CTR048044_-_COI_Exp._7_01_2025.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

9/16/2024

A.T.P. and Associates, LLC 350 W 16th Street Ste 103 Yuma AZ 85364

928-783-0000 928-783-3731

Philadelphia Insurance Company 18058 WESTE-1 CopperPoint Mutual Ins. 14216

Western Arizona Council of Governments 1235 S. Redondo Center Drive Yuma AZ 85364

The Hartford 29424

1456457360

A X 1,000,000 X 100,000

5,000

1,000,000

3,000,000 X

Y Y PHPK2569170 7/1/2024 7/1/2025

3,000,000

Professional Liab. 1,000,000 A 1,000,000

X X X X

Y Y PHPK2569170 7/1/2024 7/1/2025

A 1,000,000 X

PHUB869356 7/1/2024 7/1/2025

1,000,000 X 10,000

B XY 1007044 7/1/2024 7/1/2025

1,000,000

1,000,000

1,000,000 A C A

Director's & Officers Liability ERISA Crime Sexual Abuse/Molesation

PHPK2569170

59BDDGS9230

PHPK2569170

7/1/2024 8/4/2024 7/1/2024

7/1/2025 8/4/2025 7/1/2025

Aggregate Aggregate Occurrence

1,000,000 100,000 1,000,000

The Certificate Holder is additional insured under the general liability. Waivers of subrogation apply under the general liability, auto liability and worker's Compensation coverages per attached form: PI-GLD-HS. Waiver of Subrogation for auto liability per CA0444 03/10. Additional insured auto liability per CA2048 10/13. Waiver of subrogation General Liability per CG2404 05/09. Additional Insured General Liability per CG2010 04/13 There are no excluded proprietor/partner/executive/officer/member on the workers compensation policy. ADES - Contract number #CTR048044

Additional Insured Names: State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees

The State of Arizona and Department of Economic Security C/O: myCOI 1075 Broad Ripple Ave Ste 313 Indianolis IN 46220

� � � � � � � � � � � ! " # $ % & ' & # ( ) % & ! � * * ) % & + � % , + - . . / 0 1 2 3 4 5 6 4

7 8 ) ! & 9 : # ! & ; & < ; : 9 ) * ) & ! ) ! " # $ % & = # : ( ) 9 & 9 " 9 & # < 8 & * : > > : ? ) @ �� � � � � � � A � B � A � � � A � � � 7 � � � C � A B � A � 7� � � D � � 7 ' E � � � � � D � � � A 7 � � � ' � � A � � � 7 � � � C � A B � A � 7F G � H I � �� 1 J 3 � 6 0 3 K L 5 M � K � K 2 1 M N O 1 P N 5 M Q� * : # ; $ < ) : # & R " ) # & 9 < : % : ; = > & < & < 8 ) ! ' % 8 & 9 " > & + ) * : < ! 8 : ? $ S : ( & + ? ) > > S & ! 8 : ? ) < 8 & D & % > $ # $ < ) : ! ,7 8 & * : > > : ? ) @ ) ! $ 9 9 & 9 < : � $ # $ @ # $ = 8 T U � K 1 M L 6 3 K � 6� N 2 V P L � 6 � 3 W 5 X 3 K Y � 2 1 N M L P � P V 3 K L � 5 I L : *F 3 W P N 5 M � Z [ 5 M \ N P N 5 M L Q] & ? $ ) ( & $ ^ # ) @ 8 < : * # & % : ( & # ^ ? & ; $ ^ 8 $ ( & $ @ $ ) ! << 8 & = & # ! : : # : # @ $ ) _ $ < ) : ! 8 : ? ) < 8 & ' % 8 & 9 " > &$ S : ( & S & % $ " ! & : * = $ ^ ; & < ! ? & ; $ ` & * : # ) a " # ^ : #9 $ ; $ @ & $ # ) ! ) @ : " < : * ^ : " # : @ : ) @ : = & # $ < ) : ! : #b ^ : " # ? : # ` b 9 : & " 9 & # $ % : < # $ % < ? ) < 8 < 8 $ < = & # ! : : # : # @ $ ) _ $ < ) : $ 9 ) % > " 9 & 9 ) < 8 & b = # : 9 " % < ! c% : ; = > & < & 9 : = & # $ < ) : ! 8 $ _ $ # 9 b , 7 8 ) ! ? $ ) ( & # $ = = > ) & !: > ^ < : < 8 & = & # ! : : # : # @ $ ) _ $ < ) : ! 8 : ? ) < 8 &' % 8 & 9 " > & $ S : ( & , PHPK2153478

The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, agents, and employees

POLICY NUMBER: COMMERCIAL AUTO

CA 04 44 03 10

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CA 04 44 03 10 © Insurance Services Office, Inc., 2009 Page of

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US (WAIVER OF SUBROGATION)

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM

GARAGE COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

TRUCKERS COVERAGE FORM

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

This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.

Named Insured:

Endorsement Effective Date:

SCHEDULE

Name(s) Of Person(s) Or Organization(s):

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

The Transfer Of Rights Of Recovery Against Oth-ers To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "ac-cident" or the "loss" under a contract with that person or organization.

PHPK2569170

02/15/2024

Western Arizona Council of Governments

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor

1 2

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CA 04 44 03 10 © Insurance Services Office, Inc., 2009 Page of

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US (WAIVER OF SUBROGATION)

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM

GARAGE COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

TRUCKERS COVERAGE FORM

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

This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.

Named Insured:

Endorsement Effective Date:

SCHEDULE

Name(s) Of Person(s) Or Organization(s):

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

The Transfer Of Rights Of Recovery Against Oth-ers To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "ac-cident" or the "loss" under a contract with that person or organization.

PHPK2569170

02/15/2024

Western Arizona Council of Governments

The State of Arizona or ADOT

2 2

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13

(Ed. 4-84)

WC 00 03 13

(Ed. 4-84)

© 1983 National Council on Compensation Insurance.

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

State Blanket/Schedule/State

AZ State of Arizona. Policy shall contain a waiver of subrogation endorsement as required by written agreement, in favor of the State of Arizona, and its departments, agencies, boards, commission, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor.

AZ BLANKET

Blanket Waiver: Anyone for whom you have agreed to provide this Waiver subject to the terms of this 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.)

07/01/2021Endorsement Effective 1007044Policy No. 9Endorsement No.

Western AZ Council of GovernmentsInsured Premium $

CopperPoint Indemnity Insurance CompanyInsurance Company Countersigned by

This document may have been uploaded to the CopperPoint Portal.

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- . / 0 1 ) 2! 3 4 5 6 7 / 8 4 0 9 : ; < . = > / 7 ? - > / ; < - 5 0 1 ! 3 8 6 ; - 3 4 / ' / ; @ < 4 / 8 A 1 1 < 4 / B ! 3 4 C B D < > = < > 8 9 / ; ? < 8 8 < 0 3 CE 2 * ) ) = < 5 - 7 / 5 9 = < - ! 3 7 / ? 3 < > : ! 3 8 6 ; - 3 4 / F 0 ? 9 - 3 :

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

to a person or damage to another�s property, unless the damage to property is caused by : 0 6 ; 4 5 < / 3 > B 6 9 > 0 - , * B * * * 5 < ? < > C - 4 5 < / 3 > < 8 7 / 1 < 3 / 7 - 8 - 9 / ; 8 0 3 6 3 7 / ; : 0 6 ; 7 < ; / 4 > 4 - ; /- 3 7 8 6 9 / ; @ < 8 < 0 3 CP O V W X W Y Z [ T \ ] Z X # " Z " ` Z U [ Z a [ T L T !& O ! 1 7 - ? - . / M : 1 < ; / > 0 9 ; / ? < 8 / 8 ; / 3 > / 7 > 0 : 0 6 < 8 3 0 > 0 > = / ; D < 8 / / ) 4 5 6 7 / 7 1 ; 0 ? > = < 8 F 0 @ / ; - . / - ; > B> = / D ord �fire� is changed to �fire, lightning, explosion, smoke, or leakage from automatic fire protective systems� where it appears in:W O . = / 5 - 8 > 9 - ; - . ; - 9 = 0 1 b P c K H d e H c d f P ` I g P b B c d f P ` I g P I J d V H G L H e h i ` L I e V\ ` d \ P ` K L V I j I g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b P c K H d e H H H

G H j H K b d 2 H e b i ` I e c P C3 O b P c K H d e H H H

G H j H K b d 2 H e b i ` I e c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b P c K H d e f

V P 2 H e H K H d e b B - ; - . ; - 9 = 9 C - C B < 8 7 / 5 / > / 7 < 3 < > 8 / 3 > < ; / > : - 3 7 ; / 9 5 - 4 / 7 M : > = /1 0 5 5 0 D < 3 . (- 4 0 3 > ; - 4 > 1 0 ; - 5 / - 8 / 0 1 9 ; / ? < 8 / 8 C & 0 D / @ / ; B > = - > 9 0 ; > < 0 3 0 1 > = / 4 0 3 > ; - 4 > 1 0 ; - 5 / - 8 / 0 19 ; / ? < 8 / 8 > = - > < 3 7 / ? 3 < 1 < / 8 - 3 : 9 / ; 8 0 3 0 ; 0 ; . - 3 < * - > < 0 3 1 0 ; 7 - ? - . / M : 1 < ; / B 5 < . = > 3 < 3 . B/ ) 9 5 0 8 < 0 3 B 8 ? 0 1 / B 0 ; 5 / - 1 - . / 1 ; 0 ? - 6 > 0 ? - > < 4 1 < ; / 9 ; 0 > / 4 > < @ / 8 : 8 > / ? 8 > 0 9 ; / ? < 8 / 8 D = < 5 /; / 3 > / 7 > 0 : 0 6 0 ; > / ? 9 0 ; - ; < 5 : 0 4 4 6 9 < / 7 M : : 0 6 D < > = 9 / ; ? < 8 8 < 0 3 0 1 > = / 0 D 3 / ; < 8 3 0 > - 38 < 3 8 6 ; / 7 4 0 3 > ; - 4 > 8 /N O b P c K H d e H f c d j j P ` c H I G g P e P ` I G G H I J H G H K L c d e V H K H d e b B ' 6 M 8 / 4 > < 0 3 : O d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

- . / 0 1 ) 2! 3 4 5 6 7 / 8 4 0 9 : ; < . = > / 7 ? - > / ; < - 5 0 1 ! 3 8 6 ; - 3 4 / ' / ; @ < 4 / 8 A 1 1 < 4 / B ! 3 4 C B D < > = < > 8 9 / ; ? < 8 8 < 0 3 CE 2 * ) ) = < 5 - 7 / 5 9 = < - ! 3 7 / ? 3 < > : ! 3 8 6 ; - 3 4 / F 0 ? 9 - 3 :

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

O Q S N T L U N M B O Q S N T L U N V K N T M Q R L W L R X L X S N T P J M J R U J R Y Z T [ W J L V J W J P [ B< 8 - ? / 3 7 / 7 - 8 1 0 5 5 0 D 8 +, H - ; - . ; - 9 = , H J \ - . ] / \ ^ L ^ ] _ _ ` _ \ a < 8 - ? / 3 7 / 7 > 0 < 3 4 5 6 7 / > = / 1 0 5 5 0 D < 3 . +0 / D < 5 5 9 - : > = 0 8 / 8 6 ? 8 > = - > > = / < 3 8 6 ; / 7 I / 4 0 ? / 8 5 / . - 5 5 : 0 I 5 < . - > / 7 > 0 9 - : - 8 7 - ? - . / 8 I / 4 - 6 8 / of a �violation(s)� of the Health Insurance Portabil

< > : - 3 7 1 4 4 0 6 3 > - I < 5 < > : 1 4 > ( & ! 1 1 , C 0 / = - @ / the right and the duty to defend the insured against any �suit,� �investigation,� or �civil proceeding� seeking these damages. However, we will have no duty to defend the insured against any �suit� seeking damages, �investigation,� or �civil proceeding� to which this insurance does not apply.b H - ; - . ; - 9 = b H N c d e . - / f \ - < 8 - ? / 3 7 / 7 > 0 < 3 4 5 6 7 / > = / 1 0 5 5 0 D < 3 . - 7 7 < > < 0 3 - 5 / ' 4 5 6 8 < 0 3 8 +$ = < 8 < 3 8 6 ; - 3 4 / 7 0 / 8 3 0 > - 9 9 5 : > 0 +G H J \ a _ \ a / f \ G e 2 3 / e e 4 . e 2 f ] X _ e / # _ ] G a _ S / f e G a / f \ -

Any willful, intentional, or deliberate �violation(s)� by any insured.# H O ] / ` / \ G e L d a - Any �violation� which results in any c

; < ? < 3 - 5 9 / 3 - 5 > < / 8 6 3 7 / ; > = / & ! 1 1 Cd H Q a 5 _ ] T _ ` _ g / _ -1 3 : ; / ? / 7 : 0 > = / ; > = - 3 ? 0 3 / > - ; : 7 - ? - . / 8 1 0 ; 9 / 3 - 5 > < / 8 - 8 8 / 8 8 / 7 Cg H O f ` h e / G \ d _ T _ 6 / _ 7 - f ] L . g / a -1 3 : 4 0 ? 9 5 < - 3 4 / ; / @ < / D 8 I : > = / % / 9 - ; > ? / 3 > 0 1 & / - 5 > = - 3 7 & 6 ? - 3 ' / ; @ < 4 / 8 C8 H M N O P J Q R S

X N ) J R J P J Q R M < 8 - ? / 3 7 / 7 > 0 < 3 4 5 6 7 / > = / 1 0 5 5 0 D < 3 . - 7 7 < > < 0 3 - 5 7 / 1 < 3 < > < 0 3 8 +G H �Civil proceeding� means an action by the Department of Health and Human Services (HHS) arising out of �violations.�# H �Investigation� means an examination of an actual or alleged �violation(s)� by HHS. However, �investigation� does not include a Compliance Review.d H �Violation� means the actual or alleged failure to comply with the

; / . 6 5 - > < 0 3 8 < 3 4 5 6 7 / 7 < 3 > = /& ! 1 1 C

- . / 0 1 ) 2! 3 4 5 6 7 / 8 4 0 9 : ; < . = > / 7 ? - > / ; < - 5 0 1 ! 3 8 6 ; - 3 4 / ' / ; @ < 4 / 8 A 1 1 < 4 / B ! 3 4 C B D < > = < > 8 9 / ; ? < 8 8 < 0 3 CE 2 * ) ) = < 5 - 7 / 5 9 = < - ! 3 7 / ? 3 < > : ! 3 8 6 ; - 3 4 / F 0 ? 9 - 3 :

G H I J K ! L M N O M P Q J R S "

T ! Q ! S U R L V J M " J K S W # X $ % $ $ $ % Y Z S J R K J K [ J \ W V S ! R ] O J V ! W K! 1 ^ _ ` Y [ a G Y ^ I Y b U ^ a T O a c I Y d e f < 8 3 0 > 0 > = / ; D < 8 / / & 4 5 6 7 / 7 1 ; 0 ? > = < 8 F 0 @ / ; - . / - ; > '( H ) = / * / 7 < 4 - 5 + & 9 / 3 8 / $ < ? < > < 8 4 = - 3 . / 7 8 6 g , / 4 > > 0 - 5 5 0 1 > = / > / ; ? 8 0 1 f Y ^ e U _ d U U U - T U I U e f _ .U d f h [ a d ^ Y > 0 > = / . ; / - > / ; 0 1 'M H / 2 * B * * * 0 0 ;1 H ) = / * / 7 < 4 - 5 + & 9 / 3 8 / $ < ? < > 8 = 0 D 3 < 3 > = / % / 4 5 - ; - > < 0 3 8 0 1 > = < 8 F 0 @ / ; - . / - ; > CX H f Y ^ e U _ d U

^ _ ` Y [ a G Y B ^ _ ` Y [ a G Y ^ I Y b U ^ a T O a c I Y d e f B ' 6 g 8 / 4 > < 0 3 ( H U R " 2 V ! R ]a ] V J J Q J R S B - C ( 3 , ( g , < 8 7 / 5 / > / 7 < 3 < > 8 / 3 > < ; / > : - 3 7 ; / 9 5 - 4 / 7 g : > = / 1 0 5 5 0 D < 3 . '( g , ) = / / & 9 / 3 8 / 8 - ; / < 3 4 6 ; ; / 7 - 3 7 ; / 9 0 ; > / 7 > 0 6 8 D < > = < 3 > = ; / / : / - ; 8 0 1 > = / 7 - > / 0 1 > = /- 4 4 < 7 / 3 > C4 H a S 5 N J S ! L a L S ! 6 ! S ! J "f Y ^ e U _ d U

^ _ ` Y [ a G Y f B ^ _ ` Y [ a G Y ^ I Y b U ^ a T O a c I Y d e f B ' 6 g 8 / 4 > < 0 3 X H Y Z L N 2 " ! W R " B - ; - . ; - 9 = J H a S 5 N J S ! L a L S ! 6 ! S ! J " < 8 7 / 5 / > / 7 < 3 < > 8 / 3 > < ; / > : - 3 7 ; / 9 5 - 4 / 7 D < > = > = / 1 0 5 5 0 D < 3 . 'J H a S 5 N J S ! L a L S ! 6 ! S ! J ") 0 - 9 / ; 8 0 3 < 3 , 6 ; / 7 D = < 5 / > - 7 < 3 . 9 - ; > < 3 - > = 5 / > < 4 8 CU H f 2 \ \ N J Q J R S M V P O M P Q J R S "f Y ^ e U _ d U

^ _ ` Y [ a G Y f % f h O O T Y I Y d e a [ c O a c I Y d e f - ^ _ ` Y [ a G Y a a d b i - ; /- ? / 3 7 / 7 - 8 1 0 5 5 0 D 8 '( H 1 H < 8 7 / 5 / > / 7 < 3 < > 8 / 3 > < ; / > : - 3 7 ; / 9 5 - 4 / 7 g : > = / 1 0 5 5 0 D < 3 . '( H 1 H 8 9 > 0 / * * * 1 0 ; 4 0 8 > 0 1 g - < 5 g 0 3 7 8 ; / 9 6 < ; / 7 g / 4 - 6 8 / 0 1 - 4 4 < 7 / 3 > 8 0 ; > ; - 1 1 < 4 5 - D @ < 0 5 - > < 0 3 8- ; < 8 < 3 . 0 6 > 0 1 > = / 6 8 / 0 1 - 3 : @ / = < 4 5 / > 0 D = < 4 = > = / : 0 7 < 5 : ! 3 , 6 ; : $ < - g < 5 < > : F 0 @ / ; - . / - 9 9 5 < / 8 C ; /7 0 3 0 > = - @ / > 0 1 6 ; 3 < 8 = > = / 8 / C( H K H < 8 7 / 5 / > / 7 < 3 < > 8 / 3 > < ; / > : - 3 7 ; / 9 5 - 4 / 7 g : > = / 1 0 5 5 0 D < 3 . '( H K H < 5 5 ; / - 8 0 3 - g 5 / / & 9 / 3 8 / 8 < 3 4 6 ; ; / 7 g : > = / < 3 8 6 ; / 7 - > 0 6 ; ; / 9 6 / 8 > > 0 - 8 8 < 8 > 6 8 < 3 > = /< 3 @ / 8 > < . - > < 0 3 0 ; 7 / 1 / 3 8 / 0 1 > = / 4 5 - < ? 0 ; = 8 6 < > = B < 3 4 5 6 7 < 3 . - 4 > 6 - 5 5 0 8 8 0 1 / - ; 3 < 3 . 8 6 9 > 0 / ) B * * * -7 - : g / 4 - 6 8 / 0 1 > < ? / 0 1 1 1 ; 0 ? D 0 ; 7 Cj H Y Q \ N W P J J U R K J Q R ! > ! L M S ! W R b J > J R " J ^ W 6 J V M ] Jf Y ^ e U _ d U

^ _ ` Y [ a G Y f % f h O O T Y I Y d e a [ c O a c I Y d e f

^ _ ` Y [ a G Y f a a d b i > = /1 0 5 5 0 D < 3 . < 8 - 7 7 / 7 '; / D < 5 5 9 - :

, on your behalf, defense costs incurred by an �employee� in a criminal proceeding 0 4 4 6 ; ; < 3 . < 3 > = / 4 0 6 ; 8 / 0 1 / ? 9 5 0 : ? / 3 > C

The most we will pay for any �employee� who is alleged to be directly involved in a criminal 9 ; 0 4 / / 7 < 3 . < 8 / 2 B * * * ; / . - ; 7 5 ess of the numbers of �employees,� claims or �suits� brought or persons or organizations making claims or bringing �suits C

- . / 0 1 ) 2! 3 4 5 6 7 / 8 4 0 9 : ; < . = > / 7 ? - > / ; < - 5 0 1 ! 3 8 6 ; - 3 4 / ' / ; @ < 4 / 8 A 1 1 < 4 / B ! 3 4 C B D < > = < > 8 9 / ; ? < 8 8 < 0 3 CE 2 * ) ) = < 5 - 7 / 5 9 = < - ! 3 7 / ? 3 < > : ! 3 8 6 ; - 3 4 / F 0 ? 9 - 3 :

! G ! H I J K L M N O " P H Q R J O H S H K T

U J K # T N V # J R W H V $ # O H % X R # H K T X N $ H V J Y HW Z X [ \ ] ^ \

X ] _ Z P ` a Z W & W b c c M Z d Z ^ [ ` P e c ` e d Z ^ [ W

X ] _ Z P ` a Z W ` ` ^ f g < 8- ? / 3 7 / 7 > 0 < 3 4 5 6 7 / > = / 1 0 5 5 0 D < 3 . '( e will pay for the cost to replace keys and locks at the �clients� premises due to theft or other loss to keys entrusted to you by your �client B

6 9 > 0 - ) ) * B * * * 5 < ? < > 9 / ; 0 4 4 6 ; ; / 3 4 / - 3 7 ) ) * B * * *9 0 5 < 4 : - . . ; / . - > / C( / D < 5 5 3 0 > 9 - : 1 0 ; 5 0 8 8 0 ; 7 - ? - . / ; / 8 6 5 > < 3 . 1 ; 0 ? > = / 1 > 0 ; - 3 : 0 > = / ; 7 < 8 = 0 3 / 8 > 0 ; 4 ; < ? < 3 - 5 - 4 > > = - > you or any of your partners, members, officers, �employees�, �managers�, directors, trustees, - 6 > = 0 ; < * / 7 ; / 9 ; / 8 / 3 > - > < @ / 8 0 ; - 3 : 0 3 / > 0 whom you entrust the keys of a �client� for any 9 6 ; 9 0 8 / 4 0 ? ? < > B D = / > = / ; - 4 > < 3 . - 5 0 3 / 0 ; < 3 4 0 5 5 6 8 < 0 3 D < > = 0 > = / ; 9 / ; 8 0 3 8 C+ = / 1 0 5 5 0 D < 3 . B D = / 3 6 8 / 7 0 3 > = < 8 4 0 @ / ; - . / B - ; / 7 / 1 < 3 / 7 - 8 1 0 5 5 0 D 8 'J G , F 5 < / 3 > , ? / - 3 8 - 3 < 3 7 < @ < 7 6 - 5 B 4 0 ? 9 - 3 : 0 ; 0 ; . - 3 < * - > < 0 3 D < > = D = 0 ? : 0 6 = - @ / - D ; < > > / 3 4 0 3 > ; - 4 >0 ; D 0 ; - 0 ; 7 / ; 1 0 ; : 0 6 ; 8 / ; @ < 4 / 8 1 0 ; - 7 / 8 4 ; < h / 7 9 ; / ? < 8 / 8 - 3 7 = - @ / h < 5 5 / 7 1 0 ; : 0 6 ; 8 / ; @ < 4 / 8 C. G , / ? 9 5 0 : / / , ? / - 3 8 '0 1 2 3 3 : 3 - > 6 ; - 5 9 / ; 8 0 3 '0 J 2 ( = < 5 / < 3 : 0 6 ; 8 / ; @ < 4 / 0 ; 1 0 ; 4 * 7 - : 8 - 1 > / ; > / ; ? < 3 - > < 0 3 0 1 8 / ; @ < 4 / 50 . 2 ( = 0 : 0 6 4 0 ? 9 / 3 8 - > / 7 < ; / 4 > 5 : h : 8 - 5 - ; : B D - . / 8 0 ; 4 0 ? ? < 8 8 < 0 3 8 5 - 3 70 O 2 ( = 0 : 0 6 = - @ / > = / ; < . = > > 0 7 < ; / 4 > - 3 7 4 0 3 > ; 0 5 D = < 5 / 9 / ; 1 0 ; ? < 3 . 8 / ; @ < 4 / 8 1 0 ; : 0 6 5 0 ;0 i 2 3 3 : 3 - > 6 ; - 5 9 / ; 8 0 3 D = 0 < 8 1 6 ; 3 < 8 = / 7 > / ? 9 0 ; - ; < 5 : > 0 : 0 6 '0 J 2 + 0 8 6 h 8 > < > 6 > / 1 0 ; - 9 / ; ? - 3 / 3 > , / ? 9 5 0 : / / , - 8 7 / 1 < 3 / 7 < 3 - ; - . ; - 9 = 0 1 2 - h 0 @ / B D = 0 < 80 3 5 / - @ / 5 0 ;0 . 2 + 0 ? / / > 8 / - 8 0 3 - 5 0 ; 8 = 0 ; > " > / ; ? D 0 ; - 5 0 - 7 4 0 3 7 < > < 0 3 8 5D = < 5 / > = - > 9 / ; 8 0 3 < 8 8 6 h 6 / 4 > > 0 : 0 6 ; 7 < ; / 4 > < 0 3 - 3 7 4 0 3 > ; 0 5 - 3 7 9 / ; 1 0 ; ? < 3 . 8 / ; @ < 4 / 8 1 0 ; : 0 6 C0 7 2 , / ? 9 5 0 : / / , 7 0 / 8 3 0 > ? / - 3 '0 J 2 3 3 : - . / 3 > B h ; 0 - / ; B 9 / ; 8 0 3 5 / - 8 / 7 > 0 : 0 6 h : - 5 - h 0 ; 5 / - 8 < 3 . 1 < ; ? B 1 - 4 > 0 ; B 4 0 ? ? < 8 8 < 0 3? / ; 4 = - 3 > B 4 0 3 8 < . 3 / / B < 3 7 / 9 / 3 7 / 3 > 4 0 3 > ; - 4 > 0 ; 0 ; ; / 9 ; / 8 / 3 > - > < @ / 0 1 > = / 8 - ? / . / 3 / ; - 54 = - ; - 4 > / ; 5 0 ;0 . 2 3 3 : , ? - 3 - . / ; B , 7 < ; / 4 > 0 ; 0 ; > ; 6 8 > / / / 8 4 / 9 > D = < 5 / 9 / ; 1 0 ; ? < 3 . - 4 > 8 4 0 ? < 3 . D < > = < 3 > = /8 4 0 9 / 0 1 > = / 6 8 6 - 5 7 6 > < / 8 0 1 - 3 , / ? 9 5 0 : / / C ,O G , 9 - 3 - . / ; , ? / - 3 8 - 9 / ; 8 0 3 8 / ; @ < 3 . < 3 - 7 < ; / 4 > 0 ; < - 5 4 - 9 - 4 < > : 1 0 ; - 5 < ? < > / 7 5 < - h < 5 < > : 4 0 ? 9 - 3 : CM G ` L L # T # N K J R \ K % : V H L %W Z X [ \ ] ^ \ \

; < ] \ W ` ^ \ ^ W b P Z f < 8 - ? / 3 7 / 7 - 8 1 0 5 5 0 D 8 '1 G ! 1 4 0 @ / ; - . / 1 0 ; 3 / D 5 : - 4 = 6 < ; / 7 0 ; 1 0 ; ? / 7 0 ; . - 3 < * - > < 0 3 8 < 8 3 0 > 0 > = / ; D < 8 / / 8 4 5 6 7 / 7 1 ; 0 ? > = < 8

- . / 0 1 ) 2! 3 4 5 6 7 / 8 4 0 9 : ; < . = > / 7 ? - > / ; < - 5 0 1 ! 3 8 6 ; - 3 4 / ' / ; @ < 4 / 8 A 1 1 < 4 / B ! 3 4 C B D < > = < > 8 9 / ; ? < 8 8 < 0 3 CE 2 * ) ) = < 5 - 7 / 5 9 = < - ! 3 7 / ? 3 < > : ! 3 8 6 ; - 3 4 / F 0 ? 9 - 3 :

F 0 @ / ; - . / - ; > B - ; - . ; - 9 = ! G H G < 8 7 / 5 / > / 7 < 3 < > 8 / 3 > < ; / 5 : - 3 7 ; / 9 5 - 4 / 7 I : > = / 1 0 5 5 0 D < 3 . "H G F 0 @ / ; - . / 6 3 7 / ; > = < 8 9 ; 0 @ < 8 < 0 3 < 8 - 1 1 0 ; 7 / 7 6 3 > < 5 > = / / 3 7 0 1 > = / 9 0 5 < 4 : 9 / ; < 0 7 CJ G # - 4 = 0 1 > = / 1 0 5 5 0 D < 3 . < 8 - 5 8 0 - 3 < 3 8 6 ; / 7 "H G K L M $ N H O P $ Q L N R S Q % H T M U M V $ T $ % R Q H R S Q %

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

& 0 6 ; ? - 3 - . / ; 8 - 3 7 8 6 9 / ; @ < 8 0 ; 8 - ; / - 5 8 0 < 3 8 6 ; / 7 8 B I 6 >0 3 5 : D < > = ; / 8 9 / 4 > > 0 > = / < ; 7 6 > < / 8 - 8 : 0 6 ; ? - 3 - . / ; 8 - 3 7 8 6 9 / ; @ < 8 0 ; 8 C * - 3 - . / ; 8 - 3 7 supervisors who are your �employees� are also insureds for �bodily injury� to a co

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