2026-03-29 ACCEPTED GL,AL,WC,PROF LIAB.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

6/24/2025

Stuckey Insurance 2850 E Camelback Rd Suite 325 Phoenix AZ 85016

Abi Law 602-264-5533 abigail.law@stuckeyinsurance.com

RLI Insurance Company 13056 ACQUSCI-01 Hiscox Ins Company 10200

Acquisition Sciences, Ltd 11811 N Tatum Blvd, Ste 1060 Phoenix AZ 85028

Starstone Specialty Ins Co 44776

1007154796

A X 1,000,000 X 1,000,000

10,000

1,000,000

2,000,000 X

Y Y PEB0001473 3/29/2025 3/29/2026

2,000,000

A 1,000,000

X

X X

Y Y PEA0001009 3/29/2025 3/29/2026

A X 5,000,000 X

PEE0001014 3/29/2025 3/29/2026

5,000,000 X 10,000

A X

Y

Y PEW0001093 3/29/2025 3/29/2026

1,000,000

1,000,000

1,000,000 B C

Professional Liability E & O Excess

MPL1901515.25

MEO00084072P-03

3/29/2025 3/29/2025

3/29/2026 3/29/2026

Claim/Agg Claim/Agg

1M/1M 1M/1M

Professional Liability - Claims Made - Retro Date 3/29/93 Re: Contract No. CTR077497, Any and all work performed for or on behalf of the State of Arizona/ADOT The State of Arizona/ADOT is named an additional insured in respect to the general and auto liability policies on a primary and non-contributory basis. Waiver of subrogation applies in favor of the additional insureds. (30) days notice of cancellation shall be provided for all policies.

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

Cindy Lewis Accepted

Policy Number: RLI Insurance Company Named Insured:

PPB 304G 04 13 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

RLIPack® FOR PROFESSIONALS

BLANKET ADDITIONAL INSURED ENDORSEMENT

This endorsement modifies insurance provided under the following:

BUSINESSOWNERS COVERAGE FORM - SECTION II – LIABILITY

1. C. WHO IS AN INSURED is amended to include as an additional insured any person or organization that you agree in a contract or agreement requiring insurance to include as an additional insured on this policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by you or those acting on your behalf:

a. In the performance of your ongoing operations;

b. In connection with premises owned by or rented to you; or

c. In connection with “your work” and included within the “product-completed operations hazard”.

2. The insurance provided to the additional insured by this endorsement is limited as follows:

a. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this policy.

b. This insurance does not apply to the rendering of or failure to render any professional services.

c. This endorsement does not increase any of the limits of insurance stated in D. Liability And Medical Expenses Limits of Insurance.

3. The following is added to SECTION III H.2. Other Insurance – COMMON POLICY CONDITIONS

(BUT APPLICABLE ONLY TO SECTION II –

LIABILITY)

However, if you specifically agree in a contract or agreement that the insurance provided to an additional insured under this policy must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that:

a. The "bodily injury" or "property damage" for which coverage is sought occurs after you have entered into that contract or agreement; or

b. The "personal and advertising injury" for which coverage is sought arises out of an offense committed after you have entered into that contract or agreement.

4. The following is added to SECTION III K. 2.

Transfer of Rights of Recovery Against Others to Us – COMMON POLICY CONDITIONS (BUT

APPLICABLE TO ONLY TO SECTION II –

LIABILITY)

We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal and advertising injury" arising out of "your work" performed by you, or on your behalf, under a contract or agreement with that person or organization. We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered into by you before the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed.

ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.

Policy Number: RLI Insurance Company Named Insured:

PPA 300 03 13 Page 1 of 5

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

RLIPack® BUSINESS AUTO ENHANCEMENT

SCHEDULE OF COVERAGES ADDRESSED BY THIS ENDORSEMENT

A. Broad Form Named Insured

B. Employees As Insureds

C. Blanket Additional Insured

D. Blanket Waiver Of Subrogation

E. Employee Hired Autos

F. Fellow Employee Coverage

G. Auto Loan Lease Gap Coverage

H. Glass Repair Waiver Of Deductible

I. Personal Effects Coverage

J. Hired Auto Physical Damage Coverage

K. Hired Auto Physical Damage Loss Of Use

L. Hired Car Worldwide Coverage

M. Temporary Transportation Expenses

N. Amended Bodily Injury Definition Mental Anguish

O. Airbag Coverage

P. Amended Insured Contract Definition Railroad Easement

Q. Coverage Extensions Audio, Visual And Data Electronic Equipment Not Designed Solely For The Production Of Sound

R. Notice Of And Knowledge Of Occurrence

S. Unintentional Errors Or Omissions

T. Towing Coverage

PPA 300 03 13 Page 2 of 5

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

A. Broad Form Named Insured

The following is added to the SECTION II COVERED AUTOS LIABILITY COVERAGE, Para-graph A.1. Who Is An Insured Provision:

Any business entity newly acquired or formed by you during the policy period, provided you own fifty percent (50%) or more of the business entity and the business entity is not separately insured for Bus-iness Auto Coverage. Coverage is extended up to a maximum of one hundred eighty (180) days following the acquisition or formation of the business entity.

This provision does not apply to any person or organization for which coverage is excluded by endorsement.

B. Employees As Insureds

The following is added to the SECTION II COVERED AUTOS LIABILITY COVERAGE, Para-graph A.1. Who Is An Insured Provision:

Any employee of yours is an insured while using a covered auto you don't own, hire or borrow in your business or your personal affairs.

C. Blanket Additional Insured

The following is added to the SECTION II COVERED AUTOS LIABILITY COVERAGE, Para-graph A.1. Who Is An Insured Provision:

Any person or organization that you are required to include as an additional insured on this coverage form in a contract or agreement that is executed by you before the bodily injury or property damage occurs is an insured for liability coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an insured under the Who Is An Insured provision contained in SECTION II COVERED AUTOS

LIABILITY COVERAGE.

The insurance provided to the additional insured will be on a primary and non-contributory basis to the verage if you are required to do so in a contract or agreement that is executed by you before the bodily injury or property damage occurs.

D. Blanket Waiver Of Subrogation

The following is added to the SECTION IV BUSI- NESS AUTO CONDITIONS, A. Loss Conditions, 5.

Transfer Of Rights Of Recovery Against Others To Us:

We waive any right of recovery we may have against any person or organization to the extent required of you by a contract executed prior to any accident or loss , provided that the accident or loss arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract.

E. Employee Hired Autos

1. The following is added to the SECTION II

COVERED AUTOS LIABILITY COVERAGE,

Paragraph A.1. Who Is An Insured Provision:

An employee of yours is an insured while operating an auto hired or rented under a contract or agreement in that employee's name, with your permission, while performing duties related to the conduct of your business.

2. Changes In General Conditions:

Paragraph 5.b. of the Other Insurance Con-dition in the BUSINESS AUTO CONDITIONS is deleted and replaced with the following:

b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered autos you own:

(1) Any covered auto you lease, hire, rent or borrow; and

(2) Any covered auto hired or rented by your employee under a contract in that individual employee's name, with your permission, while performing duties related to the conduct of your business.

However, any auto that is leased, hired, rented or borrowed with a driver is not a covered auto .

F. Fellow Employee Coverage

SECTION II COVERED AUTOS LIABILITY

COVERAGE, Exclusion B.5. does not apply if you have workers compensation insurance in-force covering all of your employees.

G. Auto Loan Lease Gap Coverage

SECTION III PHYSICAL DAMAGE COVERAGE,

C. Limit Of Insurance, is amended by the addition of the following:

In the event of a total loss to a covered auto shown in the Schedule of Declarations, we will pay any unpaid amount due on the lease or loan for a covered auto , less:

1. The amount paid under the PHYSICAL DAMAGE COVERAGE section of the policy; and

2. Any:

a. Overdue lease/loan payments at the time of the loss ;

PPA 300 03 13 Page 3 of 5

b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage.

c. Security deposits not returned by the lessor;

d. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease;

and

e. Carry-over balances from previous loans or leases.

H. Glass Repair Waiver Of Deductible

SECTION III PHYSICAL DAMAGE COVERAGE,

D. Deductible is amended by adding the following:

No deductible for a covered auto will apply to glass damage if the glass is repaired rather than replaced.

I. Personal Effects Coverage

The following is added to SECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions:

c. Personal Effects Coverage

In the event of a total theft loss of your covered auto we will pay up to $400 for loss to wearing apparel and other personal effects which are:

(1) Owned by an insured ; and

(2) In or on your covered auto ;

No deductible applies to Personal Effects Coverage.

J. Hired Auto Physical Damage Coverage

The following is added to SECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions:

d. Hired Auto Physical Damage Coverage

If hired autos are covered autos for Liability Coverage and this policy also provides Physical Damage Coverage for an owned auto , then the Physical Damage Coverage is extended to autos that you hire, rent or borrow subject to the following:

(1) The most we will pay for loss in any one accident to a hired, rented or borrowed auto is the lesser of:

(a) $60,000

(b) The actual cash value of the damaged or stolen property as of the time of the loss ; or

(c) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality.

(2) An adjustment for depreciation and physical condition will be made in the event of a total loss .

(3) If a repair or replacement results in better than like kind or quality, we will not pay for the betterment.

(4) A deductible equal to the highest Physical Damage deductible applicable to any owned auto will apply.

(5) This Coverage Extension will not apply to:

(a) Any auto that is hired, rented or borrowed with a driver; or

(b) Any auto that is hired, rented or borrowed from your employee .

K. Hired Auto Physical Damage Loss Of Use

The following is added to SECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions:

e. We will pay sums which you legally must pay to the lessor of a covered auto which you have leased without a driver for thirty (30) days or less auto , provided:

(1) This insurance provides comprehensive, specified causes of loss or collision covered on the covered auto ;

(2) The loss of use results from the covered auto being damaged in an accident while you are leasing it.

We will pay up to a maximum limit of $1,500 for this covered extension.

L. Hired Car Worldwide Coverage

The following is added to SECTION II COVERED AUTOS LIABILITY COVERAGE, A.2. Coverage Extensions:

f. Hired Car Worldwide Coverage

(1) We will pay all sums an insured legally must pay as damages because of bodily injury or property damage to which this insurance applies, caused by an accident which occurs outside of the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada resulting from the maintenance, or use of any covered auto of the private passenger type you lease, hire, rent or borrow without a driver for thirty (30) days or less.

(2) With respect to any claim made or suit instituted outside the United States of America, the territories and possessions of the United States of America, Puerto Rico, and Canada:

PPA 300 03 13 Page 4 of 5

(a) You shall undertake the investigation, settlement and defense of such claims and suits and keep us advised of all proceedings and actions.

(b) You will not make any settlement without our consent.

(c) We will reimburse you:

(i) For the amount of damages be-cause of liability imposed upon you by law on account of bodily injury or property damage to which this insurance applies, and

(ii) For all reasonable expenses incurred with our consent in connection with the investigation, settlement or defense of such claims or suits Reimbursement for expenses will be part of the Limit of Insurance for liability coverage shown in the Business Auto Coverage Declarations, and not in addition to such limits.

(3) The limit of Insurance for Liability Coverage shown in the Business Auto Coverage Declarations is the most we will reimburse you for the sum of all damages imposed on you, as set forth in paragraph 2.c. above, and all expenses incurred by you arising out of any single accident or loss

(4) You must maintain the greater of the follow-ing primary auto liability insurance limits:

(a) Compulsory admitted insurance with limits required to be in force to satisfy the legal requirements of the jurisdiction where the accident occurs; or

(b) Insurance limits required by law and issued by a government entity or by an insurer licensed or permitted by law to do business in the jurisdiction where the accident occurs; or

(c) Auto liability insurance limits of at least $300,000 combined single limit or $100,000 per person/$300,000 per acci-dent Bodily Injury, $100,000 Property Damage.

If you fail to comply with the above, this insurance is not invalidated. However, in the event of a loss , we will pay only to the extent that we would have been liable had you so complied.

(5) The insurance provided by this coverage extension is excess over any other collec-tible insurance available to you whether on a primary, excess contingent or any other basis.

M. Temporary Transportation Expenses

SECTION III PHYSICAL DAMAGE COVERAGE,

A.4. Coverage Extensions, subparagraph a.

Transportation Expenses is deleted and replaced by the following:

a. Transportation Expenses

(1) We will pay up to a maximum of $1,500 for temporary transportation expense incurred by you because of Physical Damage to a covered auto .

(2) We will pay only for those covered autos for which you carry Comprehensive, Colli-sion or Specified Case of Loss Coverage.

(3) We will pay only for those expenses incurred by you during the period of time that begins twenty-four (24) hours after the covered loss and ends at the time when the covered auto can be reasonable repaired or replaced.

(4) This coverage does not apply while there are spare or reserve autos available to you for your operations.

N. Amended Bodily Injury Definition Mental Anguish

The following is added to SECTION V DEFINITIONS, Definition C.:

Bodily injury also includes mental anguish, but only when the mental anguish arises from other bodily injury, sickness or disease.

O. Airbag Coverage

The following is added to SECTION III PHYSICAL DAMAGE COVERAGE B. Exclusions 3.a.:

However, this exclusion will not apply to accidental discharge of an airbag due to mechanical or electrical breakdown.

P. Amended Insured Contract Definition Railroad Easement

SECTION V DEFINITIONS paragraph H. Insured contact is modified as follows:

1. Paragraph H.3. is replaced by the following:

3. Any easement or license agreement.

2. Paragraph H.6.a. is deleted.

Q. Coverage Extensions Audio, Visual And Data Electronic Equipment Not Designed Solely For The Production Of Sound

SECTION III PHYSICAL DAMAGE COVERAGE B.

Exclusions, exception paragraph a. to exclusion 4.c.

and 4.d. is deleted and replaced with the following:

PPA 300 03 13 Page 5 of 5

a. Equipment and accessories used with such equipment, except for tapes, records, discs or other electronic media device, provided such equipment is permanently installed in the covered auto at the time of the loss or is removable from the housing unit which is permanently installed in the covered auto at the time of the loss , and such equipment is designed to be solely operated by use of the power from the autos electrical system, in or upon the covered autos ; or

R. Notice Of And Knowledge Of Occurrence

SECTION IV BUSINESS AUTO CONDITIONS,

A.2. Duties In The Event Of Accident, Claim Suit Or Loss, subparagraph a. is deleted and replaced with the following:

a. In the event of accident , claim, suit or loss , you must give us or our authorized repre-sentative prompt notice of the accident or loss including:

(1) How, when and where the accident or loss occurred;

(2) The name and address; and

(3) To the extent possible, the names and addresses of any injured person and witnesses.

Your duty to give us or our authorized representative prompt notice of the accident or loss applies only when the accident or loss is known to:

(1) You, if you are an individual;

(2) A partner if you are a partnership; or

(3) An executive officer or insurance manager, if you are a corporation.

S. Unintentional Errors Or Omissions

SECTION IV BUSINESS AUTO CONDITIONS, B.

General Conditions; 2. Concealment Misrepre-sentation Or Fraud is amended by adding the following:

The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. However this pro-vision does not affect our right to collect additional premium or exercise our right of cancellation or nonrenewal.

T. Towing Coverage

SECTION III PHYSICAL DAMAGE COVERAGE,

A.2. Towing, is deleted and replaced by the following:

2. We will pay up to $750 for towing and labor costs incurred each time a covered auto is disabled due to a covered cause of loss. However:

a. All labor must be performed at the place of disablement; and

b. If the covered auto is a private passenger type no deductible applies; and

c. If the covered auto is not of the private passenger type our obligation to pay will be reduced by a $250 deductible per disablement.

ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.

1983 National Council on Compensation Insurance.

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

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

WC 00 03 13