ACCEPTED_ANY_ALL_GL_AL_WC_CONTRACTORS_POLL_01.30.25-01.16.26.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

TONYS-5 OP ID: TG

01/22/2025

SMS Risk Management CDS Insurance Agency LLC 42104 N Venture Dr. Ste C126 Anthem, AZ 85086 SMS Risk Management

602-996-5000 602-996-3756 shanes@cdsinsuranceagency.com

*Pekin Insurance *Main Street America Group

Tony's Lawn Management LLC 170 S California St Chandler, AZ 85225

Service American Indemnity Ironshore Specialty Ins Co

A X 1,000,000

X X X 006062538 01/16/2025 01/16/2026 100,000

5,000

1,000,000

2,000,000

X 2,000,000

1,000,000B

X X X B1P2855R 01/16/2025 01/16/2026

XA

X 006408829 01/16/2025 01/16/2026 1,000,000

1,000,000

1,000,000

D ICELLUW00161988 01/30/2025 01/30/2026 Per Claim 1,000,000

Aggegrate 2,000,000

Arizona Department of Transportation Maintenance is an additional insured with a waiver of subrogation in their favor and on a primary non-contributory basis as per written contract.

Arizona Department of Transportation Maintenance Permits Service 1324 N 22nd Ave Phoenix, AZ 85009

602-996-5000

24228 13026 39152 25445

Pollution Liab

ACCEPTED

ADOT Risk Management

POLICY NUMBER: B1P2855R COMMERCIAL AUTOMOBILE

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

64 K290 0418 Includes Copyrighted materials by © ISO Properties, Inc. Page 1 of 7

COMMERCIAL AUTOMOBILE ELITE PLUS ENDORSEMENT

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement.

1. BROAD FORM INSURED

A. Subsidiaries and Newly Acquired or Formed Organizations

The Named Insured shown in the Declarations is amended to include:

(1) Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary:

(a) That is an "insured" under any other automobile policy or

(b) That would be an "insured" under such a policy but for (i) its termination or (ii) the exhaustion of its Limit of Insurance.

(2) Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization:

(a) That is a partnership, joint venture or limited liability company,

(b) That is an "insured" under any other policy,

(c) That has exhausted its Limit of Insurance under any other policy, or

(d) 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation.

Coverage does not apply to "bodily injury" or "property damage" that results from an "accident" that occurred before you formed or acquired the organization.

B. Employees as Insureds

Paragraph A.1. - WHO IS AN INSURED

OF SECTION II - LIABILITY COVERAGE

is amended to add:

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

C. Lessors as Insureds

Paragraph A.1 - WHO IS AN INSURED OF SECTION II - LIABILITY COVERAGE is amended to add:

e. The lessor of a covered "auto" while the "auto" is leased to you under a written agreement if:

(1) The agreement requires you to provide direct primary insurance for the lessor and

(2) The "auto" is leased without a driver. Such a leased "auto" will be considered a covered "auto" you own and not a covered "auto" you hire.

2. ADDITIONAL INSURED BY CONTRACT,

PERMIT OR AGREEMENT

The following is added to A.1 WHO IS AN

INSURED OF SECTION II - LIABILITY

COVERAGE:

Any person or organization for whom you are required to name as an additional insured in a written contract or agreement that is executed or signed by you prior to a “bodily injury” or “property damage” occurrence is an “insured” for liability coverage, but only to the extent that person or organization qualifies as an “insured” under the Who Is An Insured provision contained in Section II of the coverage form.

If specifically required by the written contract or agreement referenced in the paragraph above, any coverage provided by this endorsement to an additional insured shall be primary and any

INSURED COPY

64 K290 0418 Includes Copyrighted materials by © ISO Properties, Inc. Page 2 of 7 other valid and collectible insurance available to the additional insured shall be non-contributory with this insurance. If the written contract does not require this coverage to be primary and the additional insured’s coverage to be non-contributory, then this insurance will be excess over any other valid and collectible insurance available to the additional insured.

3. AUTOS RENTED BY EMPLOYEES

Any "auto" hired or rented by your "employee" on your behalf and at your direction will be considered an "auto" you hire.

The OTHER INSURANCE Condition is amended by adding the following:

If an "employee's" personal insurance also applies on an excess basis to a covered "auto" hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the "employee's" personal insurance.

4. AMENDED FELLOW EMPLOYEE EXCLUSION

EXCLUSION 5. - FELLOW EMPLOYEE OF

SECTION II - LIABILITY COVERAGE does not apply if you have workers' compensation insurance in-force covering all of your "employees".

Coverage is excess over any other collectible insurance.

5. HIRED AUTO PHYSICAL DAMAGE

COVERAGE

If hired "autos" are covered "autos" for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form for any "auto" you own, then the Physical Damage coverages provided are extended to "autos" you hire or borrow, subject to the following limit. The most we will pay for "loss" to any hired "auto" is:

(1) $50,000;

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

(3) The cost of repairing or replacing the damaged or stolen property, whichever is smallest, minus a deductible.

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. Hired Auto Physical Damage coverage is excess over any other collectible insurance.

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.

We will also cover loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss, subject to a maximum of $1,000 per "accident".

This extension of coverage does not apply to 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.

6. PHYSICAL DAMAGE – ADDITIONAL

TEMPORARY TRANSPORTATION EXPENSE

COVERAGE

Paragraph A.4.a. OF SECTION III – PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $75 per day and a maximum limit of $2,250.

7. EXTRA EXPENSE – BROADENED

COVERAGE

Under paragraph A. OF SECTION III – PHYSICAL DAMAGE COVERAGE, the following Coverage is added:

We will pay for the expense of returning a stolen covered “auto” to you subject to Paragraph C.

Limit of Insurance.

8. LOAN/LEASE GAP COVERAGE

Under SECTION III - PHYSICAL DAMAGE COVERAGE, if a long-term leased or financed “auto" is a covered "auto", we will pay in the event of a total "loss" your additional legal obligation to the lessor or loss payee for any difference between the actual cash value of the "auto" at the time of the "loss" and the "outstanding balance" of the lease.

"Outstanding balance" means the amount you owe on the lease at the time of "loss" less any amounts representing taxes; overdue payments;

penalties, interest or charges resulting from overdue payments; additional mileage charges;

64 K290 0418 Includes Copyrighted materials by © ISO Properties, Inc. Page 3 of 7 excess wear and tear charges; lease termination fees.

9. AIRBAG COVERAGE

Under Paragraph B. Exclusions of SECTION III

- PHYSICAL DAMAGE COVERAGE, the following is added:

The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an air bag.

10. AMENDED DUTIES IN THE EVENT OF

ACCIDENT, CLAIM, SUIT, OR LOSS

The requirement in LOSS CONDITIONS 2.a –

DUTIES IN THE EVENT OF ACCIDENT,

CLAIM, SUIT, OR LOSS – of SECTION IV – BUSINESS AUTO CONDITIONS that you must notify us of an “accident” applies only when the “accident” is known to:

(1) You, if you are an individual

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

(3) A member, if you are a limited liability company; or

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

11. UNINTENTIONAL FAILURE TO DISCLOSE

HAZARDS

If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure.

12. WAIVER OF SUBROGATION

Transfer Of Rights Of Recovery Against Others To Us of SECTION IV – BUSINESS AUTO CONDITIONS is amended by adding the following:

We waive any right of recovery we may have against any person or organization to or for whom we make payment and with whom you have a written contract that requires such waiver because of payments we make for damages under this Coverage Form.

13. RESULTANT MENTAL ANGUISH COVERAGE

The definition of “bodily injury” in SECTION V – DEFINITIONS is replaced by the following:

“Bodily injury” means bodily injury, sickness, or disease sustained by any person, including mental anguish or death resulting from any of these.

14. GLASS REPAIR – WAIVER OF DEDUCTIBLE

Under paragraph D. Deductible of SECTION III

– PHYSICAL DAMAGE COVERAGE, the following is added:

No deductible applies to glass damage if the glass is repaired rather than replaced.

15. NOTICE OF CANCELLATION TO THIRD

PARTY

The following is added to A.2., Cancellation of

COMMON POLICY CONDITIONS

If we initiate a cancellation or non-renewal for any reason, other than non-payment of premium, we will mail notice of cancellation to the person or organization scheduled on the policy as an additional insured 30 days before the effective date of cancellation. We will mail such notice to the address of the Additional Insured scheduled on the policy and in at least 30 days before the effective date of the cancellation or non-renewal.

If the Insured initiates the cancellation or in case of non-payment of premium, we will not mail advance notice but, a final cancellation notice will be sent to the person or organization scheduled on the policy as an additional insured.

We will mail such notice to the additional insured address upon final cancellation of the policy.

16. VEHICLE WRAP COVERAGE

Paragraph A. Coverage of Section III – PHYSICAL DAMAGE COVERAGE is amended to include the following additional paragraph:

Vehicle Wrap

In the event of a “loss” to a covered “auto”, we will provide the following coverage if such “loss” is caused by:

a. Other than collision only if the Declarations indicates that comprehensive Coverage is provided for the covered “auto”;

b. Specified Causes of Loss only if the Decla-rations indicates that Specified Causes Of Loss Coverage is provided for the covered “auto”; or

c. Collision only if the Declarations indicates that Collision Coverage is provided for the covered “auto”.

We will pay for “loss” to a “vehicle wrap” that is installed on the covered “auto”. The most we will pay for “loss” is $5,000 per policy period.

We will not pay for “loss” due to and confined to wear and tear; or damage to paint or the vehicle caused by faulty installation of a “vehicle wrap”.

64 K290 0418 Includes Copyrighted materials by © ISO Properties, Inc. Page 4 of 7

The “vehicle wrap” is subject to the Comprehen-sive deductible for the covered “auto”, except in the event of a “loss” to a covered “auto” for which such vehicle is involved in a collision and there is both:

(1) Collision damage to the vehicle; and

(2) Damage to the “vehicle wrap”

Then the collision deductible will apply.

If the “vehicle wrap” is damaged in a collision the lesser of replacement cost or original purchase cost of the “vehicle wrap” will apply.

SECTION V. DEFINITIONS is amended to in-clude the following additional definition.

“Vehicle Wrap” means self-adhesive vinyl decals or sheets applied to the exterior body or window of a covered “auto”. Signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps.

17. GARAGEKEEPERS

The most current version of endorsement CA 99 37 that is approved in your state is added to the policy on an Excess insurance basis with a maximum limit of $10,000 and a $500 deductible for each Customer’s Auto for all perils. The limit is applicable on a blanket basis to all Insured owned locations.

18. ORIGINAL EQUIPMENT MANUFACTURER

REPLACEMENT PARTS

SECTION III – PHYSICAL DAMAGE

COVERAGE, C. Limit of Insurance, Paragraph

1. Is amended to include:

However, if the covered “auto” has less than 36,000 miles on its odometer, then the following condition will apply:

We will pay the cost to replace the damaged parts (excluding glass and mechanical parts) with new Original Equipment Manufacturer replacement parts if the damaged parts cannot be repaired.

19. FIRE DEPARTMENT SURCHARGE

Paragraph A.4. Coverage Extensions of

SECTION III – PHYSICAL DAMAGE

COVERAGE is amended by adding the following:

c. Fire Department Service Charge

When a fire department is called to save or protect a covered “auto”, its equipment, its contents, or occupants from a covered cause of loss, we will pay up to $1,500 for your liability for fire department service charges:

(1) Assumed by contract or agreement prior to loss; or

(2) Required by local ordinance

No deductible applies to this additional coverage.

20. LOSS OF USE TO RENTAL CAR

Paragraph A.4. Coverage Extensions of

SECTION III – PHYSICAL DAMAGE

COVERAGE is amended to add the following:

d. Rental Expense

We will pay the following expenses that you or any of your “employees” are legally obligated to pay because of a written contract or agreement entered into for use of a rental vehicle in the conduct of your business:

MAXIMUM WE WILL PAY FOR ANY ONE

CONTRACT OR AGREEMENT:

1. $1,000 for loss of income incurred by the rental agency during the period of time that vehicle is out of use because of actual damage to, or “loss” of, that vehicle, including income lost due to absence of that vehicle for use as a replacement;

2. $500 for administrative expenses incurred by the rental agency, as stated in the contract or agreement

21. EXTENDED COVERAGE – BAIL BONDS

Paragraph A.2.a. (2) of SECTION II – LIABILITY COVERAGE is replaced by the following:

(2) Up to $3,000 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

22. EXTENDED COVERAGE – LOSS OF

EARNINGS

Paragraph A.2.a. (4) of SECTION II – LIABILITY COVERAGE is replaced by the following:

(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.

64 K290 0418 Includes Copyrighted materials by © ISO Properties, Inc. Page 5 of 7

23. LOCKOUT REIMBURSEMENT COVERAGE

We will reimburse up to $75 per occurrence to cover your actual expenses incurred when a locksmith must be called:

(1) To open a covered “auto” because the keys are locked inside the auto; or

(2) To make a key for a covered “auto” because the key has been lost or stolen.

No deductible applies

24. NON-OWNED TRAILER – INCREASED LOAD

CAPACITY

The following is added to C. of SECTION I –

COVERED AUTOS:

Non-owned “trailers” with a load capacity of 5,000 pounds or less designed primarily for travel on public roads

25. EXTENDED COVERAGE – BUSINESS

PERSONAL PROPERTY AND PERSONAL

EFFECTS

Paragraph A.4 of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the following:

Physical Damage Coverage on a covered “auto” may be extended to “loss” to your “business personal property” or “personal effects”, not otherwise covered in the policy or, if you are an indvidual, the personal property of a family member, that is in the covered “auto” at the time of “loss”. The most we will pay for any one “loss” under this coverage extension is $500.

SECTION V - DEFINITIONS is amended by adding the following:

“Business Personal Property” and “Personal Effects” means tangible property that is worn or carried by an “insured”. It does not include tools, jewelry, money or securities.

26. RENTAL REIMBURSEMENT COVERAGE

SECTION III – PHYSICAL DAMAGE

COVERAGE is amended by the addition of the following:

(1) We will pay for rental reimbursement expenses incurred by you for the rental of an “auto” because of “loss” to a covered “auto.” Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered “auto.” No deductibles apply to this coverage.

(2) We will pay only 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 the following number of days:

(a) The number of days reasonably required to repair or replace the covered “auto.” If “loss” is caused by theft, this number of days is added to the number of days it takes to locate the covered “auto” and return it to you; or

(b) 30 days.

(3) Our payment is limited to the lesser of the following amounts:

(a) Necessary and actual expenses incurred; or

(b) $50 per day.

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

(5) If “loss” results from the total theft of a covered “auto” of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the

PHYSICAL DAMAGE COVERAGE

EXTENSION.

If Rental Reimbursement Coverage is already on the policy at higher limits, then that coverage replaces, and is not added to, the coverage provided above.

27. TEMPORARY SUBSTITUTE PHYSICAL

DAMAGE

Paragraph C. of SECTION I – COVERED AUTOS is amended by the addition of the following:

If Physical Damage Coverage is provided by this Coverage Form, the following type of vehicle is also a covered “auto” for Physical Damage Coverage:

Any “auto” you do not own while used with the permission of its owner as a temporary substitute for a covered “auto” you own that is out of service because of its:

a. Breakdown

64 K290 0418 Includes Copyrighted materials by © ISO Properties, Inc. Page 6 of 7

b. Repair

c. Servicing

d. “Loss”; or

e. Destruction

28. TOWING AND LABOR COVERAGE

Paragraph A.2. of SECTION III – PHYSICAL DAMAGE COVERAGE is replaced by the following:

We will pay up to $200 for towing and labor costs incurred each time a covered “auto” of the private passenger type or a truck of less than 20,000 pounds gross vehicle weight is disabled.

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

29. NEW AUTO REPLACEMENT

In the event of a total loss to your “new” “auto” of the private passenger type or a truck of less than 10,000 pounds gross vehicle weight to which this coverage applies, as show in the Declarations, we will pay at your option:

1. The verifiable new “auto” purchase price of your damaged auto, not including any insurance or warranties purchased;

2. The purchase price, as negotiated by us, of a new “auto” of the same or similar make, model and equipment, not including any furnishing, parts or equipment not installed by the manufac-turer or manufacturer’s dealership;

This coverage is provided without deduction for depreciation.

CONDITIONS

“New” means an “auto” in which you are the original owner and the “auto” has not been previously titled.

Coverage under this endorsement shall be applicable:

1. for no more than 365 days from the date of purchase of the “auto” to which it applies, plus the remainder of the policy term in which the 365th day from purchase ends, and;

2. When the “auto” has less than 15,000 miles

All other provisions of this policy apply.

30. DRIVE OTHER CAR FOR EXECUTIVE

OFFICERS

A. This endorsement changes only those coverages where a premium is shown in the Schedule.

B. Changes In Covered Autos Liability Coverage

Any “auto” you do not own, hire or borrow is a covered “auto” for Liability Coverage while being used by any of your “executive officers”, except:

a. Any “auto” owned by that “executive officer” or any “family member”, or

b. Any “auto” used by that “executive officer” while working in a business of selling, servicing, repairing or parking “autos”.

C. Changes In Auto Medical Payments and Uninsured and Underinsured Motorists Coverage

The following is added to Who Is An Insured:

Any “executive officer” is “insured” while “occupying” or while a pedestrian when being struck by any “auto” you do not own except:

Any “auto” owned by that “executive” or by any “family member”.

D. Changes In Physical Damage Coverage Any private passenger type “auto” you do not own, hire or borrow is a covered “auto” while in the care, custody or control of any of your “executive officers” except:

(1) Any “auto” owned by that “executive officer” or any “family member”.

(2) Any “auto” owned by that “executive officer” while working in a business of selling, servicing, repairing or parking “autos”.

E. Additional Definitions:

As used in this endorsement:

“Executive officer” means a person holding any of the officer positions created by your charter, constitution, by-laws or any other similar governing document, and that person’s spouse, while a resident of the same household.

“Family member” means a person related to the “executive officer” by blood, marriage or adoption who is a resident of the “executive officer’s” household including a ward or foster child.

F. The Insurance provided under this provision will be:

64 K290 0418 Includes Copyrighted materials by © ISO Properties, Inc. Page 7 of 7

Equal to the broadest of those coverages afforded any covered “auto”, and Excess over any other collectible insurance.

IRONSHORE SPECIALTY INSURANCE COMPANY

175 Berkeley Street

Boston, MA 02116

Toll Free: (877) IRON411

Endorsement # 5

Policy Number: Effective Date of Endorsement:

Insured Name:

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED – DESIGNATED ENTITY

PRIMARY AND NON-CONTRIBUTORY

This endorsement modifies insurance provided under the following:

CONTRACTORS ENVIRONMENTAL LEGAL LIABILITY (CELL)

It is hereby agreed that the policy to which this Endorsement is attached is amended as follows:

SCHEDULE:

Designated Person(s) or Organization(s)

Any person or organization where required by written contract or agreement executed prior to loss

A. SECTION II – WHO IS AN INSURED is amended to specify the person or organization designated in the Schedule of this

Endorsement above as a person or organization you agree to include as an insured in a written contract, written agreement or permit, but only with respect to bodily injury, property damage or environmental damage arising out of your work.

B. SECTION IV – CONDITIONS, Condition 16. Other Insurance, Paragraph a. is amended to include the following:

With respect to other insurance issued to the person(s) or organization(s) designated in the Schedule of this

Endorsement, this insurance will be primary and we will not seek contributions from any such other insurance.

ALL OTHER TERMS, CONDITIONS AND EXCLUSIONS OF THIS POLICY REMAIN UNCHANGED.

IE.END.CELL.007 (0618)

ICELLUW00161988

Tony's Lawn Management LLC

January 30, 2025

IRONSHORE SPECIALTY INSURANCE COMPANY

175 Berkeley Street

Boston, MA 02116

Toll Free: (877) IRON411

Endorsement # 6

Policy Number: Effective Date of Endorsement:

Insured Name:

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

DESIGNATED ENTITY – WAIVER OF RIGHTS OF RECOVERY

This endorsement modifies insurance provided under the following:

CONTRACTORS ENVIRONMENTAL LEGAL LIABILITY (CELL)

It is hereby agreed that the policy to which this Endorsement is attached is amended as follows:

SCHEDULE:

Designated Person(s) Or Organization(s)

Any person or organization where required by written contract or agreement executed prior to loss

SECTION IV – CONDITIONS, Condition 21. Transfer of Rights of Recovery Against Others To Us, is amended to include the following as respects the designated person(s) or organization(s) indicated in the schedule above:

In the event of any payment under this policy, we waive our right of recovery against the person(s) or organization(s) indicated in the Schedule of this Endorsement and with whom the insured has waived its right of recovery prior to a loss.

ALL OTHER TERMS, CONDITIONS AND EXCLUSIONS OF THIS POLICY REMAIN UNCHANGED.

IE.END.CELL.009 (0618)

ICELLUW00161988

Tony's Lawn Management LLC January 30, 2025

N e w S C F o r m

006408829

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

WC 00 03 13 (04-84) Copyright 1983 National Council on Compensation Insurance. Page 1 of 1

2DGlyph

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 any one not named in the Schedule.

Schedule

Any person or organization for whom you are performing work when you and such person or organization have agreed in a written contract, executed prior to the accident or loss for which we make payment under this workers compensation policy, that you must add that person or organization under a Waiver Of Our Right To Recover From Others Endorsement on a policy of Workers Compensation insurance.

State: Arizona