DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 6/1/2026 5/13/2025
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 Lockton Companies, LLC CONTACT
NAME:
DBA Lockton Insurance Brokers, LLC in CA PHONE FAX
(A/C, No, Ext): (A/C, No):
CA license #0F15767 E-MAIL
8110 E Union Ave., Ste. 100 ADDRESS:
Denver CO 80237 INSURER(S) AFFORDING COVERAGE NAIC #
denver-certs@lockton.com INSURER A : Evanston Insurance Company 35378
INSURED
The Stepping Stones Group, LLC INSURER B : --- SEE ATTACHMENT ---
1487747 184 High Street, Floor 7 INSURER C :
Boston, MA 02110 INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 17838230 REVISION NUMBER: XXXXXXX
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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY Y N MKLV5PSM001448 6/1/2025 6/1/2026 EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 100,000
X Deductible: $25K MED EXP (Any one person) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
PRO-
X POLICY JECT LOC PRODUCTS - COMP/OP AGG $ 3,000,000
OTHER: $
COMBINED SINGLE LIMIT
A AUTOMOBILE LIABILITY Y N MKLV5PSM001448 6/1/2025 6/1/2026 (Ea accident) $
1,000,000
ANY AUTO BODILY INJURY (Per person) $
XXXXXXX
OWNED SCHEDULED BODILY INJURY (Per accident) $ XXXXXXX
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
X AUTOS ONLY X AUTOS ONLY (Per accident) $ XXXXXXX
$ XXXXXXX
B UMBRELLA LIAB N N See Attachment 6/1/2025 6/1/2026 $ 5,000,000
X X OCCUR EACH OCCURRENCE
EXCESS LIAB X CLAIMS-MADE AGGREGATE $ 5,000,000
DED RETENTION $ $ XXXXXXX
WORKERS COMPENSATION PER OTH-
NOT APPLICABLE STATUTE ER
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? N/A
E.L. EACH ACCIDENT $ XXXXXXX
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ XXXXXXX
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ XXXXXXX
A Professional Liab. N N MKLV5PSM001448 6/1/2025 6/1/2026 $1M Per Claim
$3M Agg/Ded: $25K
A Sexual Abuse & Molestation MKLV5PSM001448 6/1/2025 6/1/2026 $1M Per Claim
$1M Agg/Ded $150K
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
See Attached Named Insured List. Professional Liability Claims-Made Retro Date: 07/01/2007. Sexual Abuse & Molestation Claims-Made Retro Date: 07/01/2007. Retro Dates vary by entity.
Umbrella sits excess of: General, Professional, Sexual Abuse, Hired Non-Owned, and Employers Liability RFP 21 – 522R1 Behavioral Intervention Services for Students with Disabilities – Notice of
Award. DeKalb County Board of Education included as additional insured on the General Liability and Automobile Liability as required by written contract.
CERTIFICATE HOLDER CANCELLATION See Attachments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
17838230 ACCORDANCE WITH THE POLICY PROVISIONS.
DeKalb County Board of Education
1701 Mountain Industrial Boulevard AUTHORIZED REPRESENTATIVE
Stone Mountain, GA 30083
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Attachment Code: D599118 Master ID: 1487747, Certificate ID: 17838230
SSG Additional Named Insured List
Autism Intervention Professionals, LLC
Behavioral Learning Center – CO, Inc.
Behavioral Learning Center, Inc.
Best Life Therapy II, LLC
Bluebird ABA LLC.
Building Blocks Behavior Consultants, LLC
Catalyst Speech, LLC
Center for Behavioral, Educational & Social Therapies (C.B.E.S.T.)
City Sounds of NY - Speech Language Development Center Inc; City Sounds of NY ; City Sounds of NY Speech Language
Constellations Behavioral Holdings, Inc.
Constellations Behavioral Services, LLC
EBS Children’s Institute, LLC
EBS Children’s Therapy- GA, LLC
EBS Educational Based Services, dba EBS Early Intervention
EBS Group LLC
EBS Healthcare, LLC
EBS Learning, LLC
Ed Sped Solutions, LLC
ERA Psychological Services, Inc.
Green Celtics Holdings LP
Green Celtics Intermediate Inc.
Green Celtics Parent Inc.
Green Celtics Purchaser Inc.
HM Systems, Inc.
Integrated Speech Solutions II, LLC
Kinetic Pediatric Therapy
MBS MidCo, LLC
New England ABA LLC
Positive Behavioral Solutions, LLC
San Diego County SPS, LLC
SSG HoldCo, LLC
SSG Intermediate HoldCo, LLC
SSG Investment HoldCo Inc.
SSG New York, LLC
SSG School of Psychology and Mental Health, PC
STAR of CA, LLC
Stepping Stones Healthcare Services, LLC
The Futures HealthCore, LLC
The Perfect Playground OT, PT, SLP & NP in Family Health, PLLC
The Stepping Stones Autism Services Group LLC
The Stepping Stones Group LLC
Therapy for Kids, LLC. dba: Gallagher Pediatric Therapy; dba: GPT Staffing
Therapy Time L.L.C.
Attachment Code: D650577 Master ID: 1487747, Certificate ID: 17838230
MARKEL POLICY NUMBER: MKLV5PSM001448
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - PROFESSIONAL LIABILITY WITH PRIMARY
NON-CONTRIBUTORY WHEN REQUIRED BY CONTRACT
This endorsement modifies insurance provided under the following:
SPECIFIED MEDICAL PROFESSIONS PROFESSIONAL LIABILITY INSURANCE COVERAGE PART
SPECIFIED MEDICAL PROFESSIONS PROFESSIONAL LIABILITY INSURANCE POLICY
In consideration of the premium paid, it is hereby understood and agreed that the policy is amended as follows:
A. Section The Insured is amended to include as an additional insured any natural person or legal entity to whom the
Named Insured is obligated by written contract or agreement to provide coverage as an additional insured, but only
with respect to Claims that:
1. Arise out of the conduct of Professional Services rendered or that should have been rendered by an Insured that is
not an additional insured; and
2. Are otherwise covered herein;
Provided such written contract or agreement was executed prior to the act, error, or omission in Professional Services
for which coverage is sought.
However, the insurance provided to the additional
insured: a. Only applies to the extent permitted by law;
and
b. Will not be broader than that which the Named Insured is required by the written contract or agreement to provide
for such additional insured.
When coverage does not apply for the Named Insured, no coverage or defense will apply for the additional insured.
B. With respect to the insurance afforded to the additional insured, Section Limits Of is amended as follows:
1. Paragraph C. Limit of Liability-Reduction for Refusal to Settle in the SPECIFIED
MEDICAL PROFESSIONS
PROFESSIONAL LIABILITY INSURANCE COVERAGE PART is replaced by the following:
C. Limit of Liability-Reduction for Refusal to Settle: The Company shall not settle any Claim against the
additional insured without the consent of the first Named Insured. If, however, the first Named Insured shall
refuse to consent to any settlement recommended by the Company and shall elect to contest the Claim or
continue any legal proceedings in connection with such Claim, then the Company's liability for the Claim shall
not exceed the amount for which the Claim could have been so settled including Claim Expenses incurred up
to the date of such refusal. Such amounts are subject to the provisions of the above Limits of Liability A. and
B.
2. The following is added:
The most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the written contract or agreement; or
2. Available under the applicable limits of liability;
MESM 1027 03 21 Page 1 of 2
whichever is less.
This
Attachment endorsement
Code: shall ID:
D650577 Master not 1487747,
increaseCertificate
the applicable Limits of Liability stated in the Declarations.
ID: 17838230
C. The following is added to Section Defense And Claim Expenses in the SPECIFIED MEDICAL PROFESSIONS
PROFESSIONAL LIABILITY INSURANCE COVERAGE PART and Section Defense, Settlements And Claim
Expenses in the SPECIFIED MEDICAL PROFESSIONS PROFESSIONAL LIABILITY INSURANCE POLICY:
The Company's obligation to provide defense shall not be severable with respect to the additional insured and all
other Insureds hereunder.
With respect to the additional insured and any other Insured hereunder, all Insureds will be represented by the same
attorney unless mutual representation is prohibited by law or by any applicable professional code of conduct.
D. With respect to coverage provided to the additional insured by this endorsement, the first paragraph under E. Other
Insurance of COMMON POLICY CONDITIONS is replaced by the following:
This insurance shall be in excess of the applicable Deductible stated in the Declarations, and primary and
noncontributory over any other insurance available to the additional insured provided that:
1. The additional insured is a Named Insured under such other insurance; and
2. The Named Insured has agreed in a written contract or agreement that this insurance would be primary and
noncontributory over any other insurance available to the additional insured;
unless such other insurance is written only as specific excess insurance over the Limits of Liability provided in this
policy.
If the Named Insured has not agreed in a written contract or agreement that this insurance would be primary and
noncontributory, this insurance shall be in excess of the applicable Deductible stated in the Declarations and shall be
excess over, and will not contribute with, any other insurance available to the additional insured whether such other
insurance is stated to be primary, contributory, excess, contingent or otherwise, unless such other insurance is written
only as specific excess insurance over the Limits of Liability provided in this policy.
All other terms and conditions remain unchanged.
MESM 1027 03 21 Page 2 of 2
Attachment Code: D651861 Master ID: 1487747, Certificate ID: 17838230
POLICY NUMBER: MKLV5PSM001448
EVANSTON INSURANCE COMPANY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED – GENERAL LIABILITY
WITH PRIMARY NON-CONTRIBUTORY AND SEPARATION OF INSUREDS
WHEN REQUIRED BY CONTRACT – SCHEDULED
This endorsement modifies insurance provided under the following:
SPECIFIED MEDICAL PROFESSIONS GENERAL LIABILITY INSURANCE COVERAGE PART – CLAIMS MADE
COVERAGE
SPECIFIED MEDICAL PROFESSIONS GENERAL LIABILITY INSURANCE COVERAGE PART – OCCURRENCE
COVERAGE
SCHEDULE
Name of Additional Insured Person Or Organization: As required by written contract
In consideration of the premium paid, it is hereby understood and agreed that this policy is amended as follows:
A. Section THE INSURED is amended to include as an additional insured the Person Or Organization shown in the
Schedule of this endorsement provided that the Named Insured is obligated by written contract or agreement to
provide coverage to such Person or Organization as an additional insured, but only with respect to liability for Bodily
Injury, Property Damage, or Personal and Advertising Injury caused, in whole or in part, by the Named Insured's acts
or omissions or the acts or omissions of those acting on the Named Insured's behalf in connection with the Specified
Products, Goods, Operations Or Premises shown in Item 4. of the Declarations.
However, the insurance afforded to such additional insured:
1. Only applies to the extent permitted by law;
2. Will not be broader than that which the Named Insured is required by written contract or agreement to provide for
such additional insured, if coverage is provided to the additional insured pursuant to a written contract or
agreement; and
3. Applies solely to Claims first made against the Insured during the Policy Period or Extended Reporting Period, if
purchased, if the Named Insured’s coverage is claims made.
When coverage does not apply to the Named Insured because of any exclusion, condition, or limitation contained in
this policy, no coverage or defense will apply for the additional insured.
No coverage applies to such additional insured for Bodily Injury, Property Damage, or Personal and Advertising
Injury to any Employee of the Named Insured or to any obligation of the additional insured to indemnify another
because of Damages arising out of such injury.
B. With respect to the insurance afforded to the additional insured, the following is added to Section LIMITS OF
LIABILITY:
The most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by written contract or agreement, if any; or
2. Available under the applicable Limits of Liability;
MME 1174 08 24 Page 1 of 2
Attachment Code: D651861 Master ID: 1487747, Certificate ID: 17838230
whichever is less.
This endorsement shall not increase the applicable Limits of Liability stated in the Declarations.
C. With respect to coverage provided to the additional insured by this endorsement, Common Policy Conditions is
amended as follows:
1. The first paragraph under E. Other Insurance is replaced by the following:
This insurance shall be in excess of the applicable Deductible stated in the Declarations, and primary and
noncontributory over any other insurance available to the additional insured provided that:
1. The additional insured is a Named Insured under such other insurance; and
2. The Named Insured has agreed in a written contract or agreement that this insurance would be primary and
noncontributory over any other insurance available to the additional insured;
unless such other insurance is written only as specific excess insurance over the Limits of Liability provided in
this policy.
If the Named Insured has not agreed in a written contract or agreement that this insurance would be primary and
noncontributory, this insurance shall be in excess of the applicable Deductible stated in the Declarations and
shall be excess over, and will not contribute with, any other insurance available to the additional insured whether
such other insurance is stated to be primary, contributory, excess, contingent or otherwise, unless such other
insurance is written only as specific excess insurance over the Limits of Liability provided in this policy.
2. The following Condition is added:
SEPARATION OF INSUREDS
Except with respect to the Limits of Liability, and any rights or duties stated in Condition N. Authorization, this
insurance applies:
1. As if each Named Insured were the only Named Insured; and
2. Separately to each Insured against whom a Claim is made or a suit is brought;
but only when required by a written contract or agreement.
All other terms and conditions remain unchanged.
MME 1174 08 24 Page 2 of 2
Attachment Code: D662708 Master ID: 1487747, Certificate ID: 17838230
POLICY NUMBER: MKLV5PSM001448
MARKEL
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF SUBROGATION FOR SCHEDULED ADDITIONAL INSURED(S)
This endorsement modifies insurance provided under the following:
SPECIFIED MEDICAL PROFESSIONS PROFESSIONAL LIABILITY INSURANCE COVERAGE PART
SPECIFIED MEDICAL PROFESSIONS PROFESSIONAL LIABILITY INSURANCE POLICY
SPECIFIED MEDICAL PROFESSIONS GENERAL LIABILITY INSURANCE COVERAGE PART – OCCURRENCE
COVERAGE
SPECIFIED MEDICAL PROFESSIONS GENERAL LIABILITY INSURANCE COVERAGE PART – CLAIMS MADE
COVERAGE
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s): As required by written contract
contract
In consideration of the premium paid, it is hereby understood and agreed that the following is added to Section H.
Subrogation of COMMON POLICY CONDITIONS:
The Company shall not exercise such rights of recovery against the additional insured person(s) or organization(s) stated
in the Schedule of this endorsement.
All other terms and conditions remain unchanged.
MESM 2060 03 21 Page 1 of 1
Attachment Code: D668558 Master ID: 1487747, Certificate ID: 17838230
Stepping Stones Healthcare Services, LLC
$5M Umbrella/Excess Liability Policies above Primary Policies:
Carrier Policy Number Limits
Evanston Insurance Company MKLV5UHC000010 $2mil lead over Primary
Texas Insurance Company BFLXAHTMA011500_022965_01 $2mil xs lead $2mil
QBE Specialty Insurance 140002626 $1mil xs $4mil
Company
Above policies sit over:
General Liability- Occurrence
Hired – Nonowned Auto - Occurrence
Employer’s Liability - Occurrence
Professional Liability - Claims Made
Sexual Abuse & Molestation- Claims Made
Attachment Code: D608932 Master ID: 1487747, Certificate ID: 17838230
DeKalb County Board of Education
1701 Mountain Industrial Boulevard
Stone Mountain,GA30083
Dear The Stepping Stones Group, LLC certificate holder:
In an effort to meet demand for instant electronic delivery of certificates, Lockton Companies
now provides paperless delivery of Certificates of Insurance. Thank you for your patience and
willingness to help us lessen our environmental footprint.
To ensure electronic deliver for future renewals of this certificate, we need your email address.
If you received this certificate through an internet link where the current certificate is viewable,
we have your email and no further action is needed.
In the event your mailing address has changed, will change in the future, or you no longer
require this certificate, please let us know using one of the following methods.
Your Holder ID number is 17838230.
Email: SteppingStonescertrequests@lockton.com
Toll-free automated phone service: 866-218-4018
If this certificate is no longer needed or valid, please notify us.
Thank you,
Lockton Companies
Lockton Companies
1185 Avenue of the Americas, Suite 2010
New York, NY 10036
lockton.com
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 10/1/2026 9/24/2025
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 Lockton Companies, LLC CONTACT
NAME:
DBA Lockton Insurance Brokers, LLC in CA PHONE FAX
(A/C, No, Ext): (A/C, No):
CA license #0F15767 E-MAIL
444 W. 47th St., Ste. 900 ADDRESS:
Kansas City MO 64112-1906 INSURER(S) AFFORDING COVERAGE NAIC #
(816) 960-9000 kcasu@lockton.com INSURER A : Ironshore Specialty Insurance Co 25445
INSURED
SHC SERVICES, INC. D/B/A SUPPLEMENTAL HEALTH CARE Greenwich Insurance Company
INSURER B : 22322
1545701 6955 UNION PARK CENTER DR, STE. 400 INSURER C : XL Insurance America, Inc. 24554
COTTONWOOD HEIGHTS UT 84047 INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 20823178 REVISION NUMBER: XXXXXXX
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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
A COMMERCIAL GENERAL LIABILITY Y Y HC7CACDEMS005 10/1/2025 10/1/2026 EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 500,000
MED EXP (Any one person) $ XXXXXXX
PERSONAL & ADV INJURY $ Included
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
PRO-
X POLICY JECT LOC PRODUCTS - COMP/OP AGG $ Included
OTHER: $
COMBINED SINGLE LIMIT
B AUTOMOBILE LIABILITY Y Y RAD500047710 10/1/2025 10/1/2026 (Ea accident) $
1,000,000
ANY AUTO BODILY INJURY (Per person) $
XXXXXXX
OWNED SCHEDULED BODILY INJURY (Per accident) $ XXXXXXX
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
X AUTOS ONLY X AUTOS ONLY (Per accident) $ XXXXXXX
$ XXXXXXX
A UMBRELLA LIAB N N HC7CAB3DJV006 10/1/2025 10/1/2026 $ 5,000,000
X OCCUR EACH OCCURRENCE
EXCESS LIAB X CLAIMS-MADE AGGREGATE $ 5,000,000
DED RETENTION $ $ XXXXXXX
WORKERS COMPENSATION PER OTH-
C Y RWR500040712 (WI) 10/1/2025 10/1/2026 X STATUTE ER
AND EMPLOYERS' LIABILITY Y/N
C ANY PROPRIETOR/PARTNER/EXECUTIVE RWD500040612 10/1/2025 10/1/2026 E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? N N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
A MEDICAL Y Y HC7CACDEMS005 10/1/2025 10/1/2026 $1M PER OCCURENCE
PROFESSIONAL $3M AGGREGATE
LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
PLEASE NOTE THE ABOVE EXCESS COVERAGE EXCLUDES COVERAGE FOR CORRECTIONAL FACILITIES. DEKALB COUNTY SCHOOL DISTRICT IS INCLUDED AS AN
ADDITIONAL INSURED ON THE GENERAL, AUTO, AND PROFESSIONAL LIABILITY COVERAGES, ON A PRIMARY, NON-CONTRIBUTORY BASIS, IF REQUIRED BY WRITTEN
CONTRACT. A WAIVER OF SUBROGATION APPLIES IN FAVOR OF THE ADDITIONAL INSURED WITH RESPECT TO THE GENERAL, AUTO, PROFESSIONAL, AND WORKERS
COMPENSATION LIABILITY COVERAGES, IF REQUIRED BY WRITTEN CONTRACT AND WHERE ALLOWED BY LAW. COVERAGE IS SUBJECT TO THE TERMS AND
CONDITIONS OF THE POLICY.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
20823178 ACCORDANCE WITH THE POLICY PROVISIONS.
DEKALB COUNTY SCHOOL DISTRICT
1701 MOUNTAIN INDUSTRIAL BOULEVARD AUTHORIZED REPRESENTATIVE
STONE MOUNTAIN GA 30083
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Client#: 650011 STELLTHERA
DATE (MM/DD/YYYY)
ACORD TM CERTIFICATE OF LIABILITY INSURANCE 11/04/2025
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 any rights to the certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER NAME: Shonda Harris
Marsh & McLennan Agency LLC PHONE FAX
(A/C, No, Ext): 423-643-0797 (A/C, No):
Liberty Tower, Suite 500 E-MAIL
ADDRESS: Shonda.Harris@MarshMMA.com
605 Chestnut Street INSURER(S) AFFORDING COVERAGE NAIC #
Chattanooga, TN 37450 INSURER A : National Fire & Marine Insurance 20079
INSURED INSURER B : United Wisconsin Insurance Co. 29157
Stellar Therapy Services, LLC 16871
INSURER C : Obsidian Specialty Insurance Company
P O Box 8114
INSURER D :
Chattanooga, TN 37414
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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY HN039807 11/05/2025 11/05/2026 EACH OCCURRENCE $ 2,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 100,000
MED EXP (Any one person) $ 5,000
PERSONAL & ADV INJURY $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
PRO-
POLICY JECT LOC PRODUCTS - COMP/OP AGG $ 4,000,000
OTHER: $
A AUTOMOBILE LIABILITY HN039807 11/05/2025 11/05/2026 COMBINED SINGLE LIMIT
(Ea accident) $ $1,000,000
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
X AUTOS ONLY X AUTOS ONLY (Per accident) $
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
B AND EMPLOYERS' LIABILITY
AFWCP100033288 07/01/2025 07/01/2026 X STATUTE ER
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? N N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
C Cyber Liability PLMCBSEAGWWEZZ002 11/05/2025 11/05/2026 $1,000,000
A Professional Liab HN039807 11/05/2025 11/05/2026 $2,000,000 Per Event
$4,000,000 Aggregate
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Dekalb County School District and The Dekalb County Board of Education are included as Additional Insureds
for General Liability with respect to work performed
by the Named Insured, when required by written contract, agreement or permit and subject to the provisions
and limitations of the policy.
(See Attached Descriptions)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Dekalb County Schools District THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
1701 Mountain Industrial Blvd. ACCORDANCE WITH THE POLICY PROVISIONS.
Stone Mountain, GA 30083
AUTHORIZED REPRESENTATIVE
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD
#S15386646/M15385530 JXDXM
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 12/22/2025
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 CONTACT Shirley Phillips
NAME:
The Reilly Company LLC PHONE (913) 682-1234 FAX (913) 682-8136
(A/C, No, Ext): (A/C, No):
608 Delaware St. E-MAIL shirley.phillips@reillyinsurance.com
ADDRESS:
P.O. Box 9 INSURER(S) AFFORDING COVERAGE NAIC #
Leavenworth KS 66048-0009 INSURER A : Underwriters at Lloyd's/CFC
INSURED INSURER B : Cincinnati Insurance Companies 10677
Quantum Education Professionals INSURER C : SUNZ Insurance Company 34762
Quantum Health Professionals, Inc. INSURER D :
519 Avenida Cesar E Chavez INSURER E :
Kansas City MO 64108 INSURER F :
COVERAGES CERTIFICATE NUMBER: 25-26 Master EDUC 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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED 250,000
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $
MED EXP (Any one person) $ 5,000
A Y PSO0140412914 07/01/2025 07/01/2026 PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
PRO- 1,000,000
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
B OWNED SCHEDULED PSO0140412914 07/01/2025 07/01/2026 BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000
C OFFICER/MEMBER EXCLUDED? N N/A WC558-01107-024-SZ 07/01/2025 07/01/2026
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
CLAIMS MADE:
Professional Liability EDUC Errors &
A Omissions Retro Date: 7-1-2024 PSO0140412914 07/01/2025 07/01/2026 Each Claim $1,000,000
Aggregate Limit $1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RFP 25-606 School Psychological Services
Dekalb County School District is an additional insured per written contract for work performed by the named insured. Thirty day notice of cancellation
applies to DCSD. Waiver of subrogation applies where allowed by law.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Dekalb County School District ACCORDANCE WITH THE POLICY PROVISIONS.
1701 Mountain Industrial Blvd.
AUTHORIZED REPRESENTATIVE
Stone Mountain GA 30083
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
ACORİ
CERTIFICATE OF LIABILITY INSURA DATE(MM/DDYYYY)
NCE 01/05/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA
TION ONLY AND CONFFRS NO RIGHTS UPON THE CERTIFI
THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIV CATE HOLDER.
ELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORD
POLICIES BELOW. THIS CERTIFICATE OF INSURAN
CE
ED BY THE
DOES NOT CONSTITUTE A CONTRACT BETWEEN
AUTHORIZED REPRESENTATIVE OR PRODU THE ISSUING INSURER(S),
CER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,
the policy(les) must have ADDITIONAL INSURED
endorsed. IF SUBROGATION IS WAIVED, subject to the terms provisions or be
and conditions of the pollcy, certain policias may require an endorseme
A statement on this certificate does not confer rights to the certificate nt.
holder in lieu of such endorsement(s).
PRODUCER
CONTACT
NAME: Trust Risk Management Services,
Inc.
Trust Risk Management Services, Inc. doing business in GA PHONE FAX
as Potomac Risk Management Services, Inc. (A/C, No, Ext): 855.655.1801 (ANC, No): 855.850.2230
EMAIL
111 Rockville Pike Suite 700
ADDRESS: alliedinfo@trustrms.com
Rockville, MD 20850
INSURER(S) AFFORDING COVERAGE NAIC
INSURER A: ACE American Insurance Company 22667
INSURED
INSURER B:
Naa Y Oden
2005 Valley Creek Dr INSURER C:
Lithia Spgs, GA 30122-3648 INSURER D:
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
ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYn LIMITS
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $1,000,000
CLAIMS MADE ☑ OCCUR DAMAGE TO RENTED
PREMISES (Ea occurrence) $150,00O
MED EXP (Any one person) $25,000
PERSONAL & ADV INJURY $1.000.000
GEN'L AGGREGATE LIMIT APPLIES
PER: GENERAL AGGREGATE $3.000.000
X PRO-
☑ POLICY _ JECT ☐LOC PRODUCTS-COMP/OP AGG $3.000.000
OTHER
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident)
ANY AUTO
BODILY INJURY (Per Person) S
ALL OWNED
NED ☐SCHEDULED
☐ AUTOS ☐ AUTOS BODILY INJURY (Per accident) S
☐NON-OWNED
HIRED AUTOS PROPERTY DAMAGE $
AUTOS (Per accident)
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE S
EXCESS LIAB CLAIMS-MADE AGGREGATE S
DED RETENTION S S
WORKERS COMPENSATION PER OTH
AND EMPLOYERS LIABILITY STATUTE -ER S
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT
OFFICER/MEMBER EXCLUDED?
E.L. DISEASE-EA EMPLOYEE $
(Mandatory in NH)
If yes, describe under
E.L. DISEASE - POLICY LIMIT s
DESCRIPTION OF OPERATIONS below
A PROFESSIONAL LIABILITY G73887884 08/22/2025 08/22/2026 $1,000,000
EACH INCIDENT
ANNUAL AGGREGATE $3,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
DeKalb County School District
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE
1701 Montreal Road CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL
BE DELIVERED IN
Stone Mountain, GA 30083 ACCORDANCE WITH THE POLICY PROVISIONS
AUTHORIZED REPRESENTATIVE
Colentdia A. Mall
ay
ACORD 25 (2016/03) ©1988-2015 ACORD CORPOR
ATION. All rights reservec
The ACORD name and logo are registered marks of ACORD
Page 1 of 1
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 06/27/2025
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 CONTACT WTW Certificate Center
NAME:
Willis Towers Watson Southeast, Inc. PHONE FAX
c/o 26 Century Blvd (A/C, No, Ext): 1-877-945-7378 (A/C, No): 1-888-467-2378
E-MAIL
P.O. Box 305191 ADDRESS: certificates@wtwco.com
Nashville, TN 372305191 USA INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : Valley Forge Insurance Company 20508
INSURED INSURER B : Continental Insurance Company 35289
PresenceLearning, Inc.
530 Seventh Ave, Suite M1 INSURER C :
New York, NY 10018 INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: W39526514 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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ 100,000
A MED EXP (Any one person) $ 15,000
Y Y 7092412146 07/01/2025 07/01/2026 PERSONAL & ADV INJURY 1,000,000
$
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
PRO- 2,000,000
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
B OWNED SCHEDULED Y Y 7092412163 07/01/2025 07/01/2026 BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 10,000,000
B
EXCESS LIAB CLAIMS-MADE Y Y 7092412132 07/01/2025 07/01/2026 AGGREGATE $ 10,000,000
DED RETENTION $ 10,000 $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
B ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? No N/A Y 7092469043 07/01/2025 07/01/2026
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
B Workers Compensation Y 7092469057 07/01/2025 07/01/2026 EL Each Accident $1,000,000
& Employers Liability -CA EL Disease-Pol Limit $1,000,000
Per Statute EL Disease-Each Empl $1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Certificate Holder is included as an Additional Insured as respects to General Liability, Auto Liability and
Umbrella/Excess Liability.
Waiver of Subrogation applies in favor of Additional Insured with respects to General Liability, Auto Liability,
Umbrella/Excess Liability and Workers Compensation as permitted by law.
CERTIFICATE 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.
DeKalb County School District
DeKalb County Board of Education
AUTHORIZED REPRESENTATIVE
Attention: Risk Management Department
1701 Mountain Industrial Road
Stone Mountain, GA 30083
© 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
SR ID: 27994086 BATCH: 4021993
Page 1 of 1
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 06/27/2025
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 CONTACT WTW Certificate Center
NAME:
Willis Towers Watson Southeast, Inc. PHONE FAX
c/o 26 Century Blvd (A/C, No, Ext): 1-877-945-7378 (A/C, No): 1-888-467-2378
E-MAIL
P.O. Box 305191 ADDRESS: certificates@wtwco.com
Nashville, TN 372305191 USA INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : Valley Forge Insurance Company 20508
INSURED INSURER B : Continental Insurance Company 35289
PresenceLearning, Inc.
530 Seventh Ave, Suite M1 INSURER C :
New York, NY 10018 INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: W39526514 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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ 100,000
A MED EXP (Any one person) $ 15,000
Y Y 7092412146 07/01/2025 07/01/2026 PERSONAL & ADV INJURY 1,000,000
$
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
PRO- 2,000,000
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
B OWNED SCHEDULED Y Y 7092412163 07/01/2025 07/01/2026 BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 10,000,000
B
EXCESS LIAB CLAIMS-MADE Y Y 7092412132 07/01/2025 07/01/2026 AGGREGATE $ 10,000,000
DED RETENTION $ 10,000 $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
B ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? No N/A Y 7092469043 07/01/2025 07/01/2026
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
B Workers Compensation Y 7092469057 07/01/2025 07/01/2026 EL Each Accident $1,000,000
& Employers Liability -CA EL Disease-Pol Limit $1,000,000
Per Statute EL Disease-Each Empl $1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Certificate Holder is included as an Additional Insured as respects to General Liability, Auto Liability and
Umbrella/Excess Liability.
Waiver of Subrogation applies in favor of Additional Insured with respects to General Liability, Auto Liability,
Umbrella/Excess Liability and Workers Compensation as permitted by law.
CERTIFICATE 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.
DeKalb County School District
DeKalb County Board of Education
AUTHORIZED REPRESENTATIVE
Attention: Risk Management Department
1701 Mountain Industrial Road
Stone Mountain, GA 30083
© 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
SR ID: 27994086 BATCH: 4021993
DATE(MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 01/05/2026
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 CONTACT
NAME: Trust Risk Management Services, Inc
PHONE FAX
Trust Risk Management Services, Inc. doing business in GA as Potomac (A/C, No, Ext): 877.637.9700 (A/C, No): 877.251.5111
Risk Management Services, Inc. EMAIL
ADDRESS: info@trustrms.com
1791 Paysphere Circle INSURER(S) AFFORDING COVERAGE NAIC #
Chicago, IL 60674 INSURER A: ACE American Insurance Company 22667
INSURED INSURER B:
Horizons Psychological Assessment Center, LLC INSURER C:
3350 Riverwood Pkwy Se Ste 1900 INSURER D:
Atlanta, GA 30339 2066 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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
DAMAGE TO RENTED $
CLAIMS MADE OCCUR PREMISES (Ea occurrence)
$
MED EXP (Any one person)
___________________________________
$
PERSONAL & ADV INJURY
___________________________________
GEN’L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
PRO- $
PRODUCTS–COMP/OP AGG
POLICY JECT LOC
OTHER:
COMBINED SINGLE LIMIT $
AUTOMOBILE LIABILITY
(Ea accident)
ANY AUTO BODILY INJURY (Per Person) $
ALL OWNED SCHEDULED $
AUTOS AUTOS BODILY INJURY (Per accident)
NON-OWNED PROPERTY DAMAGE $
HIRED AUTOS AUTOS (Per accident)
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
$
DED RETENTION $
WORKERS COMPENSATION PER OTH- $
AND EMPLOYERS LIABILITY STATUTE ER
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.L. DISEASE-EA EMPLOYEE $
(Mandatory in NH)
If yes, describe under $
E.L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS below
Y 78G28702954 07/01/2025 07/01/2026 Each Incident $2,000,000
Psychologist's Professional
A Liability Annual $4,000,000
Retroactive Date: 07/01/2019 Aggregate
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required):
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
Additional Insured DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
Dekalb County School District/ Dekalb County Board of Education
AUTHORIZED REPRESENTATIVE
1701 Mountain Industrial
Stone Mountain, GA, 30083
ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 12/31/2025
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 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 CONTACT
NAME:
Hiscox Inc. PHONE FAX
(A/C, No, Ext):
(888) 202-3007 (A/C, No):
5 Concourse Parkway E-MAIL contact@hiscox.com
Suite 2150 ADDRESS:
Atlanta GA, 30328 INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : Hiscox Insurance Company Inc 10200
INSURED INSURER B :
Comprehensive Psychoeducational Assessment Agency
INSURER C :
3324 Peachtree Road Northeast
Atlanta, GA 30326 INSURER D :
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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
DAMAGE TO RENTED
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
PRO-
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTY DAMAGE $
HIRED AUTOS AUTOS (Per accident)
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
A Professional Liability Y P102.595.484.3 11/03/2025 11/03/2026 Each Claim: $ 2,000,000
Aggregate: $ 2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Dekalb County School and The Dekalb County Board of Education are named as Additional Insured per the terms and conditions of Professional Liability
CERTIFICATE HOLDER CANCELLATION
Dekalb County School and The Dekalb County Board of Education
1701 Mountain Industrial Blvd SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Stone Mountain, GA 30083
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD MTTU
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 05/29/2025
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 CONTACT
NAME:
Hiscox Inc. PHONE FAX
(A/C, No, Ext):
(888) 202-3007 (A/C, No):
5 Concourse Parkway E-MAIL contact@hiscox.com
Suite 2150 ADDRESS:
Atlanta GA, 30328 INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : Hiscox Insurance Company Inc 10200
INSURED INSURER B :
Comprehensive Psychoeducational Assessment Agency
INSURER C :
3324 Peachtree Road Northeast
Atlanta, GA 30326 INSURER D :
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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
DAMAGE TO RENTED
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
PRO-
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTY DAMAGE $
HIRED AUTOS AUTOS (Per accident)
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
A Professional Liability P102.595.484.2 11/03/2024 11/03/2025 Each Claim: $ 2,000,000
Aggregate: $ 2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
ADDITIONAL INSURED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
DeKalb County School and DeKalb County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Board of Education
1701 Mountain Industrial Boulevard
Stone Mountain, GA 30083 AUTHORIZED REPRESENTATIVE
© 1988-201 ACORD CORPORATION. All rights reserved.
ACORD 25 (201 /0 ) The ACORD name and logo are registered marks of ACORD MTTU
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 05/23/2025
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).
CONTACT
PRODUCER
NAME: SHALONNE FREEMAN
PHONE FAX
CEDRIC TAYLOR (A/C, No, Ext): 404-817-8088 (A/C, No): 404-817-8085
E-MAIL
ADDRESS:
311 14TH ST NW INSURER(S) AFFORDING COVERAGE NAIC #
ATLANTA GA 30318 INSURER A : State Farm Fire and Casualty Company 25143
INSURED INSURER B : State Farm Mutual Automobile Insurance Company 25178
COMPREHENSIVE PSYCHOEDUCATIONAL ASSESSMENTS INSURER C :
AGENCY/ FALEISHA BROWN INSURER D :
3324 PEACHTREE RD NE UNIT 2607 INSURER E :
ATLANTA GA 30326 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 ADD SUB POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ 20,000
MED EXP (Any one person) $ 5,000
A Y 91-KT-H750-6 01/09/2025 01/09/2026 PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
PRO-
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: $
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY 91-KT-H750-6 01/09/2025 01/09/2026 (Ea accident) $ 1,000,000
ANY AUTO BODILY INJURY (Per person) $
618 4585-B21-11E 02/21/2025 08/21/2025
OWNED SCHEDULED
B AUTOS ONLY AUTOS Y BODILY INJURY (Per accident) $
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident) $
AGGREGATE $ 2,000,000
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
STATUTE ER $
AND EMPLOYERS' LIABILITY
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
ADDITIONAL INSURED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
DeKalb County School and DeKalb County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Board of Education
1701 Mountain Industrial Boulevard AUTHORIZED REPRESENTATIVE
Stone Mountain, GA 30083 Completed by an authorized State Farm representative. If signature
is required, please contact a State Farm agent.
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
1001486 132849.14 04-13-2022