ACCEPTED_ANY_ALL_GL_AL_WC_10.24.24-10.25.25.pdf

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

INSR ADDL SUBR

LTR INSD WVD

PRODUCER

CONTACT

NAME:

FAXPHONE

(A/C, No):(A/C, No, Ext):

E-MAIL

ADDRESS:

INSURER A :

INSURED INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

POLICY NUMBER

POLICY EFF POLICY EXP

TYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)

AUTOMOBILE LIABILITY

UMBRELLA LIAB

EXCESS LIAB

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

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

AUTHORIZED REPRESENTATIVE

EACH OCCURRENCE $

DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

PRO-

POLICY LOC PRODUCTS - COMP/OP AGGJECT

OTHER: $

COMBINED SINGLE LIMIT

$(Ea accident)

ANY AUTO BODILY INJURY (Per person) $

OWNED SCHEDULED

BODILY INJURY (Per accident) $AUTOS ONLY AUTOS

HIRED NON-OWNED PROPERTY DAMAGE

$AUTOS ONLY AUTOS ONLY (Per accident)

OCCUR EACH OCCURRENCE

CLAIMS-MADE AGGREGATE $

DED RETENTION $

PER OTH-

STATUTE ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE $

If yes, describe under

E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below

INSURER(S) AFFORDING COVERAGE NAIC #

COMMERCIAL GENERAL LIABILITY

Y / N

N / A (Mandatory in NH)

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

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.

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.

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).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

CERTIFICATE HOLDER CANCELLATION

© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

The ACORD name and logo are registered marks of ACORD

6/18/2025

(480) 237-2050 (480) 320-4516

24228

Ace Surface Maintenance LLC 3418 N 29th Ave Phoenix, AZ 85017

A 2,000,000

X X 006455396 10/25/2024 10/25/2025 100,000

5,000

2,000,000

4,000,000

4,000,000

1,000,000A

X X 006455406 10/25/2024 10/25/2025

1,000,000A 006455425 10/25/2024 10/25/2025 1,000,000

10,000

A

X 006455423 10/25/2024 10/25/2025 1,000,000

1,000,000

1,000,000

A Inland Marine 006455396 10/25/2024 Scheduled Equipment 258,500

A Employment Practices 006455396 10/25/2024 10/25/2025 Aggregate Limit 100,000

ADOT Facilities Management & Support Group are additional insureds as required by written contract. A Waiver of Subrogation applies as required by written contract per the attached endorsement. Coverage is Primary non Contributory as required by written contract per the attached endorsement.

General Liability Policy# 006455396 Endorsement 0024-25 Pekin GL AI, PNC & WOS CG50 36 08 07 & 0024-25 Pekin General Liability Enhancement CG 5037 Auto Policy# 006455406 Endorsement 0024-25 Pekin Auto AI & WOS CA 3134 1018 Workers Compensation Policy# 006455423 Endorsement 0024-25 Pekin WC Blanket WOS WC 00 03 13 (04-84)

ADOT Facilities Management & Support Group 1655 W Jackson St, Rm 181, MD 129F Phoenix, AZ 85007

ACESURF-01 SJACKSON

Breinholt Insurance Group, LLC 4115 E. Valley Auto Drive #205 Mesa, AZ 85206 info@breinholtinsurance.com

Pekin Insurance Co.

X

10/25/2025

X

X

X

X

X

X

X

Cindy Lewis Accepted

FORM NUMBER:

EFFECTIVE DATE:

The ACORD name and logo are registered marks of ACORD

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE

FORM TITLE:

Page of

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

ACORD 101 (2008/01)

AGENCY CUSTOMER ID:

LOC #:

AGENCY NAMED INSURED

POLICY NUMBER

CARRIER NAIC CODE

© 2008 ACORD CORPORATION. All rights reserved.

Breinholt Insurance Group, LLC

ACESURF-01

SEE PAGE 1

SEE PAGE 1

ACORD 25 Certificate of Liability Insurance

SEE P 1

Ace Surface Maintenance LLC 3418 N 29th Ave Phoenix, AZ 85017

SEE PAGE 1

SJACKSON

Additional Coverages:

Crime - Blanket Employee Dishonesty $25,000 Limit

Umbrella Coverage Starstone National Insurance Policy# 86592C250ALI Effective 4/23/2025-10/25/2025 $4,000,000 each occurence/aggregate

Includes copyrighted material of Insurance Services Office, Inc., CA 31 34 10 18 with its permission. Page 7 of 7

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3. Unintentional Failure To Disclose Hazards

Under SECTION IV - BUSINESS AUTO CONDITIONS, B. General Conditions, 2.

Concealment, Misrepresentation, Or Fraud is amended by adding the following:

If you unintentionally fail to disclose any hazards existing at the inception date of this policy or coverage form, we will not deny coverage under this policy or coverage form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or nonrenewal.

The following change applies to SECTION V -

DEFINITIONS:

1. Broadened Bodily Injury Definition

Under SECTION V - DEFINITIONS, definition C.

"Bodily injury", is removed and replaced by:

C. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from physical bodily injury, physical sickness, or physical disease sustained by that person.

005008415

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

COMMERCIAL AUTO ENHANCEMENT ENDORSEMENT

N e w S C F o r m

Includes copyrighted material of Insurance Services Office, Inc., CA 31 34 10 18 with its permission. Page 1 of 7

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This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

Coverages provided by this endorsement are subject to the provisions applying to the Business Auto Coverage Form unless otherwise noted. All policy provisions not in conflict with this endorsement shall apply. This endorsement is a valid part of the policy only when the form number is shown in the Declarations. The policy's deductible provisions will apply unless otherwise noted.

The following changes apply to SECTION ll -

LIABILITY:

1. Broad Form Insureds

A. Newly Formed Or Acquired Organizations

The following is added as an "insured" under A.1. Who Is An Insured:

a. Any organization you newly form or acquire, other than:

(1) A partnership, joint venture, or limited liability company; or

(2) An organization excluded either by the provisions of this Business Auto Coverage Form, or by endorsement, and over which you maintain ownership or majority interest of more than 50%, subject to the following additional provisions:

b. This insurance does not apply to:

(1) Any newly formed or acquired organization that is an "insured" under any other automobile policy or would be an "insured" under such policy but for such automobile policy's termination or the exhaustion of such automobile policy's limits of insurance;

(2) "Bodily injury", "property damage" or "covered pollution cost or expense" resulting from an "accident" that occurred before you acquired or formed the organization.

c. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier.

B. Employees As Insureds

The following is added as an "insured" under A.1. Who Is An Insured:

a. 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. Employees As Insureds- Autos Hired In The Employees' Name

The following is added as an "insured" under A.1. Who Is An Insured:

a. An "employee" of yours is an "insured" while operating an "auto" hired or rented under a written contract executed prior to "loss" for which coverage is sought in that "employee's" name, with your permission, while performing duties related to the conduct of your business.

b. With respect to coverage afforded under this section of the endorsement, paragraph 5.b. of the Other Insurance Condition is removed and replaced by the following:

(1) For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own:

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

CA 31 34 10 18 with its permission. Page 2 of 7

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(b) Any covered "auto" hired or rented by your "employee" under a written contract in the "employee's" own name and executed prior to the "loss" for which coverage is sought, 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".

D. Additional Insured - When Required By Written Contract - Primary and Noncontributory

The following is added as an "insured" under A.1. Who Is An Insured:

a. Any person or organization is an "insured" for liability coverage as afforded under SECTION II - LIABILITY COVERAGE, when you and such person or organization have agreed in a written contract effective during the policy period stated on the Declarations Page (hereinafter referred to as the "Policy Period") and executed prior to the "bodily injury", "property damage" or "covered pollution cost or expense" for which coverage is sought, that you must add that person or organization as an additional "insured" on a policy of automobile liability insurance (hereinafter referred to as the "Additional Insured").

The "Additional Insured" is covered only with respect to vicarious liability for "bodily injury", "property damage" or "covered pollution cost or expense" resulting from your ownership, maintenance, or use of a covered "auto" during the "Policy Period".

b. It is further understood that the designation of any person or organization as an "Additional Insured" does not increase the scope or limits of coverage afforded by this policy.

c. C. Limits of Insurance is amended to include:

(1) The limits of insurance applicable to the "Additional Insured" are:

(a) those specified in the written contract that requires the person or organization to be added as an "Additional Insured"; or

(b) as stated on the Declarations Page of this policy, whichever is less.

These limits of insurance are inclusive of, and not in addition to the limits of insurance shown on the Declarations Page.

d. When required under a written contract with the "Additional Insured" which is executed prior to "bodily injury", "property damage" or "covered pollution cost or expense" for which coverage is sought by the "Additional Insured" hereunder, the coverage provided to the "Additional Insured" under this endorsement shall apply on a primary and noncontributory basis with any other insurance upon which the "Additional Insured" is listed as a Named Insured.

e. If an endorsement is attached to this coverage form or policy that specifically names a person or organization as an "insured" or additional "insured", then coverage under this endorsement does not apply to that entity.

2. Broadened Supplementary Payments

a. Under 2. Coverage Extensions, Paragraph 2.a.(2) of Supplementary Payments is removed and replaced by:

(2) Up to $5,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds.

b. Under 2. Coverage Extensions, Paragraph 2.a. (4) of Supplementary Payments is removed and replaced by:

(4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work.

CA 31 34 10 18 with its permission. Page 3 of 7

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3. Amended Fellow Employee Exclusion

a. Under B., Exclusions, 5. Fellow Employee exclusion is removed and replaced by:

5. Fellow Employee

"Bodily injury" to:

a. Any fellow "employee" of the "insured" arising out of and in the course of the fellow "employee's" employment or while performing duties related to the conduct of your business; or

b. The spouse, child, parent, brother or sister of the fellow "employee" as a consequence of Paragraph a.

above.

But this exclusion does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire.

The coverage provided under this section of the endorsement shall be excess over any other insurance, whether such other insurance is stated to be primary, contributory, excess, contingent or otherwise, unless such other insurance is written only as specific excess insurance over the Limits of Liability provided in this endorsement.

The following changes apply to SECTION Ill -

PHYSICAL DAMAGE COVERAGE:

1. Towing and Labor

Under SECTION Ill - PHYSICAL DAMAGE COVERAGE, 2. Towing is replaced by the following:

We will pay up to the following limits for towing and labor costs incurred each time a covered "auto" is disabled:

a. $100 for a covered "auto" rated and classified as a private passenger vehicle or "light truck".

b. $150 for a covered "auto" rated and classified as a "medium truck".

However, labor must be performed at the place of disablement.

c. With respect to this section of this endorsement, the following definitions are added under SECTION V - DEFINITIONS:

(1) "Light truck" means a truck or van that has a "gross vehicle weight" (GVW) of 10,000 pounds or less.

(2) "Medium truck" means a truck or van that has a "gross vehicle weight" (GVW) of 10,001-20,000 pounds.

(3) "Gross Vehicle Weight" (GVW) means the maximum loaded weight for which a single "auto" is designed, as specified by the manufacturer.

2. Broadened Transportation Expenses Including Limited Rental Reimbursement Coverage

Under 4. Coverage Extensions, a., Transportation Expenses is removed and replaced by:

a. Transportation Expenses

We will pay up to $75 per day to a maximum of $2,250 for necessary and actual temporary transportation expense incurred by you because of a "loss" to a covered "auto", but only if the covered "auto" carries the coverages and meets the requirements described in (1) or (2) below:

(1) We will pay the above temporary transportation expense because of the total theft of a covered "auto" if you carry Comprehensive Coverage on that covered "auto". We will only pay for such expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss".

(2) For "loss" other than the total theft of a covered "auto" if you carry Comprehensive Coverage on that covered "auto" or for a "loss" under Collision Coverage to that covered "auto", we will pay the above temporary transportation expense because of "loss" to that covered "auto" rendering the covered "auto" inoperable. We will only pay for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of:

(a) the number of days reasonably required to repair or replace the covered "auto"; or

(b) 30 days.

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

CA 31 34 10 18 with its permission. Page 4 of 7

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(4) The Broadened Transportation Expenses Coverage described above does not apply to a covered "auto" that is described or designated as a covered "auto" on Rental Reimbursement Coverage Endorsement CA9923 attached to this coverage form.

3. Accidental Discharge Of An Airbag

a. Under B., Exclusions, 3. is removed and replaced by:

3. We will not pay for "loss" due and confined to:

a. Wear and tear, freezing, mechanical or electrical breakdown. However, "loss" due to mechanical and electrical breakdown does not apply to the accidental discharge of an airbag.

Coverage for accidental discharge of an airbag is excess over any other collectable insurance or warranty.

b. Blowouts, punctures or other road damage to tires.

This exclusion does not apply to such "loss" resulting from the total theft of a covered "auto".

4. Audio, Visual And Data Electronic Equipment Increased Limit

a. Under C. Limit Of Insurance, 2. is removed and replaced by:

2. $1,500 is the most we will pay for "loss" in any one "accident" to all electronic equipment that reproduces, receives or transmits audio, visual or data signals which, at the time of "loss", is:

a. Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment;

b. Removable from a permanently installed housing unit as described in Paragraph 2.a. above; or

c. An integral part of such equipment as described in Paragraphs 2.a.

and 2.b. above.

d. The Audio, Visual And Data Electronic Equipment Increased Limit Coverage described above does not apply to a covered "auto" that is described or designated as a covered "auto" on Audio, Vlsual And Data Electronlc Equipment Coverage Added Limits Endorsement CA9960 or Loss Payable Clause - Audio, Visual And Data Electronic Equipment Coverage Added Limits Endorsement CA9961 attached to this policy or coverage form.

5. Glass Repair - Waiver Of Deductible

a. Under Paragraph D. Deductible, for "loss" covered under SECTION Ill - PHYSICAL DAMAGE COVERAGE, the following is added:

No deductible applies to glass damage otherwise covered under SECTION Ill - PHYSICAL DAMAGE COVERAGE, if the glass is repaired rather than replaced.

6. Collision Deductible Amendment For Loss To Two (or More) Covered Autos In One Accident

a. If a Collision "loss" from one "accident" involves two or more covered "autos" under this policy or coverage form, only the highest deductible applicable to those coverages will be applied to the "loss" , if the cause of "loss" is covered for those vehicles. This provision only applies if you carry Collision Coverage for those vehicles, and does not extend coverage to any covered "autos" for which you do not carry such coverage.

7. Hired Auto Physical Damage Coverage (Limited)

Under Paragraph A. Coverage of SECTION Ill - PHYSICAL DAMAGE COVERAGE, the following is added:

CA 31 34 10 18 with its permission. Page 5 of 7

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a. If hired "autos" are covered "autos" for Liability Coverage in this policy or coverage form and if Comprehensive or Collision coverages are provided under this policy or coverage form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire subject to the following additional provisions:

(1) The most we will pay for "loss" to any hired "auto" is:

(a) The actual cash value of the damaged or stolen property at the time of the "loss" ;

(b) The cost of repairing or replacing the damaged or stolen property, with other property of like kind or quality; or

(c) $75,000 whichever is smallest, minus a deductible.

(2) The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning.

(3) Hired Auto Physical Damage Coverage is excess over any other collectible insurance.

(4) Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own scheduled in the Declarations under this policy or coverage part.

(5) This extension of coverage does not apply to:

(a) Any "auto" you hire or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households; or

(b) Any "auto" you hire or borrow:

(i) For a period of more than 30 days; or

(ii) With a driver.

b. For any "auto" which is a covered "auto" under this extension, 7. Hired Auto Physical Damage Coverage (Limited), and subject to the coverages provided to 7.a.

above, we will also pay expenses for loss of use of such "auto", subject to the following additional provisions:

(1) Such "auto" is rented or hired under a written rental contract or agreement executed prior to "loss" of such "auto" for which coverage is sought;

(2) Such loss of use is a direct consequence of a "loss" covered under this extension, 7. Hired Auto Physical Damage Coverage (Limited):

(a) For which an "insured" is legally responsible; and

(b) As a result of which the rental agency sustains a monetary "loss";

(3) The most we will pay for any expenses for loss of use is $50 per day, subject to a maximum of $1,500; and

(4) With respect to coverage afforded by this section of the endorsement, Paragraph b. Loss Of Use Expenses of Paragraph 4. Coverage Extensions in SECTION Ill - PHYSICAL DAMAGE COVERAGE does not apply.

Coverage under this extension, 7. Hired Auto Physical Damage Coverage (Limited) will be excess over any other valid and collectible insurance available to the "insured", except that no coverage will be afforded if any physical damage coverage is provided for hired or borrowed "autos" under

ITEM FOUR - SCHEDULE OF HIRED OR

BORROWED COVERED AUTO COVERAGE

AND PREMIUMS in the BUSINESS AUTO DECLARATIONS in this policy or coverage form (or which would have been provided except for the application of an exclusion).

8. Loan Or Lease GAP Coverage

Under SECTION Ill - PHYSICAL DAMAGE COVERAGE, the following is added under 4.

Coverage Extensions:

CA 31 34 10 18 with its permission. Page 6 of 7

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a. In the event of a "total loss" to a covered "auto" which is either owned by you or is leased by you for a period of 6 consecutive months or longer, we will pay any unpaid amount due on the original lease or loan for a covered "auto" which carries Comprehensive and Collision Coverage on the Business Auto Coverage form to which this endorsement attaches. The amount payable will be reduced by:

(1) The amount paid under SECTION Ill - PHYSICAL DAMAGE COVERAGE of the policy; and

(2) Any:

(a) Overdue lease/loan payments at the time of the "loss";

(b) Deductibles applicable under SECTION Ill - PHYSICAL

DAMAGE COVERAGE;

(c) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage;

(d) Security deposits not refunded by the lessor;

(e) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease;

and

(f) Carry-over balances from previous loans or leases.

b. With respect to this section of the endorsement, the following definition is added under SECTION V - DEFINITIONS:

"Total loss" means a "loss" in which the cost of repair plus the salvage value exceeds the actual cash value.

c. This Loan/Lease Gap Coverage extension shall only apply when the Auto Loan/Lease GAP Coverage Endorsement CA2071 is not included in or a part of this policy issued to you by us.

The following changes apply to SECTION IV -

BUSINESS AUTO CONDITIONS:

1. Broadened Knowledge Of Accident, Claim, Suit Or Loss

Under SECTION IV - BUSINESS AUTO CONDITIONS, Paragraph 2.a. of Duties In The Event Of Accident, Claim, Suit Or Loss is removed and replaced by:

a. In the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of the "accident" or "loss".

Include:

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

(2) The "insured's" name and address; and

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

This condition 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;

(3) An executive officer or the "employee" designated by you to give such notice, if you are a corporation; or

(4) A member or manager, if you are a limited liability company.

2. Waiver Of Transfer Of Rights Of Recovery Against Others To Us When Required By Written Contract

Under SECTION IV - BUSINESS AUTO CONDITIONS, the following is added under A.

Loss Conditions, 5. Transfer Of Rights Of Recovery Against Others To Us:

However, we waive the right of recovery we may have against any person or organization because of payment we make for "bodily injury" , "property damage" or "covered pollution cost or expense" arising out of the ownership, maintenance or use of a covered "auto" when you and such person or organization have agreed in a written contract executed prior to the "bodily injury", "property damage" or "covered pollution cost or expense" "loss" to waive your right of recovery against such person or organization.

This waiver applies only to such person or organization designated in such written contract executed prior to the "bodily injury", "property damage" or "covered pollution cost or expense" "loss" for which you have agreed to waive your right of recovery.

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