PWM_Aksia_LLC_Arizona_State_Retirement__Workers_Comp_Certificate.pdf

This document is an ACORD Certificate of Liability Insurance issued by Marsh Affinity, a division of Marsh USA LLC, for ADP TotalSource II, Inc. The certificate involves New Hampshire Insurance Co. (Insurer A) and covers worksite employees for Aksia LLC, with the certificate holder being the Arizona State Retirement System. The policy is valid from 07/01/2024 to 07/01/2025.

The insurance policy provides Workers' Compensation coverage with unlimited limits for each accident, disease (employee), and overall policy limit. All worksite employees working for Aksia LLC and paid under ADP TotalSource, Inc.'s payroll are covered under this policy. Proprietors, partners, executive officers, and members are not excluded as long as they are on the ADP TotalSource payroll or have completed the SEI Participation Addendum. The policy is specific to the state of New York, with the policy number WC 069353632 NY.