STATEOFARIZONA_W41693439.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

Willis Towers Watson Southeast, Inc.

c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA

QTC Commercial Services, LLC a wholly owned subsidiary of Leidos Holdings, Inc.

1750 Presidents Street Reston, VA 20190

SEE ATTACHED

STATE OF ARIZONA,

ARIZONA DEPARTMENT OF ADMINISTRATION,

OFFICE OF SPECIAL EVENTS

100 N. 15111Avenue, Suite 202 Phoenix, AZ 85007

11/06/2025

1-877-945-7378 1-888-467-2378 certificates@wtwco.com

Starr Indemnity & Liability Company 38318

ACE Property & Casualty Insurance Company

Everest National Insurance Company

20699

10120

Arch Insurance Company 11150

W41693439

A

1,000,000

1,000,000

10,000

1,000,000

10,000,000

2,000,000

Y Y 1000100065251 04/01/2025 04/01/2026

A

2,000,000

04/01/202604/01/2025Y Y 1000198154251

B 15,000,000

Y Y XEU G27959805 010 04/01/2025 04/01/2026 15,000,000

1000003171 A Y

3,000,000 No 04/01/2025 04/01/2026

3,000,000

3,000,000

C Excess Umbrella - 1st Layer xs of $15,000,000

Y Each Occurrence:XC5EX02152-251 04/01/2025 04/01/2026

Aggregate:

Y

419643228827140SR ID: BATCH:

$10,000,000

$10,000,000

WTW Certificate Center

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:

QTC Commercial Services, LLC a wholly owned subsidiary of Leidos Holdings, Inc.

1750 Presidents Street Reston, VA 20190

Contract Number: CTR079348

STATE OF ARIZONA, ARIZONA DEPARTMENT OF ADMINISTRATION, OFFICE OF SPECIAL EVENTS are included as an Additional Insured as respects to General Liability, Automobile Liability and Umbrella/Excess Liability and these coverages shall be Primary and Non-Contributory with any other insurance in force for or which may be purchased by Additional Insured, where required by written contract or agreement.

Waiver of Subrogation applies in favor of Additional Insured with respects to General Liability, Automobile Liability, Umbrella/Excess Liability and Workers Compensation, where required by written contract or agreement, and as permitted by law.

Umbrella/Excess follows form of the primary General, Auto and Employer’s Liability policies.

Limits, Carrier and NAIC # of the below policies same as Policy #1000003171 (All Other States & WY) Workers Compensation & Employers Liability - AZ,CT,IA,NJ,NY,NC,TX,VT - Policy # 1000003172 Workers Compensation & Employers Liability - WI - Policy # 1000003173 Workers Compensation & Employers Liability – AK, MA, FL – Policy # 1000003174 USL&H included in Workers Compensation policies.

INSURER AFFORDING COVERAGE: Arch Insurance Company NAIC#: 11150

POLICY NUMBER: DBA0000100-01 EFF DATE: 04/01/2025 EXP DATE: 04/01/2026

TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT:

Defense Base Act Injury by Accident $4M Each Accident Workers Comp - Statutory Injury by Disease $4M Each Employee Injury by Disease $4M Policy Limit

2 2

Willis Towers Watson Southeast, Inc.

See Page 1

See Page 1 See Page 1 See Page 1

25 Certificate of Liability Insurance

W41693439CERT:4196432BATCH:28827140SR ID:

10.0.2.20120224.1.869952

c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA

a wholly owned subsidiary of Leidos Holdings, Inc.

1750 Presidents Street Reston, VA 20190

SEE ATTACHED

INSURED:

STATE OF ARIZONA,

ARIZONA DEPARTMENT OF ADMINISTRATION,

OFFICE OF SPECIAL EVENTS

100 N. 15111Avenue, Suite 202 Phoenix, AZ 85007