CTR055523_COI_7.1.2025.pdf

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

INSR ADDL SUBR

LTR INSD WVD

PRODUCER CONTACT

NAME:

FAXPHONE

(A/C, No):(A/C, No, Ext):

E-MAIL

ADDRESS:

INSURER A :

INSURED INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)

AUTOMOBILE LIABILITY

UMBRELLA LIAB

EXCESS LIAB

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

AUTHORIZED REPRESENTATIVE

EACH OCCURRENCE $

DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT

OTHER: $

COMBINED SINGLE LIMIT

$(Ea accident)

ANY AUTO BODILY INJURY (Per person) $

OWNED SCHEDULED

BODILY INJURY (Per accident) $AUTOS ONLY AUTOS

HIRED NON-OWNED PROPERTY DAMAGE

$AUTOS ONLY AUTOS ONLY (Per accident)

OCCUR EACH OCCURRENCE

CLAIMS-MADE AGGREGATE $

DED RETENTION $

PER OTH-

STATUTE ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE $

If yes, describe under

E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below

INSURER(S) AFFORDING COVERAGE NAIC #

COMMERCIAL GENERAL LIABILITY

Y / N N / A

(Mandatory in NH)

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED

REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

CERTIFICATE HOLDER CANCELLATION

© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)

The ACORD name and logo are registered marks of ACORD

7/1/2024

Casa De Los Ninos, Inc.

1120 N. 5th Avenue Tucson, AZ 85705

23787 13928

A 1,000,000

X X 6006698 7/1/2024 7/1/2025 1,000,000 10,000

1,000,000 3,000,000 3,000,000

1,000,000B

X X ACP3039789796 7/1/2024 7/1/2025

C 1003495 7/1/2024 7/1/2025 1,000,000

1,000,000 1,000,000

A Professional Liabili 6006698 7/1/2024 See Remarks B Crime ACP3039789796 7/1/2024 7/1/2025 See Remarks

CTR045624-2 – for Foster and Adoption Support (FAS) The State of Arizona, and its Departments, Agencies, Boards, Commissions, Universities, Officers, Agencies and Employees are included as additional insured with a waiver of subrogation with respect to General Liability, Auto Liability arising out of the activities performed on or on behalf of the contractor.

Blanket Waiver of Subrogation applies on the Workers Compensation.

State of Arizona, Arizona Dept of Child Safety 3003 N Central Ave, 20th Floor Phoenix, AZ 85012

CASADEL-17 CBLIVEN

Tucson, AZ-The Clements Agency-HUB International Insurance Services

(NMX)

6245 E Broadway Blvd Suite 310 Tucson, AZ 85711

Jack Clements, CPA, CIC jack.clements@hubinternational.com

Social Service Contractors Indemnity Pool Nationwide Mutual Insurance Company CopperPoint Indemnity Insurance Company

X

7/1/2025

X X

XX

X

COMMERCIAL AUTO

AC 70 05 0316

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BUSINESS AUTO PROTECTION - GOLD

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

SUMMARY OF COVERAGES

A. Effect of This Endorsement

B. Newly Acquired or Formed Entities

C. Employees as Insureds- Nonowned Autos

D. Additional Insured by Contract, Permit or Agreement

E. Supplementary Payments- Bail Bonds

F. Supplementary Payments- Loss of Earnings

G. Personal Effects and Property of Others Extension

H. Prejudgment Interest Coverage

I. Fellow Employee- Officer, Managers and Supervisors

J. Hired Auto Physical Damage

K. Temporary Substitute Autos- Physical Damage Coverage

L. Expanded Towing Coverage

M. Auto Loan or Lease Coverage

N. Original Equipment Manufacturer Parts- Leased Private Passenger Types

0. Deductible Amendments

P. Rental Reimbursement Coverage

Q. Expanded Transportation Expense

R. Extra Expense- Stolen Autos

S. Physical Damage Limit of Insurance

T. New Vehicle Replacement Cost U. Physical Damage Coverage Extension

V. Transfer of Rights of Recovery Against Others To Us

W. Section IV- Business Auto Conditions- Notice of and Knowledge of Occurrence

X. Hired Car Coverage Territory

Y. Emergency Lock Out

Z. Cancellation Condition

AC 70 05 0316 Includes copyrighted material of Insurance Services Office, Inc.

with its permission

ACP BA 30-0-9789796 74QP 21193 INSURED COPY AC7005031600 0001

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Policy Number: ACP3029789796

A. EFFECT OF THIS ENDORSEMENT

Coverage provided under this policy is modified by the provisions of this endorsement. If there is any conflict between the provisions of this endorsement and the provision(s) of any state specific endorsement also attached to this poli cy, then the provision(s) of the state-specific endorsement shall apply instead of the provi sions of this endorsement that are in conflict, but only to the extent of the conflict, and only to the extent necessary to bring such provisions into conformance with the state requirement(s) contained in the provision(s) of the state-specific endorsement.

B. NEWLY ACQUIRED OR FORMED ENTITIES

The Named Insured shown in the Declarations is amended to include any organization you newly acquire or form, other than a partnership, joint venture, or limited liability company, and over which you maintain ownership or majority (more than 50%) interest; if there is no other similar in surance available to that organization. Coverage under this provision is afforded until the 1 sou, day after you acquire or form the organization or the end of the policy period, whichever is later.

C. EMPLOYEES AS INSUREDS - NONOWNED

AUTOS

The following is added to paragraph A.1 . Who Is An Insured of SECTION II - COVERED AUTOS

LIABILITY COVERAGE:

d. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your per sonal affairs.

D. ADDITIONAL INSURED BY CONTRACT,

PERMIT OR AGREEMENT

The following is added to A.1. Who Is An In sured of SECTION II - COVERED AUTOS

LIABILITY COVERAGE:

Any person or organization that you are re quired to name as an additional insured in a written contract or agreement that is executed or signed by you prior to a "bodily injury" or "property damage" occurrence is an "insured" for Covered Auto Liability coverage. How ever, with respect to covered "autos", such person or organization is an insured only to the extent that person or organization qualifies as an "insured" under A.1. Who is an Insured of

SECTION 11 - COVERED AUTOS LIABILITY

COVERAGE:

If specifically required by the written contract or agreement referenced in the paragraph above, any coverage provided by this endorsement to an additional insured shall be primary and any other valid and collectible insurance avail able to the additional insured shall be non contributory with this insurance. If the written contract does not require this coverage to be primary and the additional insured's coverage to be non-contributory, then this insurance will be excess over any other valid and collectible insur ance available to the additional insured.

E. SUPPLEMENTARY PAYMENTS BAIL

BONDS

Supplementary Payments of SECTION II - COVERED AUTOS LIABILITY COVERAGE is revised as follows:

(2) Up to $2,500 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.

F. SUPPLEMENTARY PAYMENTS - LOSS OF

EARNINGS

Supplementary Payments of the SECTION II - COVERED AUTOS LIABILITY COVERAGE is revised as follows:

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

G. PERSONAL EFFECTS AND PROPERTY OF

OTHERS EXTENSION

1. The. Care, Custody or Control Exclusion of

SECTION II COVERED AUTOS

LIABILITY COVERAGE, does not apply to "property damage" to property, other than your property, up to an amount not exceed ing $250 in any one "accident". Coverage is excess over any other valid and collectible insurance.

2. The following paragraph is added to A.4.

Coverage Extensions of SECTION 111 -

PHYSICAL DAMAGE COVERAGE:

c. We will pay up to $500 for your property that is lost or damaged as a result of a covered "loss", without applying a de ductible. Coverage is excess over any other valid and collectible insurance.

Page2 of 7 Includes copyrighted material of Insurance Services Office, Inc.

with its permission

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ously titled and which you purchased less than 365 days before the date of the "loss".

U. PHYSICAL

EXTENSIONS

DAMAGE COVERAGE

Under SECTION Ill - PHYSICAL DAMAGE COVERAGE, A. Coverage, Coverage Exten sions, b. Loss of Use Expenses is replaced by the following:

b.. Loss of Use Expenses

For Hired Auto Physical Damage, we will pay expenses for which an "insured" be comes legally responsible to pay for loss of use of a vehicle rented or hired without a driver, under a written rental contract or agreement. We will pay for loss of use ex penses if caused by:

(1) Other than collision if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto";

(2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss Coverage is provided for any covered "auto"; or

(3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto."

However, the most we will pay for any expenses for loss of use is $50 per day, to a maximum of $1,500. The insurance provided by this provision is excess over any other collectible insurance.

V. TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US

The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition:

We waive any right of recovery we may have against any person or organization to the extent required of you by a written con tract executed prior to any "accident" be cause of payments we make for damages under this coverage form.

W. NOTICE OF AND KNOWLEDGE OF

OCCURRENCE

SECTION IV - BUSINESS AUTO

CONDITIONS, Paragraph A is amended as follows:

6. NOTICE OF AND KNOWLEDGE OF

OCCURRENCE

a. Your obligation in the Duties in the Event of Accident, Claim, Suit or Loss Condi tion relative to notification requirements applies only when the "accident" or "loss" is known to:

(1) You, if you are an individual;

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

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

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

b. Your obligation in the. Duties in the Event of Accident, Claim, Suit or Loss Condition relative to providing us with documents concerning a claim or "suit" will not be considered breached unless the breach occurs after such claim or "suit" is known to:

(1) You, if you are an individual;

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

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

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

X. HIRED CAR- COVERAGE TERRITORY

Item (5) of the Policy Period, Coverage Territory GeneraConditionss replaced by the following:

(5) Anywherein theworldif a covered "auto" is leased, hired, rented or borrowed without a driver for a period of 30 days or less; and

Y. EMERGENCY LOCKOUT

We will reimburse you up to $100 for reasonable expense incurred for the services of a locksmith to gain entry into your covered "auto" subject to these provisions:

1. Your door key, electronic key or key entry pad has been lost, stolen or locked in your covered "auto" and you are unable to enter such "auto" , or

2. Your keyless entry device battery dies and you are unable to eriter such "auto" as a re-sult, ·

3. Your key, electronic key or key entry pad has been lost or stolen and you have changed the lock to prevent an unauthorized entry; and

Page 6of 7 Includes copyrighted material of Insurance Services Office, Inc with its permission.

ACP BA 30-0-9789796 74QP 21193 INSURED COPY AC7005031600 0001 46 0018246