ACCEPTED_CTR067772_GL_AL_WC_TECH_E_O_02.01.25-08.06.25_.pdf

07/09/2025

Strong Tower Insurance Group Inc 3325 E Baseline Rd

Gilbert AZ 85234-2633

Deborah McDonough

(480) 926-9011 (877) 464-6442 debbie@strongtowerig.com

Nesbitt Investment Company Nesbitt Contracting Co., Inc 100 S Price Rd Tempe AZ 85288-3118

Alaska National Insurance Company 38733 CopperPoint Indemnity Insurance Company 13928 Fortegra Specialty Insurance Company 16823

25-26 NES 5m w E&O ALL

A 25BPS13199 02/01/2025 02/01/2026

1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000

Employee Benefits(Retro 02/01/12)

1,000,000

A 25BAS13199 02/01/2025 02/01/2026

1,000,000

Uninsured motorist combined single limit

1,000,000

A 10,000

25BLU13199 02/01/2025 02/01/2026

10,000,000

B N 1029648 02/01/2025 02/01/2026 1,000,000 1,000,000 1,000,000

C Errors and Omissions

AXC1000348-00 08/06/2024 08/06/2025

General Aggregate $2,000,000 Each Claim $2,000,000 Emergency Remediation $250,000

Contract No: CTR067772; Solicitation No: BPM005470 Concrete Repair & Replacement Services. Insurance applies to any and all work performed for or on behalf of the State of Arizona / ADOT. The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees is included as additional insured with respects to the general, auto and umbrella liability if required or agreed to in a written contract subject to all provisions and limitations of the policy. General and Auto liability coverage is primary and non-contributory. A waiver of subrogation in favor of Certificate Holder applies to the general and auto liability and employers liability / workers compensation if required or agreed to in a written contract subject to all provisions and limitations of the policy. Per attached forms ANIC GL 1187 08/21; ANIC CA 1264 02/21; WC 000313 04/84;ENV3250 12/18; ENV3251 12/18;

ENV3143 03/05

The State of Arizona / ADOT 206 S 17th Ave

Phoenix AZ 85007

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

Cindy Lewis Accepted

Alaska National

INSURANCE C O MPANY

CONTRACTORS' GENERAL LIABILITY ENHANCEMENT ENDORSEMENT

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Coverage Part.

SCHEDULE OF COVERAGES ARE SUMMARIZED BELOW

1. Miscellaneous Additional Insureds 8 additional insured extensions.

Primary and Noncontributory Insurance

2. Damage To Premises Rented to You Limit increased to $500,000.

3. Medical Payments Limits increased to $15,000.

Reporting period increased to three years from the date of accident.

4. Non-owned Watercraft Increased to 50 feet.

5. Supplementary Payments Cost of bail bonds increased to $10,000.

Daily loss of earnings increased to $500.

6. Newly Formed Or Acquired Organizations Coverage extended to the end of the policy period or the next anniversary of this policy's effective date.

7. Liberalization Clause

8. Unintentional Failure To Disclose Hazards

9. Notice of Occurrence

10. Broad Knowledge of Occurrence

11. Bodily Injury - Extension of Coverage

12. Expected Or Intended Injury Reasonable force - bodily injury or property damage.

ANIC GL 1187 08 21

13. Blanket Waiver of Subrogation Waiver of subrogation where required by written contract or written agreement.

14. In Rem Actions

15. Voluntary Property Damage Limits added: $5,000 occurrence, $10,000 aggregate.

1. MISCELLANEOUS ADDITIONAL INSUREDS

Section II Who Is An Insured is amended to include as an additional Insured any person or organization described in Paragraphs 2.a.

through 2.h. below whom you are required to add as an additional insured on this policy under a written contract or written agreement. However, the written contract or written agreement must be:

1. Currently in effect or becoming effective during the term of th is policy; and

2. Executed prior to the "bodily injury", "property damage" or "personal injury and advertising injury", but

Only the following persons or organizations are additional insureds under this endorsement and coverage provided to such additional insureds is limited as provided herein:

a. State or Governmental Agency or Subdivision or Political Subdivi sions

INSURANCE COMPANY

Any state or governmental agency or subdivision or political subdivision that has issued a permit in connection with operations performed by you or on your behalf and that you are required by any ordinance, law or building code to include as an additional insured on this coverage part is an additional insured, but only with respect to liability for "bodily injury", "property damage", "personal and advertising injury" arising out of such operations.

The insurance provided to such state or political subdivision does not apply to any "bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for that state or political subdivision.

b. Controlling Interest

Any persons or organizations with a controlling interest in you but only with respect to their liability arising out of:

(1) Their financial control of you, or

(2) Premises they own, maintain or control while you lease or occupy these premises.

This insurance does not apply to structural alterations, new construo tion and demolition operations performed by or for such additional insured.

c. Managers or Lessors of Premises

A manager or lessor of premises but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the premises leased to you and subject to the following additional exclusions:

This insurance does not apply to:

(1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or

ANIC GL 1187 08 21

(2) Structural alterations, new con struction or demolition operations performed by or on behalf of such additional insured.

d. Mortgagee, Assignee or Receiver

A mortgagee, assignee or receiver but only with respect to their liability as mortgagee, assignee, or receiver and arising out of the ownership, maintenance, or use of a premises by you.

This insurance does not apply to structural alterations, new construc tion or demolition operations performed by or for such additional insured.

e. Owners or Other Interests From Whom Land Has Been Leased f.

An owner or other interest from whom land has been leased by you but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the land leased to you and subject to the following additional exclusions:

This insurance does not apply to:

(1) Any "occurrence" which takes place after you cease to lease that land; or

(2) Structural alterations, new con struction or demolition operations performed by or on behalf of such additional insured.

Co-owner of Insured Premises

A co-owner of a premises co-owned by you and covered under this insurance but only with respect to the co-owners liability as co-owner of such premises.

g. Lessor of Equipment

Any person or organization from whom you lease equipment. Such person or organization is an additional insured only with respect to their liability for "bodily injury", "property damage" or "personal and Advertising injury" caused, in whole or in part, by your maintenance, oper ation or use of equipment leased to you by such person or organization.

A person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such leased equipment ends.

With respect to the insurance afforded these additional insureds, the following additional exclusions apply:

This insurance does not apply:

(1) To any "occurrence" which takes place after the equipment lease expires; or

(2) To "bodily injury", "property damage", or "personal and advertising injury" arising out of the sole negligence of such additional insured.

h. Owners, Lessees or Contractors - Ongoing Operations and Completed Operations

1. Any person or organization for whom you are performing operations or have performed operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy;

and

2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above.

ANIC GL 1187 08 21

Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by:

a. Your acts or omissions; or

b. The acts or omissions of those acting on your behalf;

or

c. "Your Work" performed for the additional insured described in Paragraph 1. or

2. above and included in the "products-completed operations hazard."

In the performance of your ongoing operations or completed operations for the additional insured described in Paragraph 1. or 2. above.

However, the insurance afforded to such additional insured described above:

a. Only applies to the extent permitted by law; and

b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

3. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:

This insurance does not apply to:

1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:

a. The preparing, failing to approve, drawings, reports, field orders, orders or and specifica-approving, or prepare or maps, shop opinions, surveys, change drawings tions; or

b. Supervisory, inspection, architectural or engineering activities.

This exdusion applies even if the daims against any insured allege negligence or other wrongdoing in the supervision, hiring, employ ment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services.

Primary And Noncontributory Insurance

The following is added to the Other Insurance Condition and supersedes any provision to the contrary:

This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that:

(1) The additional insured is a Named Insured under such other insurance; and

(2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured.

ANIC GL 1187 08 21

Section Ill - Limits of Insurance, the following is added:

With respect to the insurance afforded to the additional insureds described in Paragraphs a.

through h. above, the most we will pay on behalf of such additional insured is the amount of insurance:

(1) Required by the contract or agreement; or

(2) Available under the applicable Limits of Insurance shown in the Dedarations;

whichever is less.

This provision shall not increase the applicable Limits of Insurance shown in the Dedaration.

2. Damage To Premises Rented to You

SECTION Ill - LIMITS OF INSURANCE, Paragraph 6. is replaced by the following :

6. Subject to Paragraph 5. above, the Damage to Premises Rented to You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner.

If a limit is shown for Damage to Premises Rented to You the most we will pay under Coverage A for damages because or "property damage" to any one premises is the Limit shown in the Declarations or $500,000, whichever is greater.

3. MEDICAL PAYMENTS

A. Section Ill - Limits of Insurance, Paragraph

7. is replaced by the following :

7. Subject to Paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person.

If a limit is shown for Medical Expense in the Declarations the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person is the Limit shown in the Declarations or $15,000, whichever is greater.

B. This provision 5. (Medical Payments) does not apply if Section I - Coverage C Medical Payments is excluded either by the provisions of the Coverage Part or by endorsement

C. Paragraph 1.a.(3)(b) of Section I - Coverage C - Medical Payments, is replaced by the following :

(b) The expenses are incurred and reported to us within three years of the date of the accident; and

4. NON-OWNED WATERCRAFT

A. If endorsement CG 21 09, CG 21 10, CG 24 50, or CG 24 51 is attached to the policy, Paragraph A. 2. g. (2) (b) is replaced by the following :

(b) A watercraft that you do not own that is:

(i) Less than 50 feet long:

and

(ii) Not being used to carry persons or property for a charge.

B. If Paragraph A. does not apply, Paragraph g.

(2) of 2. EXCLUSION under SECTION I -

COVERAGES, COVERAGE A - BODILY

INJURY AND PROPERTY DAMAGE

LIABILITY is replaced by the following:

(2) A watercraft that you do not own that is:

(a) Less than 50 feet long; and

(b) Not being used to carry

ANIC GL 1187 08 21

persons or property for a charge.

5. SUPPLEMENTARY PAYMENTS

A. Under Section I - Supplementary Payments

- Coverage A and B, Paragraph 1.b., the limit of $250 shown for the cost of bail bonds is replaced by $10,000;

B. In Paragraph 1.d., the limit of $250 shown for daily loss of earnings is replaced by $500.

6. NEWLY FORMED OR ACQUIRED

ORGANIZATIONS

Paragraph 3.a. of Section II - Who Is An Insured is deleted and replaced by the following :

Coverage under this provision is afforded only until the end of the policy period or the next anniversary of this policy's effective date after you acquire or form the organization, whichever is eartier.

7. LIBERALIZATION CLAUSE

If we adopt a change in our forms or rules which would broaden coverage for contractors under this endorsement without an additional premium charge, your policy will automatically provide the additional coverages as of the date the revision is effective in your state.

8. UNINTENTIONAL FAILURE TO DISCLOSE

HAZARDS

SECTION IV - COMMERCIAL GENERAL

LIABILITY CONDITIONS - Paragraph 6. - Representations is replaced by the following :

6. Representations

By accepting this policy, you agree:

a. The statements in the Declarations are accurate and complete;

b. Those statements are based upon representations you made to us; and

c. We have issued this policy in reliance upon your representations.

The unintentional omIssIon of, or unintentional error in, any information you provided to us which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable laws and regulations.

9. NOTICE OF OCCURRENCE

The following is added to Paragraph 2. of Section IV - Commercial General Liability Conditions - Duties In The Event of Occurrence, Offense, Claim or Suit:

Your rights under this Coverage Part will not be prejudiced if you fail to give us notice of an "occurrence", offense, daim or "suit" and that failure is solely due to your reasonable belief that the "bodily injury" or "property damage" is not covered under this Coverage Part. However, you shall give written notice of this "occurrence", offense, daim or "suit" to us as soon as you are aware that this insurance may apply to such "occurrence", offense, daim or "suit "

10. BROAD KNOWLEDGE OF OCCURRENCE

The following is added to Paragraph 2. of Section IV - Commercial General Liability Conditions - Duties in The Event of Occurrence, Offense, Claim or Suit:

You must give us or our authorized representative notice of an "occurrence", offense, daim, or "suit" only when the "occurrence", offense, claim or "suit' 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

ANIC GL 1187 08 21

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

11. EXPANDEDBODILYINJURY

Section V - Definitions, the definition of "bodily injury" is changed to read:

"Bodily injury" means bodily injury, sickness or disease sustained by a person, induding death, humiliation, shock, mental anguish or mental injury by that person at any time which results as a consequence of the bodily injury, sickness or disease.

12. EXPECTED OR INTENDED INJURY

Exdusion a. of Section I - Coverage A - Bodily Injury and Property Damage Liability is replaced by the following:

a. "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exdusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property.

13. BLANKET WAIVER OF SUBROGATION

The Transfer Of Rights Of Recovery Against Others To Us Condition (Section IV - Commercial General Liability Conditions) is amended by the addition of the following :

We waive any right of recovery against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss.

I N S U R ANCE CO M PA N Y

14. IN REM ACTIONS

Any action in rem against any vessel owned, operated by or for, or chartered by or for you will be treated in the same manner as though the action were in personam against you.

15. VOLUNTARY PROPERTY DAMAGE

The following is added, Section I - Coverage A Bodily Injury and Property Damage Liability 1., Insuring Agreement:

We will pay, at your request, for "property damage" to property of others while in the care, custody or control of an insured, arising out of your business operations away from your insured premises for which this policy is written and occurring during the policy period.

However, the "property damage" must be the result of unintentional damage or destruction but does not include disappearance, theft, or loss of use.

You agree with us that we shall have no duty to defend any claims and/or "suits" for which the only coverage provided is under this coverage extension.

For the purpose of this coverage only, Section I - Coverage A - Bodily Injury and Property Damage Liability 2. Exclusions J. (4.) is deleted.

As respects coverage afforded under Voluntary Property Damage, the following is added to Section Ill - Limits of Insurance:

Regardless of the number of insureds, claims or "suits" brought, or persons or organizations making claims or bringing "suits":

1. Subject to 2. Below, the most we will pay for "property damage" arising from any one "occurrence" arising out of "property damage to property of others caused by you and while in your care, custody or control is $5,000.

2. The most we will pay for the sum of all "property damage" in an annual policy period is $10,000. This amount is part of and not in addition to the General Aggregate Limit described in Paragraph 2. of Section Ill - Limits of Insurance.

This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 AM. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy.

Endorsement Effective 02/01/25 - 02/01/26

Insured Nesbitt Investment Company

Countersigned By -------------------

Policy No. 258 PS 13199

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

ANIC GL 1187 08 21 Page 7 of 7

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BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT - ARIZONA

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

Various provisions in this endorsement restrict coverage. Read the entire policy carefully to determine rights, duties, and what is and is not covered.

Throughout this policy, the words "you" and "your" refer to the Named Insured shown in the Declarations. The words "we", "us", and "our'' refer to the company providing this insurance.

Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION V - DEFINITIONS in the Business Auto Coverage Form.

The coverages provided by this endorsement apply per "accident" and, unless otherwise specified, are subject to all of the terms, conditions, exclusions and deductible provisions of the policy, to which it is attached.

SECTION II - COVERED AUTO LIABILITY

COVERAGE, Paragraph A.1. Who Is An Insured is amended to include:

d. Any "employee" of yours 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 business.

e. Any person or organization for whom you have agreed in writing to provide insurance such as is afforded by this Coverage Form, but only with respect to liability arising out of the ownership, maintenance or use of "autos" covered by this policy. If such person or organization has other insurance then this insurance is primary to and we will not seek contribution from the other insurance.

f. Any organization you newly acquire or form during 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 until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier.

g. 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.

SECTION II - COVERED AUTO LIABILITY

COVERAGE, Paragraph A.2.a. (2) - Supplementary Payments is replaced by the following:

(2) Up to $10,000 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.

SECTION II - COVERED AUTO LIABILITY

COVERAGE, Paragraph A.2.a. (4) - Supplementary Payments 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.

SECTION II - COVERED AUTO LIABILITY

COVERAGE, Paragraph A.2.c. - Voluntary Prop erty Damage is added as follows:

c. Voluntary Property Damage

At your written request, we may make a voluntary payment for Property Damage caused by an "insured", but without liability to a third party, up to $25,000. We will not make a Voluntary Property Damage payment to anyone who is an "insured" under this policy.

Nesbitt Investment Company 258 AS 13199 02/01/25 - 02/01/26 ANIC CA 1264 02 21 Page 1 of 5

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SECTION Ill - PHYSICAL DAMAGE COVERAGE Paragraph A.5 is added as follows:

5. If hired "autos" are covered "autos" for Liability Coverage, then the Physical Damage Coverage provided under this Coverage Form for any "auto" you own are extended to "autos" of the private passenger or "light truck" type which you lease, hire, rent or borrow without a driver for a period of 30 days or less, subject to the following limit.

The most we will pay for physical damage for an "auto" under this extension is the lesser of the actual cash value, the cost of repair or $50,000, minus a deductible unless an additional limit is purchased. The deductible will be equal to the largest deductible applicable to any owned "auto" of the private passenger or "light truck" type for that coverage. 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 of the private passenger or "light truck" type. Coverage is excess over any other valid and collectible insurance.

"Light trucks" are defined as trucks with a gross vehicle weight of 10,000 pounds or less.

The most we will pay is the amount shown in the Declarations.

SECTION Ill - PHYSICAL DAMAGE COVERAGE - Paragraph A.2. - Towing is replaced by the following:

Towing

We will pay up to $500 for towing and labor costs incurred each time a covered "auto" that is a:

a. Private passenger;

b. Truck;

c. Pick-up truck;

d. Panel; or

e. Van type vehicle under 20,000 Vehicle Weight is disabled.

labor must be performed disablement.

lbs. of Gross However, the at place of

SECTION Ill - PHYSICAL DAMAGE COVERAGE, Paragraph A.3. - Glass Breakage - Hitting a Bird or Animal - Falling Objects or Missiles is replaced by the following:

Glass Breakage - Hitting a Bird or Animal

- Falling Objects or Missiles

If you carry Comprehensive Coverage for the damaged covered "auto", we will pay the following under Comprehensive Coverage:

a. Glass Breakage;

b. "Loss" caused by hitting a bird or animal;

and

c. "Loss" caused by falling objects or missiles.

However, you have the option of having glass breakage caused by a covered "auto's" collision or overturn considered a "loss" under Collision Coverage.

SECTION Ill - PHYSICAL DAMAGE COVERAGE - Paragraph A.4.a. - Transportation Expenses is replaced by the following:

Transportation Expenses

We will pay up to $200 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" that is a:

(1) Private passenger;

(2) Truck;

(3) Pick-up truck;

(4) Panel; or

(5) Van

Nesbitt Investment Company 258 AS 13199 02/01/25 - 02/01/26 ANIC CA 1264 02 21 Page 2 of 5 type vehicle under 20,000 lbs. of Gross Vehicle Weight. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation 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".

Personal Effects We will pay up to $400 for "loss" to wearing apparel and other personal effects which are:

(1) Owned by an "insured"; and

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

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

No deductibles apply to this Personal Effects coverage.

SECTION Ill - PHYSICAL DAMAGE COVERAGE - Paragraph A.4.b. - Loss of Use Expenses is replaced by the following:

b. Loss of Use Expenses- Hired, Rented, or Borrowed Automobiles

We will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle hired, rented or borrowed without a driver under a written rental contract or agreement.

We will pay for loss of use expenses, if caused by:

(1) Other than Collision, only if the Declarations indicate that Comprehensive Coverage is provided for the vehicle withdrawn from service.

(2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss Coverage is provided for the vehicle withdrawn from service.

Nesbitt Investment Company

ANIC CA 1264 02 21

(3) Collision only if the Declarations indicate that Collision Coverage is provided for the vehicle withdrawn from service.

However, the most we will pay for any expenses for loss of use is $200 per day, to a maximum of $1,500.

If CA 99 90 is attached to this policy, the higher of the limits shown here or in CA 99 90 are applicable.

SECTION Ill - PHYSICAL DAMAGE COVERAGE - Paragraph A.4.c. - Non-Transportation Loss of Use Expenses is added as follows:

c. Non-Transportation Loss of Use Expenses

We will pay up to $2,000 for non transportation expense incurred by you, because of "loss" to a covered "auto", if caused by:

(1) Other than Collision, only if the Declarations indicate that Comprehensive Coverage is provided for the "auto" withdrawn from service;

(2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss Coverage is provided for the "auto" withdrawn from service;

or

(3) Collision only if the Declarations indicate that Collision Coverage is provided for the "auto" withdrawn from service.

SECTION Ill - PHYSICAL DAMAGE COVERAGE - Paragraph A.4.d. - Airbag Coverage is added as follows:

d. Airbag Coverage

We will pay for the cost to repair, replace, or reset an airbag that inflates for any reason other than as a result of a collision, if the Declarations indicate that the covered "auto" has Comprehensive Coverage or Specified Causes of Loss Coverage.

258 AS 13199 02/01/25 - 02/01/26

SECTION Ill - PHYSICAL DAMAGE COVERAGE - Paragraph A.4.e. - Rental Reimbursement Coverage is added as follows:

e. Rental Reimbursement Coverage

We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto" that is a:

(1) Private Passenger;

(2) Truck;

(3) Pick-up truck;

(4) Panel ; or

(5) Van type vehicle under 20,000 lbs. of Gross Vehicle Weight. Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage.

(1) 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".

(b) 30 days.

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

(3) The Rental Reimbursement Coverage described above does not apply to a covered "auto" that is described or designated as a covered "auto" on Rental Reimbursement Coverage Form CA 99 23.

SECTION Ill - PHYSICAL DAMAGE COVERAGE, the following is added to Paragraph D. Deductible:

Physical Damage Coverage for a covered "auto" of the private passenger type is changed as follows:

1. No deductible applies to "loss" to:

a. Glass used in the windshield, doors and windows of the covered "auto"; or

b. Glass, plastic or other material used in the lights of the covered "auto".

2. All other Physical Damage Coverage provisions apply.

SECTION IV - BUSINESS AUTO CONDITIONS -

Paragraph A.2.d. is added as follows:

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

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

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

(c) A member (if you are a limited liability company);

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

(e) Any "employee" authorized by you to give notice of the "accident" or "loss".

Nesbitt Investment Company 258 AS 13199 02/01/25 - 02/01/26 ANIC CA 1264 02 21 Page 4 of 5

SECTION IV - BUSINESS AUTO CONDITIONS -

Paragraph A. 5. - Transfer of Rights of Recovery Against Others To Us is amended to include:

5. Transfer of Rights of Recovery Against Others to Us

This condition does not apply to any person(s) or organization(s) to the extent that subrogation against that person or organization is waived prior to the "accident" or the "loss" under a contract with that person or organization

SECTION IV - BUSINESS AUTO CONDITIONS -

Paragraph 8.2. - Concealment, Misrepresentation Or Fraud is amended by adding Unintentional Failure to Disclose Hazards at the end of Paragraph 8.2. as follows:

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.

However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal.

ANIC CA 1264 02 21

Nesbitt Investment Company

SECTION IV - BUSINESS AUTO CONDITIONS -

Paragraph B.5.b. - Other Insurance is replaced by the following:

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

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

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

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

SECTION V - DEFINITIONS - Paragraph C. - "Bodily injury" is replaced by the following:

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

Mental anguish means any type of mental or emotional illness or disease.

258 AS 13199 02/01/25 - 02/01/26

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY

CopperPoint® Insurance Companies

COPPERPOINT • ALASKA NATIONAL

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 anyone not named in the Schedule.

Schedule

Anyone for whom you have agreed to provide this Waiver subject to the terms of the endorsement.

This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.

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

Endorsement Effective 02/01/2025 Insured Nesbitt Investment Company

Policy No. WC1029648

Insurance Company CopperPoint Indemnity Insurance Company

WC 00 0313

(Ed. 04-1984)

© Copyright 1983 National Council on Compensation Insurance, Inc. All Rights Reserved.

Endorsement No.

Premium $ 2,430.00

Countersigned by ~c. ~

Authorized Representative