2024-7-1_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

8/10/2023

Arthur J. Gallagher Risk Management Services, LLC 595 Market Street Suite 2100 San Francisco CA 94105

(415)536-8499

License#: 0D69293 Underwriters at Lloyd's London 15792 Federal Insurance Company 20281

Roman Catholic Church Diocese of Tucson Catholic Community Services of Southern Arizona, I 268 W. Adams Street Tucson AZ 85705

American Alternative Insurance Corp 19720 Arch Insurance Company 11150 Lloyd's Synd 2987

1394698699

E C A

X 2,000,000 X 50,000

X Sexual Abuse* 5,000 X Prof Liability 2,000,000

3,000,000 X

Y Y BP1002923

R2A2FF0000011-06

CO1002923

7/1/2023 7/1/2023 7/1/2023

7/1/2024 7/1/2024 7/1/2024

3,000,000

Self Insured Limit 500,000 A C A

1,000,000

X

X Uninsured X Underinsured

BP1002923

R2A2FF0000011-06

CO1002923

7/1/2023 7/1/2023 7/1/2023

7/1/2024 7/1/2024 7/1/2024

Self Insured Limit 500,000

D XWCX 0068135 01 7/1/2023 7/1/2024 SIR $500,000

1,000,000

1,000,000

1,000,000 B Crime 81221058 7/1/2023 7/1/2024 Employee Theft

Retention $1,000,000 $50,000

* Sexual Abuse : Self Insured Retention $1,000,000 -Specific/Agg Limit $4,000,000 Limit / Claims-Made Coverage As required, additional insured is included as per endorsement # 8 attached.

Professional Liability - Each Claim - $2,000,000 each claim / Annual Aggregate - $2,000,000 is included in the Policy#BP1002923, R2A2FF0000011-06 and CO1002923 as shown in above.

RE: Contract #CTR066191The State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, agents and employees shall be named as Additional Insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor for General Liability and Auto Liability per attached endorsement form. Waiver of Subrogation applies to General Liability, Auto Liability and Workers Comp policies per attached endorsement forms.

The State of Arizona Department of Economic Security P. O. Box 6123, Site Code 950A Phoenix AZ 85005

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NAMED ASSURED: The Roman Catholic Church of The Diocese of Tucson (as more fully defined in Endorsement 1)

Policy Number: BP1002923

Effective Date: July 01, 2023

Authority Ref No: B1551JEE65S23A000

Endorsement Number 8

CERTIFICATES OF INSURANCE ENDORSEMENT

CERTIFICATES OF INSURANCE:

It is hereby understood and agreed that holders of Certificates of Insurance issued against this Policy that are shown as Additional ASSUREDS are added to this Policy pursuant to the terms of this Policy as described in GENERAL POLICY DEFINITION 1.

Where Certificates of Insurance are requested for Additional ASSUREDS who do not fall within GENERAL POLICY DEFINITION 1, prior agreement of Underwriters and subsequent endorsement of this Policy is required

GENERAL POLICY DEFINITION 1. ASSURED is stated as follows -

1. ASSURED means not only the NAMED ASSURED as stated on the Declaration Page, but also includes any past, present or future: agencies, subsidiaries, affiliates, institutions and societies owned by or operated by the NAMED ASSURED, officials, members of boards or commissions, trustees, directors, officers, partners, volunteers, student teachers, or employees of the NAMED ASSURED while acting within the scope of their duties as such, and any person, organization, trustee or estate to whom the NAMED ASSURED is obligated by virtue of a written contract or agreement to provide insurance such as is offered by this policy, but only in respect of operations by or on behalf of the NAMED ASSURED.

GENERAL POLICY CONDITION 20. WAIVER OF SUBROGATION is stated as follows –

20. WAIVER OF SUBROGATION: This policy shall not be invalidated if the ASSURED, by written agreement, has waived or shall waive its right of recovery from any party for loss or damage covered hereunder; provided that any such waiver is made prior to the occurrence of said loss or damage.

MORTGAGORS, LOSS PAYEES & LENDER LOSS PAYEES:

It is understood and agreed that GENERAL POLICY CONDITION 12. of this policy is deleted and replaced with the following:

12. MORTGAGORS, CREDITORS & LOSS PAYEES: Where required by written contract, the interest of any mortgagor, creditor or loss payee on property covered by this policy is included as if a separate endorsement were attached hereto to the extent of the amount of mortgage, loan or interest in property held by the ASSURED as of the date of loss subject to the limits of liability set forth in this policy.

NAMED ASSURED: The Roman Catholic Church of The Diocese of Tucson (as more fully defined in Endorsement 1)

PRIMARY NON-CONTRIBUTORY:

It is also agreed that, only where required by written contract between the NAMED ASSURED and the Certificate holder, this insurance shall be considered primary to any insurance held by the Certificate holder and theirs shall be excess.

MUNICIPALITY PERMITS:

Further, where required by written contract or evidenced in the insurance requirements of a permit issued by a municipality at the request of the NAMED ASSURED, that municipality shall be added to this policy as an Additional ASSURED but only as respects liabilities arising out of the subject matter of the written contract or issued permit and then only for liabilities arising from actions by or on behalf of the NAMED

ASSURED.

EXCEPT AS AMENDED IN THIS ENDORSEMENT, THIS INSURANCE IS SUBJECT TO ALL

COVERAGE TERMS, CLAUSES, AND CONDITIONS IN THE POLICY TO WHICH THIS

ENDORSEMENT IS ATTACHED.

NAMED INSURED: The Roman Catholic Church of The Diocese of Tucson (as more fully defined in Endorsement 1)

Endorsement Number 27

It is hereby understood and agreed that Endorsement Number 26 ADDITIONAL ASSURED ENDORSEMENT – (ADES) is deleted in its entirety and replaced with the following:

ADDITIONAL ASSURED AMENDATORY

It is hereby understood and agreed that the following entity is added as an additional ASSURED with respect to liability arising out of the activities performed by or on behalf of the Catholic Community Services of Southern Arizona for coverage under COVERAGE SECTION II GENERAL LIABILITY and COVERAGE SECTION III AUTOMOBILE LIABILITY but only as respects liability for BODILY INJURY, PERSONAL INJURY or PROPERTY DAMAGE, caused in whole or in part by the NAMED ASSURED arising out of the various projects as specified in written contract or written agreement. The Underwriters will indemnify the Additional ASSURED for sums, as more fully defined by the term ULTIMATE NET LOSS not to exceed the SPECIFIC EXCESS LIMITS OF INSURANCE or minimum limit of insurance required by the contract or agreement, whichever is less. This endorsement shall not increase the applicable SPECIFIC EXCESS LIMIT OF INSURANCE and Annual Aggregate stated in the SCHEDULE OF SPECIFIC EXCESS LIMITS OF INSURANCE. Any claim arising out of the sole negligence of the Additional ASSURED is excluded under this Policy.

Additional ASSURED:

The State of Arizona, Department of Economic Security The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor.

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds with respect to liability arising out of the activities performed by, or on behalf of, the Contractor involving automobiles owned, hired and/or non-owned by the Contractor.

1789 W. Jefferson Street, Mail Drop 6271 Phoenix, AZ 85007

All rights of subrogation under the insurance policy listed above have been waived against The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor.

EXCEPT AS AMENDED IN THIS ENDORSEMENT, THIS INSURANCE IS SUBJECT TO ALL

COVERAGE TERMS, CLAUSES, AND CONDI ITIONS IN THE POLICY TO WHICH THIS

NAMED INSURED: The Roman Catholic Church of The Diocese of Tucson (as more fully defined in Endorsement 1)

ENDORSEMENT IS ATTACHED.

00 ML0207 00 11 03 Page 1 of 1

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

This endorsement modifies insurance provided under the following:

EXCESS WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY

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 below. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.

SCHEDULE

The State of Arizona, Department of Economic Security

The State of Arizona, and its Departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor.

Address:

1789 W. Jefferson Street, Mail Drop 6271 Phoenix, AZ 85007

All other terms and conditions of this Policy remain unchanged.

Issued By: Arch Insurance Company

Endorsement Number: 7

Policy Number: WCX 0068135 01

Named Insured: Roman Catholic Church Diocese of Tucson

This endorsement is effective on the inception date of this Policy unless otherwise stated herein:

Endorsement Effective Date: July 1, 2023

President