ACCEPTED_ANY_ALL_GL_AL_WC_04.21.25-11.29.25.pdf

1001486 132849.14 04-13-2022

INSR

LTR TYPE OF INSURANCE

ADD

INSD

SUB

WVD POLICY NUMBER

POLICY EFF

(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY) LIMITS

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY

PRO-

JECT LOC

OTHER:

EACH OCCURRENCE $

DAMAGE TO RENTED

PREMISES (Ea occurrence) $

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GENERAL AGGREGATE $

PRODUCTS - COMP/OP AGG $

AUTOMOBILE LIABILITY

ANY AUTO

OWNED

AUTOS ONLY

SCHEDULED

AUTOS

HIRED

AUTOS ONLY

NON-OWNED

AUTOS ONLY

COMBINED SINGLE LIMIT

(Ea accident) $

BODILY INJURY (Per person) $

BODILY INJURY (Per accident) $

PROPERTY DAMAGE

(Per accident) $

UMBRELLA LIAB OCCUR

EXCESS LIAB CLAIMS-MADE

DED RETENTION $

EACH OCCURRENCE $

AGGREGATE $

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below

Y / N N / A

PER

STATUTE

OTH-

ER $

E.L. EACH ACCIDENT $

E.L. DISEASE - EA EMPLOYEE $

E.L. DISEASE - POLICY LIMIT $

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

CANCELLATION

E-MAIL

ADDRESS:

CONTACT

NAME:

PHONE

(A/C, No, Ext):

FAX

(A/C, No):

INSURER(S) AFFORDING COVERAGE NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

PRODUCER

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.

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.

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

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)

ACORD 25 (2016/03)

© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

AUTHORIZED REPRESENTATIVE

A Y Y 90-B1-P650-9 02/16/2025 02/16/2026

1,000,000 300,000 5,000 1,000,000 2,000,000 2,000,000

B Y Y

313 8788-D21-53D

313 8788-D21-53D

04/21/2025

10/21/2025

10/21/2025

04/21/2026 1,000,000 1,000,000

C N Y 90-J4-W327-8 11/29/2024 11/29/2025

1,000,000 1,000,000 thad.olive.xd9w@statefarm.com

Thad Olive 832-999-4292

State Farm Lloyds 43419

State Farm Mutual Automobile Insurance Company 25178

State Farm Fire and Casualty Company 25143

Thad Olive State Farm 1716 Dulles Avenue Ste 102

Sugar Land TX 774785389

TEST MASTERS EDUCATIONAL SERVICES INC

13100 SOUTHWEST FWY

SUGAR LAND TX 77478

10/08/2025

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

Phoenix AZ 85007

Insurance applies to any and all work performed for or on behalf of the State of Arizona / DOT Endorsement #4028A corresponds with policy 313 8788-D21-53D Endorsement #4196A corresponds with policy 313 8788-D21-53D

Completed by an authorized State Farm representative. If signature is required, please contact a State Farm agent.

Cindy Lewis Accepted

1. SECTION II — WHO IS AN INSURED of

SECTION II — LIABILITY is amended to in-clude, as an additional insured, any person or organization shown in the Schedule, but only with respect to liability for "bodily in-jury", "property damage", or "personal and advertising injury" caused, in whole or in part, by:

a. Ongoing Operations

(1) Your acts or omissions; or

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

in the performance of your ongoing opera-tions for that additional insured; or

Name And Address Of Additional Insured Person Or Organization:

STATE OF ARIZONA / ADOT

206 S 17TH AVE

PHOENIX, AZ 85007-3213

b. Products-Completed Operations

"Your work" performed for that additional insured and included in the "products-completed operations hazard".

2. Any insurance provided to the additional in-sured shall only apply with respect to a claim made or a "suit" brought for damages for which you are provided coverage.

3. Primary Insurance. The insurance afforded the additional insured shall be primary insur-ance. Any insurance carried by the additional insured shall be noncontributory with respect to coverage provided by you.

There will be no refund of premium in the event this endorsement is cancelled.

All other policy provisions apply.

CMP-4786

CMP-4786

CMP-4786 ADDITIONAL INSURED — OWNERS, LESSEES, OR CONTRACTORS

(Scheduled)

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY

SA Policy No. 90-B1-P650-9 2619-FB63

This endorsement modifies insurance provided under the following:

BUSINESSOWNERS COVERAGE FORM

SCHEDULE

Policy Number:

Named Insured:

TEST MASTERS EDUCATIONAL SERVICES INC

, Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission.

90-B1-P650-9

1006104 137713.1 10-23-2013

Name And Address Of Person Or Organization:

STATE OF ARIZONA / ADOT

206 S 17TH AVE

PHOENIX, AZ 85007-3213

The following is added to Paragraph 10.b. of SECTION I AND SECTION II — COMMON POLICY

CONDITIONS:

We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we make for injury or damage arising out of:

a. Your ongoing operations; or

b. "Your work" done under contract with that person or organization and included in the "products-completed operations hazard".

This waiver applies only to the person or organization shown in the Schedule.

All other policy provisions apply.

1006225 137715.1 11-19-2013

CMP-4787

CMP-4787

CMP-4787 WAIVER OF TRANSFER OF RIGHTS OR RECOVERY AGAINST

OTHERS TO US

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY

SA Policy No. 90-B1-P650-9 2619-FB63

This endorsement modifies insurance provided under the following:

BUSINESSOWNERS COVERAGE FORM

SCHEDULE

Policy Number:

Named Insured:

TEST MASTERS EDUCATIONAL SERVICES INC

, Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission.

90-B1-P650-9

Page 1 of 1 4028A ©, Copyright, State Farm Mutual Automobile Insurance Company, 2015

4028A ADDITIONAL INSURED (Prior Notice of Termination)

This endorsement is a part of the policy. Except for the changes this endorsement makes, all other provisions of the policy remain the same and apply to this endorsement.

1. A person or legal entity shown on the Declarations Page as an Additional Insured is provided Liability Coverage, but only to the extent that person or legal entity qualifies as an insured as defined in Liability Coverage.

2. An Additional Insured has the same right of recovery under Liability Coverage as if they had not been shown on the Declarations Page as an Additional Insured.

3. If Liability Coverage is changed or terminated as to the interest of the Additional Insured, we will provide the Additional Insured 10 days notice of such change or termination, unless another number of days notice is shown on the Declarations Page.

Page 1 of 1 4196A ©, Copyright, State Farm Mutual Automobile Insurance Company, 2015

4196A WAIVER OF SUBROGATION UNDER THE LIABILITY COVERAGE

This endorsement is a part of the policy. Except for the changes this endorsement makes, all other provisions of the policy remain the same and apply to this endorsement.

It is agreed that we have no right of subrogation under Liability Coverage against the person or legal entity whose name is shown immediately following the title of this endorsement on the Dec-larations Page to the extent that you have waived your legal right to recover from that person or legal entity pursuant to a written contract you had duly executed with that person or legal entity prior to the accident or loss.

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04

(Ed. 10-84)

TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the

Information Page.

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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us.

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

The premium for this endorsement is shown in the Schedule.

Schedule

1. Specific Waiver

Name of person or organization

Blanket Waiver

Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.

2. Operations:

3. Premium

The premium charge for this endorsement shall be _______ percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described.

4. Minimum Premium

5. Advance Premium

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.)

Endorsement Effective Policy No. Endorsement No.

Insured Premium $

Insurance Company Countersigned By ____________________________

WC 42 03 04

(Ed. 10-84)

THE STATE OF ARIZONA/ ADOT

State Farm Fire and Casualty Company

TEST MASTERS EDUCATIONAL

11-29-24 90 J4W327 8