2024-7-1_CGAUWPro-COI-Spray_Systems_.pdf

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE

INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #

NAME:

CONTACT

(A/C, No):

FAX

E-MAIL

ADDRESS:

PRODUCER

(A/C, No, Ext):

PHONE

INSURED

REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED

REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

OTHER:

(Per accident)

(Ea accident)

N / A

SUBR

WVD

ADDL

INSD

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

$PROPERTY DAMAGE

BODILY INJURY (Per accident)

BODILY INJURY (Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY

Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH)

DESCRIPTION OF OPERATIONS below If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE

E.L. DISEASE - POLICY LIMIT

E.L. DISEASE - EA EMPLOYEE

E.L. EACH ACCIDENT

ER

OTH-

STATUTE

PER

LIMITS(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR

INSR

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

EXCESS LIAB

UMBRELLA LIAB $EACH OCCURRENCE

$AGGREGATE

OCCUR

CLAIMS-MADE

DED RETENTION $

$PRODUCTS - COMP/OP AGG

$GENERAL AGGREGATE

$PERSONAL & ADV INJURY

$MED EXP (Any one person)

$EACH OCCURRENCE

DAMAGE TO RENTED

$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY

PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE

ACORD 25 (2016/03)

© 1988-2016 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

Willis Towers Watson Insurance Services West, Inc.

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

Spray Systems of Arizona 2202 W. Medtronic Way Suite #108 Tempe, AZ 852815107

If required by written contract, the General Liability policy includes an Additional Insured and Waiver of Subrogation endorsement in favor of Certificate Holder. The General Liability policy shall be Primary to any other insurance in force for or which may be purchased by the Additional Insured.

If required by written contract, the Auto Liability policy includes an Additional Insured and Waiver of Subrogation endorsement in favor of Certificate Holder. The Auto Liability policy shall be Primary to any other insurance in

Arizona Department of Environmental Quality 1110 W. Washington Street Phoenix, AZ 85007

06/30/2023

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

Starr Surplus Lines Insurance Company 13604

Everest Reinsurance Company

Starr Indemnity & Liability Company

26921

38318

W29513234

A

3,000,000

100,000

5,000

2,000,000

6,000,000

3,000,000

Y Y 1000067650231 07/01/2023 07/01/2024

B

1,000,000

07/01/202407/01/2023Y Y CF3CA00326-231

A 7,000,000

Y Y 1000337831231 07/01/2023 07/01/2024 7,000,000

100 0004700 02 C Y

1,000,000 No 07/01/2023 07/01/2024

1,000,000

1,000,000

A Pollution Liability

Professional Liability

Each Occurrence1000067650231 07/01/2023 07/01/2024

Each Claim

303571324356371SR ID: BATCH:

2,000,000

2,000,000

Willis Towers Watson Certificate Center

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: FORM TITLE:

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE Page of

AGENCY CUSTOMER ID:

LOC #:

AGENCY

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSURED

EFFECTIVE DATE:

Spray Systems of Arizona 2202 W. Medtronic Way Suite #108 Tempe, AZ 852815107 force for or which may be purchased by the Additional Insured.

Waiver of Subrogation applies in favor of the certificate holder with respects to Workers Compensation if required by written contract, as permitted by law.

Umbrella/Excess Liability Follows Form of Underlying Coverage.

Re: Contract No. CTR059029 Statewide Emergency Response and Non-Emergency Environmental Services

Additional Insured entities: The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees

2 2

Willis Towers Watson Insurance Services West, Inc.

See Page 1

See Page 1 See Page 1 See Page 1

25 Certificate of Liability Insurance

W29513234CERT:3035713BATCH:24356371SR ID:

SL 739 (07-11) Page 1 of 3 Copyright © Starr Surplus Lines Insurance Company. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

2.

IF NEITHER OF THESE BOXES ARE CHECKED, THIS ENDORSEMENT IS VOID. IF MORE

THAN ONE OF THE THESE BOXES ARE CHECKED, THIS ENDORSEMENT IS VOID.

II. SECTION III – LIMITS OF INSURANCE, is amended to include the following:

1. The Limits of Insurance and the rules below fix the most we will pay regardless of the number of:

a. Insureds;

b. Claims made or "suits" brought; or

c. Persons or organizations making claims or bringing "suits".

2. The General Aggregate Limit is the most we will pay for the sum of:

a. Medical expenses under Coverage C;

b. Damages under Coverage A, except damages because of "bodily injury" or

"property damage" included in the products-completed operations hazard"; and

c. Damages under Coverage B.

3. Persons or organizations making claims or bringing "suits".

4. The Products-Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products-completed operations hazard".

5. Subject to 2 above, the Personal and Advertising Injury Limit is the most we will pay

Per Project General Aggregate Limit

Per Project and Per Location General Aggregate Limit

[ ] Overall Policy Aggregate Limit

Per Location General Aggregate Limit

$6,000,000[x ]

AMENDMENT OF LIMITS OF INSURANCE

(PER PROJECT OR PER LOCATION AGGREGATE LIMIT)

Policy Number: 1000067650231 Effective Date: 07/01/2023 at 12:01 A.M.

Named Insured: Spray Systems of Arizona Inc

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

I. Your policy is amended to include either a Per Project General Aggregate Limit, a Per Location General Aggregate Limit or a Per Project and Per Location General Aggregate Limit. Please select only one of the following:

1.

SL 739 (07-11) Page 2 of 3

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

under Coverage B for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization.

6. Subject to 2 or 3 above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of:

a. Damages under Coverage A; and

b. Medical expenses under Coverage C because of all "bodily injury" and "property damage" arising out of any one “occurrence”.

7. Subject to 5 above, the Damage to Premises Rented to You Limit is the most we will pay under Coverage A because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission by the owner.

8. Subject to 5 above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person.

9. Subject to 2, 4, 5, 6, and/or 7 above, the Per Project Aggregate Limit is the most we will pay under Coverages A, B, and C combined for the sum of:

a. Damages under Coverage A;

b. Damages under Coverage B; and

c. Medical expenses under Coverage C arising out of the any single Location described above.

10. Subject to 2, 4, 5, 6, and/or 7 above, the Per Location Aggregate Limit is the most we will pay under Coverages A, B, and C combined for the sum of:

d. Damages under Coverage A;

e. Damages under Coverage B; and

f. Medical expenses under Coverage C arising out of the any single Location described above.

11. The Overall Policy Aggregate is the most we will pay in any policy period regardless of number of projects or locations.

The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance.

III. The Limits of Insurance shown in the Declarations are deleted in their entirety and replaced by the Limits of Insurance set forth below.

Limits of Insurance

General Aggregate Limit $6,000,000

Each Occurrence Limit $3,000,000

Products-Completed Operations Aggregate Limit $3,000,000

Personal & Advertising Injury Limit $2,000,000

Damage to Premises Rented to You $100,000 Medical Expense Limit $5,000 Overall Policy Aggregate Limit Capped At $6,000,000

SL 739 (07-11) Page 3 of 3

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

IV. SECTION V – DEFINITIONS: is amended to include the following:

23. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway, or right-of-way railroad.

ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

COMMERCIAL GENERAL LIABILITY

CG 20 10 12 19

© Insurance Services Office, Inc., 2018 Page 1 of 1CG 20 10 12 19

ADDITIONAL INSURED – OWNERS, LESSEES OR

CONTRACTORS – SCHEDULED PERSON OR

ORGANIZATION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by:

1. Your acts or omissions; or

2. The acts or omissions of those acting on your behalf;

in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:

This insurance does not apply to "bodily injury" or "property 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 location of the covered operations has been completed; or

2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.

C. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable limits of insurance;

whichever is less.

This endorsement shall not increase the applicable limits of insurance.

Location(s) Of Covered Operations

Where Required By Written Contract

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Where Required By Written Contract

Name Of Additional Insured Person(s) Or Organization(s)

POLICY NUMBER: 1000067650231

CG 20 37 12 19

© Insurance Services Office, Inc., 2018 Page 1 of 1CG 20 37 12 19

ADDITIONAL INSURED – OWNERS, LESSEES OR

CONTRACTORS – COMPLETED OPERATIONS

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

SCHEDULE

A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard".

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

B. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable limits of insurance;

whichever is less.

This endorsement shall not increase the applicable limits of insurance.

Location And Description Of Completed Operations Where Required By Written Contract

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Where Required By Written Contract

Name Of Additional Insured Person(s) Or Organization(s)

SL 820 01 (10/14) Page 1 of 1

ADDITIONAL INSURED – OWNERS, LESSEES OR

CONTRACTORS – COMPLETED OPERATIONS

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)

Section II – Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" at the location designated and described in the schedule of this endorsement performed for that insured and included in the "products-completed operations hazard".

All other terms and conditions of this Policy remain unchanged.

Location And Description of Completed Operations:

Where Required By Written Contract

Additional Premium:

$500

Name of Person or Organization:

Where Required By Written Contract

Policy Number: 1000067650231 Named Insured: Spray Systems of Arizona Inc

Effective Date: 07/01/2023 at 12:01 A.M.

CG 20 28 12 19

© Insurance Services Office, Inc., 2018 Page 1 of 1CG 20 28 12 19

ADDITIONAL INSURED – LESSOR OF

LEASED EQUIPMENT

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s).

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

B. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires.

C. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable limits of insurance;

whichever is less.

This endorsement shall not increase the applicable limits of insurance.

Where Required By Written Contract

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Name Of Additional Insured Person(s) Or Organization(s):

SL 821 01 (10/14) Page 1 of 1 Copyright © Starr Surplus Lines Insurance Company. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

ADDITIONAL INSURED – OWNERS, LESSEES OR

CONTRACTORS – SCHEDULED PERSON OR

ORGANIZATION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)

A. Section II – Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured.

B. With respect to the insurance afforded to these additional insureds, the following exclusion is added:

2. Exclusions

This insurance does not apply to "bodily injury" or "property 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 site of the covered operations has been completed; or

(2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.

All other terms and conditions of this Policy remain unchanged.

Where Required By Written Contract

Name of Person or Organization:

Policy Number: 1000067650231 Named Insured: Spray Systems of Arizona Inc

Effective Date: 07/01/2023 at 12:01 A.M.

SL 023 (06/11) Page 1 of 1

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

Primary and Non-contributory, Additional Insured and Waiver of Subrogation

This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policy(ies) carefully.

Commercial General Liability Coverage Form Owners and Contractors Protective Liability Coverage form Products/Completed Operations Liability Coverage Form

Contractors Pollution Liability Coverage Form Professional Liability Coverage Form

Site Pollution Liability Coverage Form

SCHEDULE

Where Required By Written Contract

A. SECTION II - WHO IS AN INSURED is amended to include as an insured the person or organization shown in the schedule of this endorsement, but only with respect to liability arising out of “your work” for that insured by or for you.

B. As respects additional insureds as defined above, this insurance also applies to “bodily injury” or “property damage” arising out of your negligence when the following written contract requirements are applicable:

1. Coverage available under this coverage part shall apply as primary insurance. Any other insurance available to these additional insured’s shall apply as excess and not contribute as primary to the insurance afforded by this endorsement.

2. We waive any right of recovery we may have against these additional insured’s because of payments we make for injury or damage arising out of “your work” done under a written contract with the additional insured.

3. The term insured is used separately and not collectively, but the inclusion of more than one insured shall not increase the limits or coverage provided by this insurance.

Insureds and Agents are advised that certificates of insurance should be used only to provide evidence of insurance in lieu of an actual copy of the applicable insurance policy. Certificates should not be used to amend, expand or otherwise alter the terms of the actual policy.

ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.

Effective Date: 07/01/2022 at 12:01 A.M.Policy Number: 1000067650231

Named Insured: Spray Systems of Arizona, Inc.

CG 24 04 12 19

© Insurance Services Office, Inc., 2018 Page 1 of 1CG 24 04 12 19

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US (WAIVER OF SUBROGATION)

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

ELECTRONIC DATA LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES

POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

RAILROAD PROTECTIVE LIABILITY COVERAGE PART

UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS

SCHEDULE

The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions:

We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above.

Any person or organization to whom you become obligated to waive your rights of recovery against, under any contract or agreement you enter into prior to the occurrence of loss.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Name Of Person(s) Or Organization(s):

MANUSCRIPT (06/10) Page 1 of 2 Includes copyrighted material of ISO Properties, Inc., used with its permission.

Amendment- Notice of Cancellation for Third Parties Policy Number: 1000067650231 Effective Date: 07/01/2023 at 12:01 A.M.

Named Insured: Spray Systems of Arizona Inc

This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policy(ies) carefully.

Auto Dealers Coverage Form, Business Auto Coverage Form, Business Auto Physical Damage Coverage Form, Commercial General Liability Coverage Form, Contractor's Pollution Liability Coverage Form, Electronic Data Liability Coverage Form, Excess Liability Policy Form, Garage Coverage Form, Liquor Liability Coverage Form, Motor Carrier Coverage Form, Owners And Contractors Protective Liability Coverage Form-Coverage For Operations Of Designated Contractor, Pollution Liability Coverage Form Designated Sites, Products/Completed Operations Liability Coverage Form, Product Withdrawal Coverage Form, Professional Liability Coverage Form, Railroad Protective Liability Coverage Form, Site Pollution Liability Coverage Form, Special Protective And Highway Liability Policy-New York Department Of Transportation, Truckers Coverage Form, Underground Storage Tank Policy Designated Tanks.

It is agreed that in the event the "Insurer" cancels the policy for any reason other than non-payment of premium, the "First Named Insured" must, within five (5) days of receiving the notice of cancellation, provide the "Insurer", either directly or through the retail broker, with a written list of certificate holder(s) ("Schedule") that the "First Named Insured" is contractually obligated to notify in the event that the policy is cancelled. The "Schedule" must specify the name and current email address of a contact for each certificate holder.

The "Insurer" will endeavor to provide notice of cancellation to the certificate holder(s) listed in the "Schedule" by email. The "Insurer" agrees to provide such notice of cancellation at a rate of $10 per notified certificate holder up to a maximum of $25,000 for this policy.

This notification of a pending cancellation of coverage is intended as a courtesy only. The "Insurer's" failure to provide such notice will neither extend the policy cancellation nor negate cancellation of the policy; nor will this failure result in obligation or liability of any kind upon the "Insurer", its agents or representatives.

This endorsement does not affect, in any way, coverage provided under this policy, the cancellation of this policy or the effective date of cancellation.

The following definitions apply to this endorsement:

1."First Named Insured" means the named insured shown in the Declarations Page of this policy.

MANUSCRIPT (06/10) Page 2 of 2

2."Insurer" means the insurance company shown in the header on the Declarations Page of this policy.

3. "Schedule" means the written list of certificate holder(s).

All other terms and conditions of this Policy remain unchanged.

Signed for STARR SURPLUS LINES INSURANCE COMPANY

COMMERCIAL AUTO

ECA 04 521 04 14

ECA 04 521 04 14 Copyright, Everest Reinsurance Company, 2014 Includes copyrighted material of Insurance Services Office, Inc., used with its permission

ADDITIONAL INSURED – DESIGNATED ORGANIZATION

BUSINESS AUTO COVERAGE PART

SCHEDULE

Name Of Additional Insured Organization

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

The following is added to the Who Is An Insured paragraph under Section II – Liability Coverage:

The organization shown in the Schedule with respect to the operation, maintenance, or use of a covered "auto" if you are required to add such organization to this policy as an additional insured in order to comply with the terms of a written "insured contract" or written agreement. This does not apply when such contract or agreement:

A. Involves the owner or anyone else from whom you hire or borrow a covered “auto” unless it is a “trailer” connected to a covered “auto” you own; or

B. Is executed after the date of “loss”.

This paragraph does not apply if:

1. The terms and conditions of the written “insured contract” had been agreed upon prior to the “accident” or “loss”; and

2. You can definitively establish that the terms and conditions of the written “insured contract” ultimately executed are the same as those which had been agreed upon prior to the “accident” or “loss”.

Policy Number: CF3CA00326-231

Spray Systems of Arizona, Inc.

2202 W. Medtronic Way Suite 108 Tempe, AZ 85281

ECA 24 509 04 14

ECA 24 509 04 14 Copyright, Everest Reinsurance Company, 2014 Includes copyrighted material of Insurance Services Office, Inc., used with its permission

PRIMARY AND NONCONTRIBUTORY –

OTHER INSURANCE CONDITION – BLANKET

BUSINESS AUTO COVERAGE PART

Paragraph c. of the Other Insurance General Condition is replaced by the following:

c. Regardless of the provisions of Paragraph a.

above, this Coverage Form’s Liability Coverage is primary and we will not seek contribution from any other insurance for any liability assumed under an “insured contract” that requires liability to be assumed on a primary noncontributory basis.

Additionally, only the coverage and limit of insurance requirements of the “insured contract” shall apply, and in no event shall those requirements exceed the coverage and limits of insurance provided under this policy.

ECA 24 503 02 14

ECA 24 503 02 14 Copyright, Everest Reinsurance Company, 2014 Includes copyrighted material of Insurance Services Office, Inc., used with its permission.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US

AUTO DEALERS COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

SCHEDULE

Name of Person or Organization:

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)

The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following:

We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for an “accident” or “loss”, provided that you are required under a written agree-ment to waive your rights of recovery. The written agreement must be made prior to the date of the “accident” or “loss”. This waiver applies only to the person or organization shown in the Schedule above.

Spray Systems of Arizona, Inc.

2202 W. Medtronic Way, Suite 108 Tempe, AZ 85281

Other Insurance – Primary and Noncontributory for Additional Insured Amendatory Endorsement

Policy Number: 1000337831231 Effective Date: 07/01/2023 at 12:01 A.M.

Named Insured: Spray Systems of Arizona Inc

This endorsement modifies insurance provided under the following:

EXCESS LIABILITY POLICY

It is hereby agreed that SECTION IV. CONDITIONS, I. Other Insurance is deleted in its entirety and replaced by the following:

I. Other Insurance

If other insurance applies to “Ultimate Net Loss” that is also covered by this Policy, this Policy will apply excess of, and will not contribute to, the other insurance. Nothing herein will be construed to make this Policy subject to the terms, conditions and limitations of such other insurance. However, other insurance does not include:

1. “Underlying Insurance”;

2. Insurance that is specifically written as excess over this Policy; or

3. Insurance held by a person(s) or organization(s) qualifying as an additional insured in “Underlying Insurance,” but only when the written contract or agreement that mandates such additional insured status:

a. Requires a specific limit of insurance that is in excess of the Underlying Limits of Insurance;

b. Requires that your insurance be primary and not contribute with that of the additional insured; and

c. Is executed prior to the loss.

In such case as described in subparagraph 3. above, we shall not seek contribution from the additional insured’s primary or excess insurance for which they are a named insured for amounts payable under this insurance.

The Limits of Insurance afforded the additional insured pursuant to subparagraph 3. above shall be the lesser of the following:

a. The minimum limits of insurance required in the contract or agreement; or

b. The Limits of Insurance shown in the Declarations of this Policy.

Other insurance includes any type of self-insurance or other mechanism by which an Insured arranges for the funding of legal liabilities.

SL-373 (0219) Page 1 of 1

EXCESS LIABILITY

SL-233 (0221)

SL-233 (0221) Page 1 of 1 Copyright © Starr Surplus Lines Insurance Company. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc., with its permission.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

Waiver of Subrogation Endorsement

This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and evidenced as such on the declarations page. Please read the endorsement and respective policy(ies) carefully.

EXCESS LIABILITY POLICY

It is hereby agreed that SECTION IV. CONDITIONS, K. Transfer of Rights of Recovery Against Others to Us is amended to include the following:

SCHEDULE

We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Policy. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above.

All other terms and conditions of this Policy remain unchanged.

Name Of Person(s) Or Organization(s):

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

All as required by written contract.

Named Insured:

Effective Date: Policy Number: 1000337831231

Spray Systems of Arizona Inc

07/01/2023 at 12:01 A.M.

SL 106 (04-11) Page 1 of 1

The following is added to the Cancellation Condition, When We Do Not Renew Condition or as amended by an applicable state cancellation/nonrenewal endorsement:

If we cancel or do not renew the Named Insured’s policy for any statutorily permitted reason, other than nonpayment of premium, we will mail written notice of such cancellation or nonrenewal to the additional person or organization designated in the Schedule above. The Number of Days Notice indicated in the Schedule above is the minimum number of days we will mail notice to the person or organization designated above before the effective date of such cancellation or nonrenewal

All other terms, definitions, conditions and exclusions of this policy remain unchanged.

Where Required By Written Contract

Where Required By Written Contract

Number of Days Notice:

WHEN WE DO NOT RENEW (Nonrenewal): 30Number of Days Notice:

30CANCELLATION:

ADDRESS:

NAME:

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NOTICE OF CANCELLATION OR NONRENEWAL TO

DESIGNATED ADDITIONAL INSURED

Policy Number: 1000337831231 Effective Date: 07/01/2023 at 12:01 A.M.

Named Insured: Spray Systems of Arizona Inc

This endorsement modifies insurance provided under the following:

EXCESS LIABILITY POLICY FORM

ADDITIONAL ENTITY RECEIVING NOTICE OF CANCELLATION OR NONRENEWAL

MANUSCRIPT (06/10) Page 1 of 2

Amendment- Notice of Cancellation for Third Parties Policy Number: 1000337831231 Effective Date: 07/01/2023 at 12:01 A.M.

Named Insured: Spray Systems of Arizona Inc

This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policy(ies) carefully.

Auto Dealers Coverage Form, Business Auto Coverage Form, Business Auto Physical Damage Coverage Form, Commercial General Liability Coverage Form, Contractor's Pollution Liability Coverage Form, Electronic Data Liability Coverage Form, Excess Liability Policy Form, Garage Coverage Form, Liquor Liability Coverage Form, Motor Carrier Coverage Form, Owners And Contractors Protective Liability Coverage Form-Coverage For Operations Of Designated Contractor, Pollution Liability Coverage Form Designated Sites, Products/Completed Operations Liability Coverage Form, Product Withdrawal Coverage Form, Professional Liability Coverage Form, Railroad Protective Liability Coverage Form, Site Pollution Liability Coverage Form, Special Protective And Highway Liability Policy-New York Department Of Transportation, Truckers Coverage Form, Underground Storage Tank Policy Designated Tanks.

It is agreed that in the event the "Insurer" cancels the policy for any reason other than non-payment of premium, the "First Named Insured" must, within five (5) days of receiving the notice of cancellation, provide the "Insurer", either directly or through the retail broker, with a written list of certificate holder(s) ("Schedule") that the "First Named Insured" is contractually obligated to notify in the event that the policy is cancelled. The "Schedule" must specify the name and current email address of a contact for each certificate holder.

The "Insurer" will endeavor to provide notice of cancellation to the certificate holder(s) listed in the "Schedule" by email. The "Insurer" agrees to provide such notice of cancellation at a rate of $10 per notified certificate holder up to a maximum of $25,000 for this policy.

This notification of a pending cancellation of coverage is intended as a courtesy only. The "Insurer's" failure to provide such notice will neither extend the policy cancellation nor negate cancellation of the policy; nor will this failure result in obligation or liability of any kind upon the "Insurer", its agents or representatives.

This endorsement does not affect, in any way, coverage provided under this policy, the cancellation of this policy or the effective date of cancellation.

The following definitions apply to this endorsement:

1."First Named Insured" means the named insured shown in the Declarations Page of this policy.

MANUSCRIPT (06/10) Page 2 of 2

2."Insurer" means the insurance company shown in the header on the Declarations Page of this policy.

3. "Schedule" means the written list of certificate holder(s).

All other terms and conditions of this Policy remain unchanged.

Signed for STARR SURPLUS LINES INSURANCE COMPANY

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY

(Ed. 04-84)

WC 00 03 13

Schedule

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.

Any person or organization to whom you become obligated to waive your rights of recovery against, under any contract or agreement you enter into prior to the occurrence of loss.

Endorsement Effective: Policy No.: Endorsement No.:

Insured: Premium:

Insurance Company: Countersigned by:

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.)

WC 00 03 13

(Ed. 04-84) Page 1 of 1

7/1/2023 100 0004700 02

Spray Systems of Arizona, Inc.

2202 W. Medtronic Way, Ste. 108 Tempe, AZ 85281

Starr Indemnity & Liability Co.

399 Park Avenue New York, New York 10022

10.0.2.20120224.1.869952

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

2202 W. Medtronic Way Suite #108 Tempe, AZ 852815107

endorsement in favor of Certificate Holder. The General Liability policy shall be Primary to any other insurance in force for or which may be purchased by the Additional Insured.

If required by written contract, the Auto Liability policy includes an Additional Insured and Waiver of Subrogation endorsement in favor of Certificate Holder. The Auto Liability policy shall be Primary to any other insurance in

INSURED:

Arizona Department of Environmental Quality 1110 W. Washington Street Phoenix, AZ 85007