The_State_of_Arizona_-_Copy_-_Copy_-_Copy_-_Copy_-_Copy_Redacted.pdf

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Attached to
Master Agreement AZ|CTR071407
Contract number
CTR071407
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance for Another Chance Program, LLC, issued by Kenny Ong Financial Services in Tolleson, Arizona. The certificate involves multiple insurers including American Alternative Insurance Corporation, Progressive Insurance, and National Liability & Fire Insurance Company. The certificate holder is the State of Arizona and the Arizona Department of Child Safety, located in Phoenix, Arizona.

The insurance coverage includes Commercial General Liability, Automobile Liability, Workers Compensation, and Professional Liability policies effective from 06/01/2024 to 06/01/2025. The Commercial General Liability policy has a $1,000,000 each occurrence limit and a $2,000,000 general aggregate limit. The Professional Liability coverage provides $1,000,000 per occurrence and a $3,000,000 aggregate limit. The certificate includes provisions for the State of Arizona and the Arizona Department of Child Safety to be named as Additional Insureds, with a waiver of subrogation endorsement for losses arising from work performed by the contractor.

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Text version

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

05/31/2024

Kenny Ong Financial Services - AZ

9059 West McDowell Road

Suite 100

Tolleson AZ 85353

Jerry Avila

(602) 492-1378 (602) 492-9669 jerryavilajr@gmail.com

Another Chance Program, LLC

American Alternative Insurance Corporation

Progressive Insurance

National Liability & Fire Insurance Company

A

Y Y 302301 1461821 06/01/2024 06/01/2025

1,000,000

500,000

5,000

1,000,000

2,000,000

2,000,000

B ✘

✘ Y Y 02183850 06/01/2024 06/01/2025

1,000,000

C Y Y A9WC209978 06/01/2024 06/01/2025

1,000,000

1,000,000

1,000,000

A Professional Liability

Y Y 382301 1461821 06/01/2024 06/01/2025

Each Occurrence $ 1,000,000

Aggregate $ 3,000,000

The State of Arizona and the Arizona Department of Child Safety shall be named as Additional Insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor.

Waiver of subrogation endorsement against the State of Arizona, its departments, agencies, boards, commissions universitites and its officers, officials, agents and employees for losses arising from work performed by or on behalf of the contractor.

The State of Arizona and the Arizona Department of Child Safety

3003 N Central Ave

Phoenix, AZ 85012

File details come from the government source that posted it. Updated .