate 4444

CUAI0696-00

6/15/2021 – 6/15/2022 AA1122000

Insurer S: Underwriters at Lloyd’s LDUSA2105091 6/15/2021 – 6/15/2022 AA1122000