ACCEPTED CTR060480 GL,AL,WC 01.01.24-01.01.25.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

1/22/2024

Arthur J. Gallagher Risk Management Services, LLC 220 Emerson Place Suite 200 Davenport IA 52801

Julie Brockert 563-316-3418 563-322-1046 julie_brockert@ajg.com

Charter Oak Fire Insurance Company 25615 Travelers Property Casualty Co of America 25674

Stanley Consultants, Inc.

225 Iowa Avenue Muscatine IA 52761

The Travelers Indemnity Company of CT 25682 Navigators Insurance Company 42307

1045267057

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

5,000

1,000,000

2,000,000 X

Y Y P-630-4885B479-COF-24 1/1/2024 1/1/2025

2,000,000

B 1,000,000

X

X X

Y Y 810-2L649784-24-43-G 1/1/2024 1/1/2025

B X X 15,000,000CUP-9S313559-24-NF 1/1/2024 1/1/2025

15,000,000

C X

N

Y UB-8J736329-24-43-G 1/1/2024 1/1/2025

1,000,000

1,000,000

1,000,000 D Excess Liability CH24EXRZ0G0YAIV 1/1/2024 1/1/2025 Each Occ

Aggregate $5,000,000 $5,000,000

RE: SCI # R0004.22.19 – ADOT Multi Modal Planning, ADOT BPM004111 The State of Arizona or ADOT, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are Additional Insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor, as respects general liability and auto policies, pursuant to and subject to the policy’s terms, definitions, conditions and exclusions.

The insurance provided in the general liability and auto policies is primary and any other insurance shall be excess only, and not contributing. Waiver of Subrogation applies to The State of Arizona or ADOT, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contract, as respects general liability, auto, and workers compensation policies, pursuant to and subject to the policy’s terms, definitions, conditions, and exclusions. 30 day cancellation notice applies.

STATE OF ARIZONA

ARIZONA DEPARTMENT OF TRANSPORTATION

1739 W. Jackson St., Ste. A Phoenix AZ 85007

THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE

F0950 Accepted

COMMERCIAL AUTO

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

CA T3 53 02 15

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BUSINESS AUTO EXTENSION ENDORSEMENT

Page 1 of 4© 2015 The Travelers Indemnity Company. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

GENERAL DESCRIPTION OF COVERAGE – This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover-age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en-dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.

A. BROAD FORM NAMED INSURED

B. BLANKET ADDITIONAL INSURED

C. EMPLOYEE HIRED AUTO

D. EMPLOYEES AS INSURED

E. SUPPLEMENTARY PAYMENTS – INCREASED

LIMITS

F. HIRED AUTO – LIMITED WORLDWIDE COV-

ERAGE – INDEMNITY BASIS

G. WAIVER OF DEDUCTIBLE – GLASS

PROVISIONS

A. BROAD FORM NAMED INSURED

The following is added to Paragraph A.1., Who Is An Insured, of SECTION II – COVERED AUTOS

LIABILITY COVERAGE:

Any organization you newly acquire or form dur-ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage.

Coverage under this provision is afforded only un-til the 180th day after you acquire or form the or-ganization or the end of the policy period, which-ever is earlier.

B. BLANKET ADDITIONAL INSURED

The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II – COVERED

AUTOS LIABILITY COVERAGE:

Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi-tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which

H. HIRED AUTO PHYSICAL DAMAGE – LOSS OF

USE – INCREASED LIMIT

I. PHYSICAL DAMAGE – TRANSPORTATION

EXPENSES – INCREASED LIMIT

J. PERSONAL PROPERTY

K. AIRBAGS

L. NOTICE AND KNOWLEDGE OF ACCIDENT OR

LOSS

M. BLANKET WAIVER OF SUBROGATION

N. UNINTENTIONAL ERRORS OR OMISSIONS

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.

C. EMPLOYEE HIRED AUTO

1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II – COV-

ERED AUTOS LIABILITY COVERAGE:

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

2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV – BUSI-

NESS AUTO CONDITIONS:

b. For Hired Auto Physical Damage Cover-age, the following are deemed to be cov-ered "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 an "employee's" name, with your

810-2L649784-24-43-G Policy Period 1/01/2024-1/01/2025

BLANKET ADDITIONAL INSURED

CA T3 53 02 15Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

permission, while performing duties related to the conduct of your busi-ness.

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

D. EMPLOYEES AS INSURED

The following is added to Paragraph A.1., Who Is An Insured, of SECTION II – COVERED AUTOS

LIABILITY COVERAGE:

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

E. SUPPLEMENTARY PAYMENTS – INCREASED

LIMITS

1. The following replaces Paragraph A.2.a.(2), of SECTION II – COVERED AUTOS LIABIL-

ITY COVERAGE:

(2) Up to $3,000 for cost of bail bonds (in-cluding bonds for related traffic law viola-tions) required because of an "accident" we cover. We do not have to furnish these bonds.

2. The following replaces Paragraph A.2.a.(4), of SECTION II – COVERED AUTOS LIABIL-

ITY COVERAGE:

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

F. HIRED AUTO – LIMITED WORLDWIDE COV-

ERAGE – INDEMNITY BASIS

The following replaces Subparagraph (5) in Para-graph B.7., Policy Period, Coverage Territory, of SECTION IV – BUSINESS AUTO CONDI-

TIONS:

(5) Anywhere in the world, except any country or jurisdiction while any trade sanction, em-bargo, or similar regulation imposed by the United States of America applies to and pro-hibits the transaction of business with or within such country or jurisdiction, for Cov-ered Autos Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent 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.

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

(i) You must arrange to defend the "in-sured" against, and investigate or set-tle any such claim or "suit" and keep us advised of all proceedings and ac-tions.

(ii) Neither you nor any other involved "insured" will make any settlement without our consent.

(iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit".

(iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in-sured" pays with our consent, but only up to the limit described in Para-graph C., Limits Of Insurance, of

SECTION II – COVERED AUTOS

LIABILITY COVERAGE.

(v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga-tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para-graph C., Limits Of Insurance, of

SECTION II – COVERED AUTOS

LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses.

(b) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess, contingent or on any other basis.

(c) This insurance is not a substitute for re-quired or compulsory insurance in any country outside the United States, its ter-ritories and possessions, Puerto Rico and Canada.

CA T3 53 02 15 Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission.

© 2015 The Travelers Indemnity Company. All rights reserved.

You agree to maintain all required or compulsory insurance in any such coun-try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in-surance requirements.

(d) It is understood that we are not an admit-ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can-ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance.

G. WAIVER OF DEDUCTIBLE – GLASS

The following is added to Paragraph D., Deducti-ble, of SECTION III – PHYSICAL DAMAGE

COVERAGE:

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

H. HIRED AUTO PHYSICAL DAMAGE – LOSS OF

USE – INCREASED LIMIT

The following replaces the last sentence of Para-graph A.4.b., Loss Of Use Expenses, of SEC-

TION III – PHYSICAL DAMAGE COVERAGE:

However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident".

I. PHYSICAL DAMAGE – TRANSPORTATION

EXPENSES – INCREASED LIMIT

The following replaces the first sentence in Para-graph A.4.a., Transportation Expenses, of

SECTION III – PHYSICAL DAMAGE COVER-

AGE:

We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in-curred by you because of the total theft of a cov-ered "auto" of the private passenger type.

J. PERSONAL PROPERTY

The following is added to Paragraph A.4., Cover-age Extensions, of SECTION III – PHYSICAL

DAMAGE COVERAGE:

Personal Property We will pay up to $400 for "loss" to wearing ap-parel and other personal property which is:

(1) Owned by an "insured"; and

(2) In or on your covered "auto".

This coverage applies only in the event of a total theft of your covered "auto".

No deductibles apply to this Personal Property coverage.

K. AIRBAGS

The following is added to Paragraph B.3., Exclu-sions, of SECTION III – PHYSICAL DAMAGE

COVERAGE:

Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in-flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only:

a. If that "auto" is a covered "auto" for Compre-hensive Coverage under this policy;

b. The airbags are not covered under any war-ranty; and

c. The airbags were not intentionally inflated.

We will pay up to a maximum of $1,000 for any one "loss".

L. NOTICE AND KNOWLEDGE OF ACCIDENT OR

LOSS

The following is added to Paragraph A.2.a., of

SECTION IV – BUSINESS AUTO CONDITIONS:

Your duty to give us or our authorized representa-tive prompt notice of the "accident" or "loss" ap-plies only when the "accident" or "loss" is known to:

(a) You (if you are an individual);

(b) A partner (if you are a partnership);

(c) A member (if you are a limited liability com-pany);

(d) An executive officer, director or insurance manager (if you are a corporation or other or-ganization); or

(e) Any "employee" authorized by you to give no-tice of the "accident" or "loss".

M. BLANKET WAIVER OF SUBROGATION

The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV – BUSINESS AUTO CONDI-

TIONS :

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 ex-tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by

BLANKET WAIVER OF SUBROGATION

CA T3 53 02 15Page 4 of 4 © 2015 The Travelers Indemnity Compa ny. All rights reserved .

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

such contract. The waiver applies only to the person or organization designated in such contract.

N. UNINTENTIONAL ERRORS OR OMISSIONS

The following is added to Paragraph B.2., Con-cealment, Misrepresentation, Or Fraud, of

SECTION IV – BUSINESS AUTO CONDITIONS:

The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How-ever this provision does not affect our right to col-lect additional premium or exercise our right of cancellation or non-renewal.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BLANKET ADDITIONAL INSURED – PRIMARY AND

NON-CONTRIBUTORY WITH OTHER INSURANCE

© 2016 The Travelers Indemnity Company. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

Page 1 of 1CA T4 74 02 16

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

PROVISIONS

1. The following is added to Paragraph A.1.c., Who Is An Insured, of SECTION ll – COVERED

AUTOS LIABILITY COVERAGE:

This includes any person or organization who you are required under a written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured".

2. The following is added to Paragraph B.5., Other Insurance of SECTION IV – BUSINESS AUTO

CONDITIONS:

Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is the first named insured when the written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non-contributory.

810-2L649784-24-43-G 1/01/2024-1/01/2025

COMMERC GENERAL L LIAL IABI ITY

BLANKET ADDITIONAL INSURED WRITTEN

CONTRACTS (ARCHITECTS, ENGINEERS AND

SURVEYORS)

This endorsement i ies insurance pro ided under t folmod f v he lowing:

COMMERC GENERAL L ITY VERA AIAL IABIL CO GE P RT

1. SECT II WHO ISThe fo lowing is added to plies only to such "bodily injury or "propertyl "ION AN INSURED: damage" tha fore the end o the pe-t occurs be f riod o t me f which the "writ contrac re-f i or ten tAny person or organization that you agree in a quiring insurance" requires you to pro idev"written contrac ring " tot requi insurance include as such coverage or the end of the pol eriod,icy pan additiona insured on this Co Part,l verage but:

whichever is earlier.

a. Only with respect to liab li f "bod y injur ",i ty or il y

2. 4.a. SEC-The fol is added to Paragraph olowing f"property da " or "personal y";mage injur and

T ON IV COMMERCIAL GENERAL LIABILI YI T

b. I and only to the e tent that the in orf, x , jury CONDI IONST :

damage is caused by acts or omissions of The insurance prov to the additional insuredidedyou or your subcontractor in the performance is excess over any va id and collec le "other in-l tibof "your work" to which the "written contract surance", whether primary e contingent or, xcess,requiring insurance" applies. The person or on any other basis, that is ava lable to the addi-iorganization does not quali as an additionalfy tional we cover. However finsured for a loss , i youinsured with respect to the independent acts specif ll agree in the "writ contract requ ingica y ten iror o .missions of such person or organization insurance" that this insurance prov to the ad-ided

The insurance prov additionalided to such insured dit insured under this Co Part mional verage ust is l m fo lows:i ited as l apply on a pr mary basis or a pr mary and non-i i

c. In the e ent that the Li i of Insurance of contributory basis, this insurance is pri y tov m ts mar this Co Part shown in the Declarations "other insurance" a i to the addit in-verage va lable ional exceed the l m ts of l li required by the sured which co or organization asi i iabi ty vers that person "written contract requir insurance", the in- a named insured for such loss, and we wil noting l surance prov to the addit insured share with that "other insurance". But this insur-ided ional shall be li i li i l li requi ance pro ided to the addi ional insured stil is ex-m ted to the m ts of iabi ty red v t l by that "written contract requir insurance". cess o any v l and col ib "other insur-ing ver a id lect le This endorsement shall not increase the li its ance", whether pri e contingent or onm mary, xcess, of insurance described in Section Li its any other basis, that is a ai le to the additIII m v lab ional O Insurance.f insured when that person or organization is an additiona insured under any "other insurance".ld. This insurance does not apply to the render-ing o or fa lure to render any "pro l The fol is added tof i fessiona lowing3. SEC ION IV C M-T O

MERCIAL GEN I COND TERAL LIABIL TY I IONS:serv " or construction manage errorsices ment or omissions. Duties iti l IOf An Add ona nsured

e. This insurance does not apply to "bodi in-ly As a condition o co erage pro ided to the addi-f v v jury" or "property damage" caused by "your tional insured:

work" and included in the "products-

a. The additional insured must gi us writtenvecomp operations hazard" unless theleted notice as soon as practicable o an "occur-f"written contract requir insurance" specifing i-rence" or an of which may result in afensecall requ you to pro i such co eragey ires v de v clai . To the ex possible, such noticem tentfor that addit and then the insur-ional insured, should include:ance pro ided to the addi l insured ap-v tiona

CG D4 14 04 08 Page 1 o 22008 The Travelers Companies, Inc. f

P-630-4885B479-COF-24 Policy Period 1/01/2024-1/01/2025

COMMERC GENERAL L LIAL IABI ITY

i. How, when and where the "occurrence" any pro ider o other insurance which wouldv f or o fense took placef ; co the addit insured for a loss wever ional co . However th condition does not af ectver , is fii. The names and addresses of any injured whether this insurance prov to the addi-idedpersons and witnesses; and tional insured is pri to that o insur-mary theriii. The nature and locat o any in orion f jury ance ava lable to the addit insured whichi ionaldamage arising out o the "occurrence" orf co that person or organization as aversof ense.f named insured.

b. I a c m is made or "suit is brought againstf lai "

4. DE I IONSThe fo is added to the Sec-llowing FIN Tthe additional insured, the additional insured tion:must:

" r ten contract requir insurance" means thatW it ingi. I media record the speci ics of them tely f part of any written contract or agreement underclai or "suit" recei ed;m and the date v and which you are required to inc a person or or-ludeii. Noti y us as soon as practicable.f ganization as an additional insured on this Cover-

The addit insured must see to it that weional age Part, pro i that the "bodi in " andv ded ly jury recei e written notice o the cla m or "suit" asv f i "property damage" occurs and the "personal in-soon as practicable. jury" f m itted:is caused by an o fense co m

c. The addit insured must i m telyional m edia send a. A the signing and e ion o contractfter xecut f the us copies of al legal papers recei in con-l ved or agreement by you;

nection with the c i "sui ", cooperate withla m or t b. W i f t or agreementh le that part o the contrac is us in the in igation or sett ment o thevest le f in e f ; andf ect clai or de against the "suit", and oth-m fense

c. Before f li iod.the end o the po cy pererwise comply l icy ions.with al pol condit

d. The addit insured must tender the de-ional fense and inde ty o any c m or "suit tomni f lai "

Page 2 o 2f 2008 The Travelers Companies, Inc. CG D4 14 04 08

COMMERCIAL GENERAL LIABILITY

XTEND ENDORSEMENT FOR ARCHITECTS, ENGINEERS

AND SURVEYORS

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITYCOVERAGE PART

GENERAL DESCRIPTION OF COVERAGE – This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that c overage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.

A. H.Non-Owned Watercraft– 75 Feet Long Or Less Blanket Additional Insured – Governmental Entities – Permits Or Authorizat ions Relating ToB. Who Is An Insured – Unnamed Subsidiaries Premises

C. Who Is An Insured – Retired Partners, Members, I. Blanket Additional Insured – GovernmentalDirectors And Employees

Entities – Permits Or Authorizat ions Relating To D. Who Is An Insured – Employees And Volunteer Operations

Workers – Bodily Injury To Co-Employees, Co- J. Incidental Medical MalpracticeVolunteer Workers And Retired Partners, Members, Directors And Employees K. Medical Payments – Increased Limit E. Who Is An Insured – Newly Acquired Or Formed L. Amendment Of Excess Insurance Condition –

Limited Liability Companies Professional Liabil ity F. Blanket Additional Insured – Controlling Interest M. Blanket Waiver Of Subrogation – When Required

By Written Contract Or AgreementG. Blanket Additional Insured – Mortgagees, N. Contractual Liability – Railroads

PROVISIONS uses or is responsible for the use of a watercraft that you do not own that is:A. NON-OWNED WATERCRAFT – 75 FEET (1)LONG OR LESS 75 feet long or less; and

(2)1. (2) Not being used to carry any personThe following replaces Paragraph of or property for a charge;g. Aircraft, Auto Or WatercraftExclusion , ,

2. SECTION I –in Paragraph of B. WHO IS AN INSURED – UNNAMED

COVERAGES – COVERAGE A – BODILY SUBSIDIARIES

INJURY AND PROPERTY DAMAGE SECTION II – WHO ISThe following is added to

LIABILITY: AN INSURED:

(2)

Any of your subsidiaries, other than a partnership

(a) 75 feet long or less; and or joint venture, that is not shown as a Named

(b) Not being used to carry any person Insured in the Declarations is a Named Insured or property for a charge; if:

2. 2.e.The following replaces Paragraph of a. You are the sole owner of, or maintain an

SECTION II – WHO IS AN INSURED: ownership interest of more than 50% i n, such

e. subsidiary on the first day of the policyAny person or organization that, with period; andyour express or implied consent, either

CG D3 79 02 19 Page 1 of 6© 2017 The Travelers Indemnity Company. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

Assignees, Successors Or Receivers

A watercraft you do not own that is:

P-630-4885B479-COF-24 Policy Period 1/01/2024-1/01/2025

b. Such subsidiary is not an insured under Unless you are in the business or occupation of providing professional health caresimilar other insurance.

(1)(a) (b) (c) (d)services, Paragraphs , , andNo such subsidiary is an insured for "bodily above do not apply to "bodily injury" arisinginjury" or "property damage" that occurred, or out of providing or failing to provide first aid"personal and advertising injury" caused by an or "Good Samaritan services" by any of youroffense committed: retired partners, members, directors or

a. Before you maintained an ownership interest "employees", other than a doctor. Any such of more than 50% i n such subsidiary; or retired partners, members, directors or

"employees" providing or failing to provideb. After the date, i f any, during the policy period first aid or "Good Samaritan services" duringthat you no longer maintain an ownership their work hours for you will be deemed to beinterest of more than 50% in such subsidiary.

acting within the scope of their employment

1. IIFor purposes of Paragraph of Section – Who by you or performing duties related to the Is An Insured, each such subsidiary will be conduct of your business.

deemed to be designated in the Declarations as:

(2) "Personal injury":

a. A limited liability company;

(a) To you, to your current or retired

b. An organization other than a partnership, partners or members (if you are a joint venture or limited liability company; or partnership or joint venture), to your current or retired members (if you are ac. A trust;

limited liability company), to your other as indicated in its name or the documents that current or retired directors or govern its structure. "employees" while in the course of his or

C. WHO IS AN INSURED – RETIRED PARTNERS, her employment or performing duties related to the conduct of your business,MEMBERS, DIRECTORS AND EMPLOYEES or to your other "volunteer workers"

2.The following is added to Paragraph of while performing duties related to the SECTION II – WHO IS AN INSURED: conduct of your business;

Any person who is your retired partner, member, (b) To the spouse, child, parent, brother or director or "employee" that is performing services sister of that current or retired partner, for you under your direct supervision, but only for member, director, "employee" or

"volunteer worker" as a consequence ofacts within the scope of their employment by you (2)(a)Paragraph above;or while performing duties related to the conduct of your business. However, no such retired (c) For which there is any obligation to partner, member, director or "employee" is an share damages with or repay someone else who must pay damages because ofinsured for:

(2)(a)the injury described in Paragraph

(1) "Bodily injury": (b)or above; or

(a) To you, to your current partners or (d) Arising out of his or her providing or members (if you are a partnership or failing to provide professional health care joint venture), to your current members services.

(if you are a limited liability company) or

(3) "Property damage" to property:to your current directors;

(a)(b) Owned, occupied or used by; orTo the spouse, child, parent, brother or sister of that current partner, member or (b) Rented to, in the care, custody or control director as a consequence of Paragraph of, or over which control is(1)(a) above;

being exercised for any purpose by;

(c) For which there is any obligation to you, any of your retired partners, membersshare damages with or repay someone or directors, your current or retiredelse who must pay damages because of "employees" or "volunteer workers", any(1)(a)the injury described in Paragraph

(b)or above; or current partner or member (if you are a partnership or joint venture), or any current(d) Arising out of his or her providing or member (if you are a limited liabilityfailing to provide professional health care company) or current director.services.

CG D3 79 02 19Page 2 of 6 © 2017 The Travelers Indemnity Company. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

physical

D. WHO IS AN INSURED – EMPLOYEES AND organization will be deemed to be VOLUNTEER WORKERS – BODILY INJURY designated in the Declarations as:

TO CO-EMPLOYEES, CO-VOLUNTEER a. A limited liability company;

WORKERS AND RETIRED PARTNERS,

b. An organization other than a partnership,MEMBERS, DIRECTORS AND EMPLOYEES joint venture or limited

2.a.(1)The following is added to Paragraph of or

SECTION II – WHO IS AN INSURED:

c. A trust;

(1)(a) (b) (c)Paragraphs , and above do not as indicated in its name or the documentsapply to "bodily injury" to a current or retired co-that govern its structure."employee" while in the course of the co-

F. BLANKET ADDITIONAL INSURED –"employee's" employment by you or performing CONTROLLING INTERESTduties related to the conduct of your business, or to "bodily injury" to your other "volunteer 1. SECTION II –The following is added to workers" or retired partners, members or WHO IS AN INSURED:

directors while performing duties related to the

Any person or organization that has financialconduct of your business.

control of you is an insured with respect to

E. WHO IS AN INSURED – NEWLY ACQUIRED liability for "bodily injury", "property damage" OR FORMED LIMITED LIABILITY COMPANIES or "personal and advertising injury" that

3.The following replaces Paragraph of arises out of:

SECTION II – WHO IS AN INSURED: a. Such financial control; or

3. Any organization you newly acquire or form, b. Such person's or organization's other than a partnership or joint venture, and ownership, maintenance or use of of which you are the sole owner or in which premises leased to or occupied by you.

you maintain an ownership interest of more

The insurance provided to such person orthan 50%, will qualify as a Named Insured if organization does not apply to structuralthere is no other similar insurance available alterations, new construction or demolitionto that organization. However:

operations performed by or on behalf of such

a. Coverage under this provision is person or organization.

afforded only:

2. 4.The following is added to Paragraph of

(1) Until the 180th day after you acquire SECTION II – WHO IS AN INSURED:

or form the organization or the end This paragraph does not apply to anyof the policy period, whichever is premises owner, manager or lessor that hasearlier, if you do not report such financial control of you.organization in writing to us within

180 days after you acquire or form it; G. BLANKET ADDITIONAL INSURED – or MORTGAGEES, ASSIGNEES, SUCCESSORS

OR RECEIVERS(2) Until the end of the policy period, when that date is later than 180 da ys SECTION II – WHO ISThe following is added to after you acquire or form such AN INSURED:

organization, if you report such

Any person or organization that is a mortgagee,organization in writing to us within assignee, successor or receiver and that you180 days after you acquire or form it;

have agreed in a written contract or agreement

b. ACoverage does not apply to "bodily to include as an additional insured on this injury" or "property damage" that Coverage Part is an insured, but only with occurred before you acquired or formed respect to its liability as mortgagee, assignee, the organization; and successor or receiver for "bodily injury", "property

c. BCoverage does not apply to "personal damage" or "personal and advertising injury" and advertising injury" arising out of an that:

offense committed before you acquired

a. Is "bodily injury" or "property damage" that or formed the organization.

occurs, or is "personal and advertising injury" 1.For the purposes of Paragraph of Section caused by an offense that is committed, II – Who Is An Insured, each such

CG D3 79 02 19 Page 3 of 6© 2017 The Travelers Indemnity Company. All rights reserved.

liability company;

subsequent to the signing of that contract or openings, sidewalk vaults, elevators, street agreement; and banners or decorations.

b. I. BLANKET ADDITIONAL INSURED –Arises out of the ownership, maintenance or GOVERNMENTAL ENTITIES – PERMITSuse of the premises for which that OR AUTHORIZATIONS RELATING TOmortgagee, assignee, successor or receiver OPERATIONSis required under that contract or agreement to be included as an additional insured on SECTION II – WHO ISThe following is added to this Coverage Part . AN INSURED:

The insurance provided to such mortgagee, Any governmental entity that has issued a permit assignee, successor or receiver is subject to the or authorization with respect to operations following provisions: performed by you or on your behalf and that you

a. The limits of insurance provided to such are required by any ordinance, law, building code mortgagee, assignee, successor or receiver or written contract or agreement to include as an will be the minimum limits that you agreed to additional insured on this Coverage Part is an provide in the written contract or agreement, insured, but only with respect to liability for or the limits shown in the Declarations, "bodily injury", "property damage" or "personal whichever are less. and advertising injury" arising out of such operations.b. The insurance provided to such person or organization does not apply to: The insurance provided to such governmental entity does not apply to:(1) Any "bodily injury" or "property damage" that occurs, or any "personal and a. Any "bodily injury", "property damage" or advertising injury" caused by an offense "personal and advertising injury" arising out that is committed, after such contract or of operations performed for the agreement is no longer in effect; or governmental entity; or

(2) Any "bodily injury", "property damage" or b. Any "bodily injury" or "property damage" "personal and advertising injury" arising included in the "products-completed out of any structural alterations, new operations hazard".

construction or demolition operations

J. INCIDENTAL MEDICAL MALPRACTICEperformed by or on behalf of such

1. b.The following replaces Paragraph of themortgagee, assignee, successor or definition of "occurrence" in thereceiver.

DEFINITIONS Section:H. BLANKET ADDITIONAL INSURED –

b. An act or omission committed inGOVERNMENTAL ENTITIES – PERMITS OR providing or failing to provide "incidentalAUTHORIZATIONS RELATING TO PREMISES medical services", first aid or "Good

SECTION II – WHO ISThe following is added to Samaritan services" to a person, unless AN INSURED: you are in the business or occupation of providing professional health careAny governmental entity that has issued a permit services.or authorization with respect to premises owned or occupied by, or rented or loaned to, you and 2. The following replaces the last paragraph of that you are required by any ordinance, law, 2.a.(1) SECTION II – WHO ISParagraph of building code or written contract or agreement to AN INSURED:

include as an additional insured on this Unless you are in the business or occupation Coverage Part is an insured, but only with of providing professional health care respect to liability for "bodily injury", "property (1)(a) (b) (c) (d)services, Paragraphs , , and damage" or "personal and advertising injury" above do not apply to "bodily injury" arising arising out of the existence, ownership, use, out of providing or failing to provide:

maintenance, repair, construction, erection or

(a) "Incidental medical services" by any ofremoval of any of the following for which that your "employees" who is a nurse,governmental entity has issued such permit or nurse assistant, emergency medicalauthorization: advertising signs, awnings, technician, paramedic, athletic trainer,canopies, cellar entrances, coal holes, audiologist, dietician, nutritionist,driveways, manholes, marquees, hoist away

CG D3 79 02 19Page 4 of 6 © 2017 The Travelers Indemnity Company. All rights reserved.

occupational therapist or occupational that is available to any of your "employees" for "bodily injury" that arises out of providingtherapy assistant, physical therapist or or failing to provide "incidental medicalspeech-language pathologist; or services" to any person to the extent not(b) First aid or "Good Samaritan services"

2.a.(1) IIsubject to Paragraph of Section –by any of your "employees" or "volunteer Who Is An Insured.workers", other than an employed or

K. MEDICAL PAYMENTS – INCREASED LIMITvolunteer doctor. Any such "employees" or "volunteer workers" providing or failing 7.The following replaces Paragraph of to provide first aid or "Good Samaritan SECTION III – LIMITS OF INSURANCE:services" during their work hours for you

7. 5.Subject to Paragraph above, the Medicalwill be deemed to be acting within the scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct CCoverage for all medical expenses of your business. because of "bodily injury" sustained by any

3. one person, and will be the higher of:The following replaces the last sentence of

5. SECTION III – LIMITS OFParagraph of a. $10,000; or

INSURANCE:

b. The amount shown in the Declarations ofFor the purposes of determining the this Coverage Part for Medical Expenseapplicable Each Occurrence Limit, all related Limit.acts or omissions committed in providing or failing to provide "incidental medical L. AMENDMENT OF EXCESS INSURANCE services", first aid or "Good Samaritan CONDITION – PROFESSIONAL LIABILITY services" to any one person will be deemed

4.b.The following is added to Paragraph ,to be one "occurrence".

Excess Insurance SECTION IV –, of

4. The following exclusion is added to COMMERCIAL GENERAL LIABILITY

2. Exclusions SECTION I –Paragraph , , of CONDITIONS:

COVERAGES – COVERAGE A – BODILY

This insurance is excess over any of the otherINJURY AND PROPERTY DAMAGE insurance, whether primary, excess, contingentLIABILITY:

or on any other basis, that is Professional

Sale Of Pharmaceuticals Liability or similar coverage, to the extent the "Bodily injury" or "property damage" arising loss is not subject to the professional services out of the violation of a penal statute or A Bexclusion of Coverage or Coverage .

ordinance relating to the sale of

M. BLANKET WAIVER OF SUBROGATION –pharmaceuticals committed by, or with the WHEN REQUIRED BY WRITTEN CONTRACTknowledge or consent of the insured.

OR AGREEMENT

5. DEFINITIONSThe following is added to the

8. TransferThe following is added to Paragraph ,Section:

Of Rights Of Recovery Against Others To Us, "Incidental medical services" means: SECTION IV – COMMERCIAL GENERALof

a. Medical, surgical, dental, laboratory, x- LIABILITY CONDITIONS:

ray or nursing service or treatment, If the insured has agreed in a written contract oradvice or instruction, or the related agreement to waive that insured's right offurnishing of food or beverages; or recovery against any person or organization, we

b. The furnishing or dispensing of drugs or waive our right of recovery against such person medical, dental, or surgical supplies or or organization, but only for payments we make appliances. because of:

6. 4.b.The following is added to Paragraph , a. "Bodily injury" or "property damage" that Excess Insurance SECTION IV –, of occurs; orCOMMERCIAL GENERAL LIABILITY

b. "Personal and advertising injury" caused byCONDITIONS:

an offense that is committed;This insurance is excess over any valid and collectible other insurance, whether primary, subsequent to the signing of that contract or excess, contingent or on any other basis, agreement.

CG D3 79 02 19 Page 5 of 6© 2017 The Travelers Indemnity Company. All rights reserved.

N. CONTRACTUAL LIABILITY – RAILROADS

1. c.The following replaces Paragraph of the definition of "insured contract" in the DEFINITIONS Section:

c. Any easement or l icense agreement;

2. f.(1)Paragraph of the definition of "insured DEFINITIONScontract" in the Section is deleted.

CG D3 79 02 19Page 6 of 6 © 2017 The Travelers Indemnity Company. All rights reserved.

ISSUE D :ATE

DESIGNATED PERSON OR ORGANIZATION – NOTICE OF

CANCELLATION, NONRENEWAL OR MATERIAL

LIMITATION OF COVERAGE PROVIDED BY US

This endorsement modifies insurance provided under the following:

ALL COVERAGE PARTS INCLUDED IN THIS POLICY

SCHEDULE

CANCELLATION: Number of Days Notice:

WHEN WE DO NOT RENEW (Nonrenewal): Number of Days Notice:

MATERIAL LIMITATION OF COVERAGE: Number of Days Notice:

PERSON OR

ORGANIZATION:

ADDRESS:

PROVISIONS in such Schedule. We will mail such notice to the address shown in the Schedule above at least theA. If we cancel this policy for any legally permitted number of days shown for When We Do Notreason other than nonpayment of premium, and a Renew (Nonrenewal) in such Schedule before thenumber of days is shown for Cancellation in the effective date of nonrenewal.Schedule above, we will mail notice of cancellation to the person or organization shown C. If we add a material limitation on the coverage in such Schedule. We will mail such notice to the provided by this policy, and a number of days is address shown in the Schedule above at least the shown for Material Limitation Of Coverage in the number of days shown for Cancellation in such Schedule above, we will mail notice of such Schedule before the effective date of cancellation. limitation to the person or organization shown in

B. If we do not renew this policy for any legally such Schedule. We will mail such notice to the permitted reason other than nonpayment of address shown in the Schedule above at least the premium, and a number of days is shown for number of days shown for Material Limitation Of When We Do Not Renew (Nonrenewal) in the Coverage in such Schedule before the effective Schedule above, we will mail notice of date of such limitation.

nonrenewal to the person or organization shown

IL T3 54 05 19 © 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1

STATE OF ARIZONA

ARIZONA DEPARTMENT OF TRANSPORTATION

1739 W. Jackson St., Ste. A Phoenix, AZ 85007

WORKERS COMPENSATION

AND

EMPLOYERS LIABILITY POLICY

ENDORSEMENT WC 99 06 R4 (00)

POLICY NUMBER: UB-8J736329-24-43-G

NOTICE OF CANCELLATION OR NONRENEWAL

TO DESIGNATED PERSONS OR ORGANIZATIONS

The following is added to PART SIX CONDITIONS:

Notice Of Cancellation Or Nonrenewal To Designated Persons Or Organizations If we cancel or non-renew this policy for any reason other than non-payment of premium by you, we will provide notice of such cancellation or non-renewal to each person or organization designated in the Schedule below. We will mail or deliver such notice to each person or organization at its listed address at least the number of days shown for that person or organization before the cancellation or nonrenewal is to take effect.

You are responsible for providing us with the information necessary to accurately complete the Schedule below.

If we cannot mail or deliver a notice of cancellation or nonrenewal to a designated person or organization because the name or address of such designated person or organization provided to us is not accurate or complete, we have no responsibility to mail, deliver or otherwise notify such designated person or organization of the cancellation or nonrenewal.

SCHEDULE

Name and Address of Designated Persons or Organizations:

ST ASSIGN:DATE OF ISSUE:

© 2013 The Travelers Indemnity Company. All rights reserved.

Number of Days Notice

1/01/2024

STATE OF ARIZONA

ARIZONA DEPARTMENT OF TRANSPORTATION

WORKERS COMPENSATION

AND

EMPLOYERS LIABILITY POLICY

ENDORSEMENT WC 00 03 13 (00)-

POLICY NUMBER:

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

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

DESIGNATED PERSON:

DESIGNATED ORGANIZATION:

DATE OF ISSUE: 1/01/2024 ST ASSIGN:

UB-8J736329-24-43-G

IA

STATE OF ARIZONA

ARIZONA DEPARTMENT OF TRANSPORTATION