2023.11.30 COI.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)

© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

2/14/2023

Reseco Insurance Advisors, LLC 7901 N. 16th Street, Suite 100 Phoenix AZ 85020

602-753-4250 602-419-2242 certificates@resecoadvisors.com

Cincinnati Insurance Companies 23280 5830 Greenwich Insurance Company 22322

CS Construction, Inc.

22023 North 20th Avenue Suite A Phoenix AZ 85027

Accredited Specialty Insurance Comany Pacific Compensation Insurance Company 11555

497842451

A X 1,000,000 X 500,000

X $5,000 PD Ded 10,000

1,000,000

2,000,000 X

Y Y EPP0465363 11/30/2022 11/30/2023

2,000,000

A 1,000,000

X

X X X HA Phys Dam

Y Y EBA0465363 11/30/2022 11/30/2023

Comp/Coll Deductibles 1,000/$1,000 A X 5,000,000

X

EPP0465363 11/30/2022 11/30/2023

5,000,000 X 10,000

D XY 1019352 11/30/2022 11/30/2023

1,000,000

1,000,000

1,000,000 B B C

Professional Liability Pollution Liability Cyber Liability

PEC003929808

PEC003929808

2-CIA-AZ-17-S0113837-00

11/30/2022 11/30/2022 11/30/2022

11/30/2023 11/30/2023 11/30/2023

Aggregate Limit Each Occurrence Occurrence/Aggregate

2,000,000 2,000,000

3MM/3MM

Certificate holders and those parties, required by written contract, are included as Additional Insured with respects to the General Liability, Automobile Liability and Excess/Umbrella Liability on a primary and non-contributory basis, subject to all provisions and limitations of the policy. Waiver of Subrogation in favor of Certificate Holder and those parties required, by written contract, applies to the General Liability, Automobile Liability and Employers Liability/Workers Compensation, subject to all provisions and limitations of the policy.

CS Job #: B1564 Job Name: ITS Installation, Repair and Replacement Services – Solicitation #BPM005010 – Contract #CTR064363

ADOT

1324 N. 22nd Avenue Phoenix AZ 85009 a8812 Accepted

Includes copyrighted material of Insurance GA 4284 AZ 09 18 Services Office, Inc., with its permission. Page 1 of 3

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CONTRACTORS ADDITIONAL INSURED - BROAD FORM -

AUTOMATIC STATUS AND AUTOMATIC WAIVER OF

SUBROGATION WHEN REQUIRED IN WRITTEN CONTRACT,

AGREEMENT, PERMIT OR AUTHORIZATION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

A. Additional Insured - Owners, Lessees or Contractors - Automatic Status for Other Parties When Required in Written Contract or Agreement with You

1. Section II - Who is an Insured is amended to include as an additional in-sured any person or organization you have agreed in writing in a contract or agreement to add as an additional in-sured on this Coverage Part. Such per-son(s) or organization(s) is an additional insured only with respect to liability for:

a. "Bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by the performance of your ongoing opera-tions by you or on your behalf, under that written contract or written agreement. Ongoing operations does not apply to "bodily injury" or "proper-ty damage" occurring after:

(1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the loca-tion of the covered operations has been completed; or

(2) That portion of "your work" out of which the injury or damage aris-es has been put to its intended use by any person or organiza-tion other than another contrac-tor or subcontractor engaged in performing operations for a prin-cipal as a part of the same pro-ject; and

b. "Bodily injury" or "property damage" caused, in whole or in part, by "your work" performed under that written contract or written agreement and in-cluded in the "products-completed operations hazard", but only if:

(1) The Coverage Part to which this endorsement is attached pro-vides coverage for "bodily injury" or "property damage" included within the "products-completed operations hazard"; and

(2) The written contract or written agreement requires you to pro-vide additional insured coverage included within the "products-completed operations hazard" for that person or organization.

If the written contract or written agreement requires you to provide additional insured coverage included within the "products-completed oper-ations hazard" for a specified length of time for that person or organiza-tion, the "bodily injury" or "property damage" must occur prior to the ex-piration of that period of time in order for this insurance to apply.

If the written contract or written agreement requires you to provide additional insured coverage for a person or organization per ISO addi-tional insured endorsement form number CG 20 10, without specifying an edition date, and without specifi-cally requiring additional insured coverage included within the "prod-ucts-completed operations hazard", this Paragraph b. does not apply to that person or organization.

2. If the written contract or written agree-ment described in Paragraph 1. above specifically requires you to provide addi-tional insured coverage to that person or organization:

a. Arising out of your ongoing opera-tions or arising out of "your work"; or

Policy Number: EPP 046 53 63

GA 4284 AZ 09 18 Services Office, Inc., with its permission. Page 2 of 3

b. By way of an edition of an ISO addi-tional insured endorsement that in-cludes arising out of your ongoing operations or arising out of "your work";

then the phrase caused, in whole or in part, by in Paragraph A.1.a. and/or Para-graph A.1.b. above, whichever applies, is replaced by the phrase arising out of.

3. With respect to the insurance afforded to the additional insureds described in Para-graph A.1., the following additional exclu-sion applies:

This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:

a. The preparing, approving or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or draw-ings and specifications; or

b. Supervisory, inspection, architectural or engineering activities.

This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hir-ing, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "prop-erty damage", or the offense which caused the "personal and advertising inju-ry", involved the rendering of, or the fail-ure to render, any professional architec-tural, engineering or surveying services.

4. This Paragraph A. does not apply to addi-tional insureds described in Paragraph B.

B. Additional Insured - State or Governmental Agency or Subdivision or Political Subdi-vision - Automatic Status When Required in Written Permits or Authorizations

1. Section II - Who is an Insured is amended to include as an additional in-sured any state or governmental agency or subdivision or political subdivision you have agreed in writing in a contract, agreement, permit or authorization to add as an additional insured on this Coverage Part. Such state or governmental agency or subdivision or political subdivision is an additional insured only with respect to op-erations performed by you or on your be-half for which the state or governmental agency or subdivision or political subdivi-sion issued, in writing, a contract, agree-ment, permit or authorization.

2. With respect to the insurance afforded to the additional insureds described in Para-graph B.1., the following additional exclu-sions apply:

This insurance does not apply to:

a. "Bodily injury", "property damage" or "personal and advertising injury" aris-ing out of operations performed for the federal government, state or mu-nicipality; or

b. "Bodily injury" or "property damage" included within the "products-completed operations hazard."

C. The insurance afforded to additional insureds described in Paragraphs A. and B.:

1. Only applies to the extent permitted by law; and

2. Will not be broader than that which you are required by the written contract, writ-ten agreement, written permit or written authorization to provide for such addition-al insured; and

3. Does not apply to any person, organiza-tion, state, governmental agency or sub-division or political subdivision specifically named as an additional insured for the same project in the schedule of an en-dorsement added to this Coverage Part.

D. With respect to the insurance afforded to the additional insureds described in Paragraphs A. and B., the following is added to Section III

- Limits of Insurance:

The most we will pay on behalf of the addi-tional insured is the amount of insurance:

1. Required by the written contract, written agreement, written permit or written au-thorization described in Paragraphs A.

and B.; or

2. Available under the applicable Limits of Insurance shown in the Declarations;

whichever is less.

This endorsement shall not increase the appli-cable Limits of Insurance shown in the Decla-rations.

E. Section IV - Commercial General Liability Conditions is amended to add the following:

Automatic Additional Insured Provision

This insurance applies only if the "bodily inju-ry" or "property damage" occurs, or the "per-sonal and advertising injury" offense is com-mitted:

1. During the policy period; and

GA 4284 AZ 09 18 Services Office, Inc., with its permission. Page 3 of 3

2. Subsequent to your execution of the writ-ten contract or written agreement, or the issuance of a written permit or written au-thorization, described in Paragraphs A.

and B.

F. Except when G. below applies, the following is added to Section IV - Commercial General Liability Conditions, 5. Other Insurance, and supersedes any provision to the contrary:

When Other Additional Insured Coverage Applies on an Excess Basis

This insurance is primary to other insurance available to the additional insured described in Paragraphs A. and B. except:

1. As otherwise provided in Section IV - Commercial General Liability Condi-tions, 5. Other Insurance, b. Excess In-surance; or

2. For any other valid and collectible insur-ance available to the additional insured as an additional insured by attachment of an endorsement to another insurance policy that is written on an excess basis. In such case, this insurance is also excess.

G. The following is added to Section IV - Com-mercial General Liability Conditions, 5.

Other Insurance, and supersedes any provi-sion to the contrary:

Primary Insurance When Required by Writ-ten Contract, Agreement, Permit or Author-ization

Except when wrap-up insurance applies to the claim or "suit" on behalf of the additional in-sured, this insurance is primary to any other insurance available to the additional insured described in Paragraphs A. and B. provided that:

1. The additional insured is a Named In-sured under such other insurance; and

2. You have agreed in writing in a contract, agreement, permit or authorization de-scribed in Paragraph A. or B. that this in-surance would be primary to any other in-surance available to the additional in-sured.

As used in this endorsement, wrap-up insur-ance means any insurance provided by a con-solidated (wrap-up) insurance program.

Primary and Noncontributory Insurance When Required by Written Contract, Agreement, Permit or Authorization

Except when wrap-up insurance applies to the claim or "suit" on behalf of the additional in-sured, this insurance is primary to and will not seek contribution from any other insurance available to the additional insured described in Paragraphs A. and B. provided that:

1. The additional insured is a Named In-sured under such other insurance; and

2. You have agreed in writing in a contract, agreement, permit or authorization de-scribed in Paragraph A. or B. that this in-surance would be primary and would not seek contribution from any other insur-ance available to the additional insured.

As used in this endorsement, wrap-up insur-ance means any insurance provided by a con-solidated (wrap-up) insurance program.

H. Section IV - Commercial General Liability Conditions, 9. Transfer of Rights of Recov-ery Against Others to Us is amended by the addition of the following:

We waive any right of recovery we may have against any additional insured under this en-dorsement against whom you have agreed to waive such right of recovery in a written con-tract, written agreement, written permit or writ-ten authorization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a written contract, written agreement, written permit or written authorization. However, our rights may only be waived prior to the "occur-rence" giving rise to the injury or damage for which we make payment under this Coverage Part. The insured must do nothing after a loss to impair our rights. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce those rights.

GA 233 AZ 09 09 Services Office, Inc., with its permission. Page 1 of 14

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CONTRACTORS' COMMERCIAL GENERAL LIABILITY

BROADENED ENDORSEMENT

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

A. Endorsement - Table of Contents:

Coverage: Begins on Page:

1. Employee Benefit Liability Coverage

2. Unintentional Failure to Disclose Hazards

3. Damage to Premises Rented to You

4. Supplementary Payments

5. Medical Payments

6. Voluntary Property Damage (Coverage a.) and Care, Custody or Control

Liability Coverage (Coverage b.)

7. 180 Day Coverage for Newly Formed or Acquired Organizations

8. Waiver of Subrogation

9. Automatic Additional Insured - Specified Relationships:

× Managers or Lessors of Premises;

× Lessor of Leased Equipment;

× Vendors;

× State or Political Subdivisions - Permits Relating to Premises;

× State or Political Subdivisions - Permits; and × Contractors' Operations

10. Broadened Contractual Liability - Work Within 50' of Railroad Property

11. Property Damage to Borrowed Equipment

12. Employees as Insureds - Specified Health Care Services:

× Nurses;

× Emergency Medical Technicians; and × Paramedics

13. Broadened Notice of Occurrence

B. Limits of Insurance:

The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorsement, except as provided below:

1. Employee Benefit Liability Coverage

Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000

3. Damage to Premises Rented to You

The lesser of:

a. The Each Occurrence Limit shown in the Declarations; or

b. $500,000 unless otherwise stated $

4. Supplementary Payments

a. Bail bonds: $ 1,000

b. Loss of earnings: $ 350

Policy #EPP0465363

GA 233 AZ 09 09 Services Office, Inc., with its permission. Page 10 of 14

(3) We may pay any part or all of the deductible amount to effect set-tlement of any claim or "suit" and, upon notification of the ac-tion taken, you shall promptly re-imburse us for such part of the deductible amount as has been paid by us.

7. 180 Day Coverage for Newly Formed or Acquired Organizations

SECTION II - WHO IS AN INSURED is amended as follows:

Subparagraph a. of Paragraph 4. is here-by deleted and replaced by the following:

a. Insurance under this provision is af-forded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier;

8. Waiver of Subrogation

SECTION IV - COMMERCIAL GENERAL

LIABILITY CONDITIONS, 9. Transfer of Rights of Recovery Against Others to Us is hereby amended by the addition of the following:

We waive any right of recovery we may have because of payments we make for injury or damage arising out of your ongo-ing operations or "your work" done under a written contract requiring such waiver with that person or organization and in-cluded in the "products-completed opera-tions hazard". However, our rights may only be waived prior to the "occurrence" giving rise to the injury or damage for which we make payment under this Cov-erage Part. The insured must do nothing after a loss to impair our rights. At our re-quest, the insured will bring "suit" or trans-fer those rights to us and help us enforce those rights.

9. Automatic Additional Insured - Speci-fied Relationships

a. The following is hereby added to

SECTION II - WHO IS AN INSURED:

(1) Any person or organization de-scribed in Paragraph 9.a.(2) be-low (hereinafter referred to as additional insured) whom you are required to add as an additional insured under this Coverage Part by reason of:

(a) A written contract or agree-ment; or

(b) An oral agreement or con-tract where a certificate of insurance showing that per-son or organization as an additional insured has been issued, is an insured, provided:

(a) The written or oral contract or agreement is:

1) Currently in effect or becomes effective dur-ing the policy period;

and

2) Executed prior to an "occurrence" or offense to which this insurance would apply; and

(b) They are not specifically named as an additional in-sured under any other pro-vision of, or endorsement added to, this Coverage Part.

(2) Only the following persons or or-ganizations are additional in-sureds under this endorsement, and insurance coverage provid-ed to such additional insureds is limited as provided herein:

(a) The manager or lessor of a premises leased to you with whom you have agreed per Paragraph 9.a.(1) above to provide insurance, but only with respect to liability aris-ing out of the ownership, maintenance or use of that part of a premises leased to you, subject to the following additional exclusions:

This insurance does not ap-ply to:

1) Any "occurrence" which takes place after you cease to be a tenant in that premises.

2) Structural alterations, new construction or demolition operations performed by or on be-half of such additional insured.

(b) Any person or organization from which you lease equipment with whom you have agreed per Paragraph 9.a.(1) above to provide in-surance. Such person(s) or organization(s) are insureds solely with respect to their liability arising out of the maintenance, operation or use by you of equipment leased to you by such per-

AA 4171 11 05

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED BY CONTRACT

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

GARAGE COVERAGE FORM

This endorsement changes the policy effective on the inception date of the policy unless another date is indi-cated below.

Endorsement effective 11/30/2022 Policy No. EBA465363

Named Insured CS Construction, Inc.

Countersigned by

(Authorized Representative)

Section II – Liability Coverage – Who is an Insured is amended to include as an insured any person or organi-zation with which you have agreed in a valid written contract to provide insurance as is afforded by this policy.

This provision is limited to the scope of the valid written contract.

This provision does not apply unless the valid written contract has been executed prior to the “bodily injury” or “property damage”.

Policy No. EBA0465363 Effective: 11/30/2022

AA 4174 11 05

PRIMARY AND NONCONTRIBUTORY INSURANCE

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

This endorsement changes the policy effective on the inception date of the policy unless another date is indi-cated below.

Endorsement effective 11/30/2022 Policy No. EBA0465363

Named Insured CS Construction, Inc.

Countersigned by

(Authorized Representative)

With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.

1. NONCONTRIBUTORY INSURANCE

Section IV – BUSINESS AUTO CONDITIONS B.5.c OTHER INSURANCE is replaced by the following:

c. Regardless of the provisions of Paragraph a. above, this Cover-age Form’s Liability Coverage is primary and we will not seek con-tribution from any other insurance for any liability assumed under an “insured contract” that requires li-ability to be assumed on a primary noncontributory basis.

AA 4172 11 05

BLANKET WAIVER OF SUBROGATION - AUTO

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

This endorsement changes the policy effective on the inception date of the policy unless another date is indi-cated below.

Endorsement effective 11/30/2022 Policy No. EBA0465363

Named Insured CS Construction, Inc.

Countersigned by

(Authorized Representative)

With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.

1. BLANKET WAIVER OF SUBROGATION

Section IV – BUSINESS AUTO CONDITIONS A.5 is amended by the addi-tion of the following:

We waive any right of recovery we may have against any person or organization because of payments we make for “bodily injury” or “property damage” arising out of the operation of a covered “auto” when you have assumed liability for such “bodily injury” or “property damage” under an “in-sured contract”, provided the “bodily injury” or “property damage” occurs subsequent to the execution of the “insured contract.”

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13

(Ed. 4-84)

WC 00 03 13

(Ed. 4-84)

© 1983 National Council on Compensation Insurance.

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)

This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.

Schedule State Blanket/Schedule/State

CO BLANKET

NV BLANKET

AZ BLANKET

Blanket Waiver: Anyone for whom you have agreed to provide this Waiver subject to the terms of this endorsement

This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.

(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)

1019352Policy No. 11Endorsement No.Endorsement Effective 11/30/2022 Insured CS Construction Inc Premium $

CopperPoint Indemnity Insurance CompanyInsurance Company Countersigned by