Arizona_Department_of_Administration_KE_G_Construction_Inc_25-26_GLALXSPOLLWC_9-23-2025_996223240.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

9/23/2025

Marsh & McLennan Agency LLC 4703 E Camp Lowell Drive, #101 Tucson AZ 85712

Cherie Pijanowski, Senior Client Manager 520-722-3000 x284 cherie.pijanowski@marshmma.com

Arch Insurance Company 11150 KEGCONST1 Navigators Insurance Company 42307

KE&G Construction Inc 3949 E Irvington Rd Tucson AZ 85714

Great American Insurance Company 16691 Indian Harbor Insurance Company 36940

996223240

A X 2,000,000 X 1,000,000

10,000

2,000,000

4,000,000 X

Y Y ZAGLB1050700 5/1/2025 5/1/2026

4,000,000

A 2,000,000

X

Y Y ZACAT9343200 5/1/2025 5/1/2026

B C

X 5,000,000 X

Y AZ25EXCZ01YLJIV

TUE340277405

5/1/2025 5/1/2025

Y 5/1/2026 5/1/2026

5,000,000 X 0 Great Amer Excess See below

A X

N

Y ZAWCI1053500 5/1/2025 5/1/2026

1,000,000

1,000,000

1,000,000 D Pollution Liability PEC002923915 5/1/2025 5/1/2026 Each Pollution Condit

Pollution Aggregate SelfInsured Retention

$3,000,000 $6,000,000 $25,000

COVERAGE IS SUBJECT TO ALL POLICY TERMS, CONDITIONS, DEFINITIONS, EXCLUSIONS, FORMS & ENDORSEMENTS. APPLICABLE ENDORSEMENTS ARE ATTACHED WITH REGARD TO THE FOLLOWING (If required by written contract):

Forms Listing & Project Information (If Applicable) follows on page #2 (Acord 101):

GENERAL LIABILITY:

1. Automatic Additional Insured-Ongoing and Completed Operations coverage per attached endorsements CG2010 and CG2037.

2. Blanket Primary/NonContributory coverage per attached endorsement CG2001 04-13.

See Attached...

Arizona Department of Administration General Services Division 1400 West Washington Street, Suite B200 Phoenix AZ 85007

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: FORM TITLE:

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE Page of

AGENCY CUSTOMER ID:

LOC #:

AGENCY

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSURED

EFFECTIVE DATE:

KEGCONST1

1 1

Marsh & McLennan Agency LLC KE&G Construction Inc 3949 E Irvington Rd Tucson AZ 85714

25 CERTIFICATE OF LIABILITY INSURANCE

3. Blanket Waiver of Subrogation if required by written contract per attached endorsement CG2404 05-09.

4. Blanket Additional Insured-State or Governmental Agency or Subdivision or Political Subdivision-Permits or Authorizations per attached endorsement CG2012 04-13.

5. General Aggregate Limit applies Per Project per attached endorsement CG2503 05-09.

6. Blanket 30 Day Notice of Cancellation per attached endorsement ML008700 11-10.

AUTOMOBILE:

1. Additional Insured – Blanket per attached endorsement 00CA011500 10-13

2. Blanket Primary/NonContributory coverage per attached endorsement CA0449 11-16.

3. Blanket Waiver of Subrogation if required by written contract per attached endorsement CA0444 10-13.

4. Blanket 30 Day Notice of Cancellation per attached endorsement ML008700 11-10.

WORKERS' COMPENSATION

1. Blanket Waiver of Subrogation if required by written contract per attached endorsement WC000313.

2. Blanket 30 Day Notice of Cancellation per attached endorsement ML008700 11-10..

EXCESS LIABILITY

1. Excess Liability Coverage shown above is excess limits over the general liability, auto liability and employers liability coverage limits.

2. Primary and Non-contributory coverage applies if required by written contract per attached endorsements

3. Great American Excess Liability Policy limit: $4,000,000/$4,000,000. This policy sits excess of the Navigators $5M/$5M Excess Liability policy. Total Commercial Excess Liability limits for all layers is $9,000,000/$9,000,000.

POLLUTION LIABILITY

1. Blanket Additional Insured - Vicarious Liability - Job Site, Transportation and Non-owned Disposal Site if required by written contract.

RE: ADVS-Sierra Vista - Southern Arizona Veterans' Memorial Cemetery Expansion; Solicitation #BPM006982; Agency Project: PCS-25-061

All locations where required by a written contract or written agreement that require this edition date.

ZAGLB1050700

KE&G Construction Inc

05/01/2025 agreement that require this edition date.

INSURED:

POLICY #: POLICY PERIOD: TO

05/01/202605/01/2025ZAGLB1050700

POLICY NUMBER: COMMERCIAL GENERAL LIABILITY

CG 20 10 10 01

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 20 10 10 01 © ISO Properties, Inc., 2000 Page 1 of 1

ADDITIONAL INSURED – OWNERS, LESSEES OR

CONTRACTORS – SCHEDULED PERSON OR

ORGANIZATION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name of Person or Organization:

ALL PARTIES WHERE REQUIRED BY A WRITTEN CONTRACT OR WRITTEN AGREEMENT THAT

REQUIRE THIS EDITION DATE.

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)

A. Section II – Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured.

B. With respect to the insurance afforded to these additional insureds, the following exclusion is added:

2. Exclusions

This insurance does not apply to "bodily inju-ry" or "property damage" occurring after:

(1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the addi-tional insured(s) at the site of the cov-ered operations has been completed;

or

(2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than an-other contractor or subcontractor en-gaged in performing operations for a principal as a part of the same project.

05/01/2025 05/01/2026ZAGLB1050700

05/01/2025 05/01/2026ZAGLB1050700

agreement that require this edition date.

ZAGLB1050700 05/01/202605/01/2025

All locations where required by a written contract or written agreement that require this edition date.

05/01/2025ZAGLB1050700 05/01/2026

POLICY #: EFFECTIVE: EXPIRATION:

05/01/2025ZAGLB1050700 05/01/2026

ZAGLB1050700

POLICY #: POLICY PERIOD: TO:

ZAGLB1050700 05/01/202605/01/2025

05/01/202605/01/2025ZAGLB1050700

00 CA0115 00 10 13 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED - BLANKET

This endorsement modifies insurance provided under the following:

AUTO DEALERS COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

Under Covered Autos Liability Coverage, the Who is An Insured provision is amended to include as an "insured" the person or organization who is required under a written contract to be included as an "insured" under this policy, but only with respect to their legal liability for your acts or omissions or the act or omissions of a person for whom Covered Autos Liability Coverage is afforded under this policy.

All other terms and conditions of this policy remain unchanged.

Endorsement Number:

Policy Number:

Named Insured:

This endorsement is effective on the inception date of this Policy unless otherwise stated herein:

Endorsement Effective Date:

ZACAT9343200

COMMERCIAL AUTO

CA 04 49 11 16

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CA 04 49 11 16 © Insurance Services Office, Inc., 2016 Page 1 of 1

PRIMARY AND NONCONTRIBUTORY –

OTHER INSURANCE CONDITION

This endorsement modifies insurance provided under the following:

AUTO DEALERS COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

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

A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance – Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary:

This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that:

1. Such "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 such "insured".

B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary:

This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that:

1. Such "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 such "insured".

INSURED:

POLICY#: POLICY PERIOD: TO:

ZACAT9343200 05/01/2025 05/01/2026

ZACAT9343200

KE&G Construction Inc ZAWCI1053500

NAV-EXC-348A (01/11) Page 1 of 1Navigators Insurance Company

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

COMMERCIAL EXCESS LIABILITY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

AMENDMENT OF CONDITIONS

OTHER INSURANCE

PRIMARY AND NON-CONTRIBUTING

This endorsement modifies insurance provided under the following:

COMMERCIAL EXCESS LIABILITY COVERAGE PART

SCHEDULE

When required by written contract executed before the "loss."

A. Section IV - Conditions, 9. Other Insurance is deleted and replaced by the following:

9. This insurance is excess over any other insurance available to the insured except:

a. insurance that is purchased specifically to apply in excess of this policy; or

b. insurance available to the person or organization shown in the Schedule of this endorsement as an additional insured on the “controlling underlying insurance.”

B. When this insurance applies on a primary and non-contributing basis, the Limits of Insurance available for the additional insured will be the lesser of:

1. the amounts shown in item 3 of the Declarations of this policy; or

2. the amount of insurance you are required to provide the additional insured in the written contract or agreement.

All other terms of the policy remain unchanged.

POLICY NUMBER: AZ25EXCZ01YLJIV

TAU 9 9 9 9

( E d . 1 1 / 9 7 )

GENERAL ENDORSEMENT

TAU 9 9 9 9 ( E d . 1 1 / 9 7 ) PRO ( P a g e o f )

POLICY NUMBER: TUE340277405