Updated_Certificate_of_Liability__1_.pdf

ACORD

CERTIFICATE OF LIABILITY INSURANCE I

DATE (MMIDD/YYYY)

� 04/16/2025 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.

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).

PRODUCER �2tI�cT Joe Armstrong SHEPHERD INSURANCE & FINANCIAL wg

N

:o Extl:833-889-0198 I f ffc Nol: 517-886-8655

SERVICES

PO BOX30668

�flJ� ss

: servicecenter.ao@aoins.com

LANSING, Ml 48909-8168 INSURERISl AFFORDING COVERAGE NAIC#

INSURER A : Auto-Owners 18988 INSURED INSURER B : Owners 32700

KIRBY AUTOCARE LLC KA LEASING INC INSURER C:

6400 N VIEWPOINT DR INSURER D:

PRESCOTT VALLEY, AZ 86314-3218 INSURER E:

INSURER F:

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

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.

INSR

LTR

B

A

A

TYPE OF INSURANCE

)(_ COMMERCIAL GENERAL LIABILITY

□ CLAIMS-MADE @ OCCUR

Garage

GEN'L AGGREGATE LIMIT APPLIES PER: � □ PRO-POLICY JECT

OTHER:

AUTOMOBILE LIABILITY

DLoc

ANY AUTO

OWNED

� AUTOS ONLY

HIRED

� SCHEDULED

AUTOS

NON-OWNED

� AUTOS ONLY � AUTOS ONLY

UMBRELLA LIAB

H

OCCUR �

EXCESS LIAB CLAIMS-MADE

OED I I RETENTION $

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE

[TIOFFICER/MEMBER EXCLUDED?

(Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below

ADDL SUBR POLICY EFF POLICY EXP

'"'"D WVD POLICY NUMBER IMMIDD/YYYYl IMMIDD/YYYYl y y 50-811114-00 07/29/2024 07/29/2025 y y 50-811144-00 07/29/2024 07/29/2025

N/A y A 106-604-031 07/29/2024 07/29/2025

LIMITS

EACH OCCURRENCE

DAMAGE TO RENTED

PREMISES /Ea occurrence) MED EXP (Any one person)

PERSONAL & ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGG

fE����d��tf lNGLE LIMIT

BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE/Per accident)

EACH OCCURRENCE

AGGREGATE

� I �ifTUTE I I OTH-ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE

E.L. DISEASE - POLICY LIMIT

$1,000,000 $300,000 $10,000 $1,000,000 $2,000,000 $2,000,000 $1,000,000

$1,000,000 $1,000,000 $1,000,000

DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Addltlonal Remarks Schedule, may be attached If more space Is required) The State of Arizona, its departments, agencies, boards, commissions, officers, officials, agents, and employees are included as an additional insureds on the above CGL and commercial auto policies. This is with respect to liability arising out of the activities performed by, or on behalf of, the contractor involving automobiles owned, hired and/or non owned by the contractor. A waiver of subrogation is in place on the CGL, auto, and work comp in favor of the State of Arizona. Coverage afforded is on a primary and non contributory basis. 30 day notice of cancellation applies in favor of cert holder.

CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE

Joe Armstrong

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The State of Arizona/ADOT 206 S 17th Ave Phoenix, AZ 85007