CTR056116__-_Renewal_Insurance_Documentation.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

12/22/2023

Lovitt & Touché A Marsh and McLennan Agency, LLC 8605 E. Raintree Drive, Suite 200 Scottsdale AZ 85260

Linda Perez

Linda.Perez@MarshMMA.com

CopperPoint Indemnity Insurance Company 13928 CIVIFOU-C1 GuideOne Insurance Company 15032

Civitan Foundation, Inc.

12635 N. 42nd St.

Phoenix AZ 85032

1430514460

B X 1,000,000 X 1,000,000

20,000

1,000,000

3,000,000 X

010030656 12/31/2023 12/31/2024

3,000,000

B 1,000,000

X 010030657 12/31/2023 12/31/2024

B X X 1,000,000010030222 12/31/2023 12/31/2024

1,000,000 X 2,500

A X

N

1020240 1/1/2024 1/1/2025

1,000,000

1,000,000

1,000,000 B Professional Liability

Sexual Abuse or Molestation Liab.

010030656 12/31/2023 12/31/2024 Prof Agg/Occurrence

SAM Agg/Occurrence $3Mil / $1 Mil $3Mil / $1 Mil

The above-indicated Additional Insured and Waiver of Subrogation (WOS) are provided with respects to General Liability, when required in a written and executed contract. Such coverage afforded by these policies (or update as applicable) for the benefit of the additional insured(s) is primary and any other coverage maintained by such additional insured(s) shall be non-contributory when required in a written and executed contract. Subject to all policy terms, conditions and exclusions

Supporting endorsements attached include: GCG6510 0923, CG2001 0413, CA0001 1013, GCA2300 0219 RE: Contract Number CTR056116 State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor. Coverage for General Liability is Primary See Attached...

State of Arizona and Arizona Department of Economic Security c/o myCOI 1075 Broad Ripple Ave, Ste 313 Indianapolis IN 46220

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:

CIVIFOU-C1

1 1

Lovitt & Touché A Marsh and McLennan Agency, LLC Civitan Foundation, Inc.

12635 N. 42nd St.

Phoenix AZ 85032

25 CERTIFICATE OF LIABILITY INSURANCE

and Non-Contributory per form CG 10 01 04/13. Coverage for Auto Liability is Primary and Non-Contributory per Form CA 00 01 10 13. General Liability, Automobile Liability, and Workers Compensation coverage contains a waiver of subrogation in favor of the State of Arizona, its departments, agencies, boards, commissions, universities and its officers, agents and employees for the losses arising from work performed by or on behalf of the Contractor. Sexual Abuse and Molestation coverage is included. 30 Day Notice of Cancellation for non-payment of premium.

3.

4.

5.

6.

7.

8.

9.

F.

1.

a.

b.

2.

Medically Derived Injury

Any claim or "suit" arising out of a "medically derived injury”

Violation Of Any Statute Or Regulation

Any liability arising out of the willful or intentional violation of any statute or regulation including but not limited to the fines and penalties assessed by a court or regulatory authority.

Misconduct, Molestation Or Harassment

Any "bodily injury", "personal and advertising injury", mental or emotional pain or anguish, or any defamation or slander, sustained by any person arising out of or resulting from any actual or alleged act of “abuse“, "sexual misconduct or sexual molestation" or "sexual harassment" of any kind. We have no right or duty to investigate, settle, defend or pay any claim or "suit" asserting any act of “abuse”, "sexual misconduct or sexual molestation", "sexual harassment" or any breach of duty contributing to or arising from such act.

Professional Services

Any liability arising out of any act or omission in the providing of or failure to provide "professional services".

Statutory Enforcement

Any liability or responsibility to meet the requirements or standards of care enforced by any department of human services, department of elder care or similar regulatory body, regardless of the law or statutory basis of such enforcement.

Guaranteeing Results

Including but not limited to any contract or agreement guaranteeing the results of any “professional services” or any type or form of counseling or any type or form of medical, dental, physiological, psychological, addiction, behavioral, chiropractic, holistic, or any other similar treatment.

Abuse

Any claim or "suit" arising out of "abuse".

SECTION II – WHO IS AN INSURED is amended as follows:

Paragraph 3. is amended as follows:

a. Paragraph 3.a. is replaced with:

Coverage under this provision is afforded only until the end of the policy period during which you acquired or formed the organization.

Paragraph 3.d. is added:

d. Coverage under this provision is afforded only when the newly acquired or formed organization operates or conducts the same or similar business as you.

The following is also an insured:

Broadened Named Insured – Any organization and subsidiary thereof which you control and actively manage whether through ownership of voting securities, by contract, or otherwise, on the effective date of this policy. However, coverage does not apply to any organization or subsidiary not named in the Declarations as a Named Insured, if they are also insured under another similar policy, or would have been insured but for such policy’s termination or the exhaustion of its limits of insurance.

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

Copyright 2023 GuideOne Insurance

GCG 65 10 09 23

3.

a.

(1)

(2) b.

(1)

(2) c.

(1)

(2) d.

Each of the following is also an additional insured when you have agreed, in a written contract, that such person or organization be added as an additional insured on your policy, provided the written contract is initiated prior to an "occurrence" resulting in damages:

Engineers, Architects Or Surveyors

Any architect, engineer or surveyor engaged by you but only with respect to liability for “bodily injury”, “property damage” or “personal and advertising injury” caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf in connection with your premises or in the performance of your ongoing operations.

However, the insurance provided to such additional insured engineers, architects, or surveyors does not apply to “bodily injury”, “property damage” or “personal and advertising injury” arising out of the rendering of or the failure to render any professional services by or for you, including:

The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or

Supervisory, inspection, architectural or engineering activities.

This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, 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 services by or for you.

Owners Of Leased Land

Any person or organization from whom you lease land but only with respect to liability arising out of the ownership, maintenance or use of that part of the land leased to you.

However, the insurance afforded to these additional insured owners of leased land does not apply to:

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

Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured.

State Or Governmental Agency Or Subdivision Or Political Subdivision – Permits Or Authorizations

Any state or governmental agency or subdivision or political subdivision, but only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization.

With respect to the insurance afforded these additional insureds, this insurance does not apply to:

“Bodily injury”, “property damage” or “personal and advertising injury” arising out of operations performed for the federal government, state or municipality; or

“Bodily injury” or “property damage” included within the “products-completed operations hazard”.

Contractual Obligations

Any person or organization where required by a written contract executed prior to the “occurrence”. Such person or organization is an additional insured for "bodily injury", "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the Named Insured.

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

Copyright 2023 GuideOne Insurance e.

(1)

(2) f.

(1)

(2) g.

(1)

(2)

(3)

(4)

(5)

(6)

(7)

Manager Or Lessor Of Premises

Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions:

This insurance does not apply to:

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

Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization.

Lessor Of Leased Equipment – Automatic Status When Required In Lease Agreement With You

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

With respect to the insurance afforded to these additional insureds:

A person's or organization's status as an additional insured ends when their contract or agreement with you for such leased equipment ends; and

This insurance does not apply to any "occurrence" which takes place after the equipment lease expires.

Vendors

Any person or organization but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business .

The insurance afforded the vendor does not apply to:

"Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement;

Any express warranty unauthorized by you;

Any physical or chemical change in the product made intentionally by the vendor;

Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container;

Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products;

Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product;

Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or

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

Copyright 2023 GuideOne Insurance

(8)

(a)

(b) h.

(1)

(2)

(a)

(b) i.

(1)

(2)

(3)

(1)

(2)

(3)

(4)

"Bodily injury" or "property damage” arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf.

However, this exclusion does not apply to:

The exceptions contained in Subparagraphs (4) or (6); or

Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products.

This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products.

Funding Source

Any person or organization with respect to their liability arising out of:

Their financial control of you, or

Premises they own, maintain or control while you lease or occupy those premises. This insurance does not apply to:

Any “occurrence” or offense which takes place after you cease to lease or occupy those premises; or

Structural alterations, new construction and demolition operations performed by or for that person or organization.

State Or Governmental Agency Or Subdivision Or Political Subdivision – Permits Or Authorizations Relating To Premises

Any state or governmental agency or subdivision or political subdivision but only with respect to the following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies:

The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar exposures;

The construction, erection, or removal of elevators; or

The ownership, maintenance, or use of any elevators covered by this insurance.

However, A person or organization is an additional insured under this provision only for that period of time required by the written contract;

No such person or organization is an insured under this provision if such person or organization is included as an insured by an endorsement issued by us and attached to the Commercial General Liability Coverage Form;

The insurance afforded to such additional insured only applies to the extent permitted by law; and

The insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

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

Copyright 2023 GuideOne Insurance j.

k.

4.

G.

1.

1.

a.

b.

c.

d.

2.

6.

Medical Directors and Administrators

Your medical directors and administrators but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish “professional services” or “medical or healthcare services” as a physician or psychiatrist in the treatment of a patient.

Home Care Providers

At the first Named lnsured's option, any person or organization under your direct supervision and control while providing on your behalf private home respite or foster home care for the developmentally disabled. Such duties do not include the furnishing or failure to furnish “professional services” or “medical or healthcare services” in the treatment of a patient.

With respect to the insurance afforded to these additional insureds, identified in Paragraph F.3. of this endorsement, the following is added to Section III – Limits Of Insurance:

The most we will pay on behalf of the additional insured is the lesser of:

a. The limit of insurance required by the contract or agreement; or

b. The amount of coverage available under the applicable Limits of Insurance shown in the Declarations;

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

SECTION III - LIMITS OF INSURANCE is amended as follows:

Paragraph 1. is deleted and replaced with:

The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of:

Insureds;

Claims made or “suits” brought;

Persons or organizations making claims or bringing “suits” or

Policies involved.

Paragraph 6. is deleted and replaced with:

Subject to Paragraph 5. above, 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 or temporarily occupied by you with permission of the owner, is the higher of $1,000,000 or the amount shown in the Declarations for the Damage To Premises Rented To You Limit.

However, if damage by fire to premises rented to you is not otherwise excluded, the word fire in the above paragraph is replaced with fire, lightning, explosion, smoke or sprinkler leakage.

3. The following is added to SECTION III – LIMITS OF INSURANCE:

a. If two or more policies or Coverages issued by us apply to the same insured and these policies or Coverages also apply to the same claim or “suit” the maximum amount we will pay as damages under all of the policies or Coverages will not exceed the highest applicable Limit of Insurance that applies to any one of the policies or Coverages.

This condition does not apply to any insurance that was purchased specifically to apply in excess of the applicable Limits of Insurance shown in the Declarations.

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

Copyright 2023 GuideOne Insurance

H.

1.

ii.

2.

3.

4.

(1)

(2)

(3)

I.

1.

3.

2.

4.

3.

SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows:

Subsection 4. Other Insurance, Paragraph b. Excess Insurance, Subsection (1)(a)(ii) is replaced with the following if damage to premises rented to you is not otherwise excluded:

That is fire, lightning, explosion, smoke or sprinkler leakage insurance for premises rented to you or temporarily occupied by you with permission of the owner.

Subsection 8. Transfer Of Rights Of Recovery Against Others To Us is amended to include:

However, the insured may waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract.

The following condition is added:

10. Liberalization

If we revise this NONPROFIT AND HUMAN SERVICES GENERAL LIABILITY ENDORSEMENT to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective in your state.

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

Primary And Noncontributory Insurance

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

The additional insured is a Named Insured under such other insurance;

This insurance is required by a written and executed contract to be primary and not to seek contribution from any other insurance available to the additional insured, but only as it pertains to such written contract; and

The loss to be covered occurs on or after the effective date of the written contract.

SECTION V – DEFINITIONS is amended as follows:

Subsection 3. “Bodily injury” is deleted and replaced with the following:

"Bodily injury" means physical injury, sickness, or disease sustained by a person, including death of a person resulting from any of these. “Bodily injury” also means mental injury, mental anguish, humiliation, or shock sustained by a person, if directly resulting from physical injury, sickness, or disease sustained by that person.

Subsection 4. “Coverage territory” is deleted and replaced by the following:

"Coverage territory" means anywhere in the world provided that the claim is made, and any "suit" that may arise therefrom is filed, within the United States of America (including its territories and possessions), Puerto Rico or Canada, unless further restricted by endorsement.

Paragraph 9. “Insured Contract” subsection a. is replaced by the following:

a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke or sprinkler leakage to premises while retained to you or temporarily occupied by you with permission of the owners is not an “insured contract”.

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

Copyright 2023 GuideOne Insurance

POLICY NUMBER: 01-0030-656

PRIMARY AND NONCONTRIBUTORY –

OTHER INSURANCE CONDITION

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

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

Primary And Noncontributory Insurance

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.

CG 20 01 04 13© Insurance Services Office, Inc., 2012

4.

5.

a.

(1)

(2) b.

c.

6.

a.

b.

7.

a.

b.

(1)

(2)

(3)

(4)

No Benefit To Bailee – Physical Damage Coverages

We will not recognize any assignment or grant any coverage for the benefit of any person or organization holding, storing or transporting property for a fee regardless of any other provision of this Coverage Form.

Other Insurance

For any covered "auto" you own, this Coverage Form provides primary insurance. For any covered "auto" you don't own, the insurance provided by this Coverage Form is excess over any other collectible insurance. However, while a covered "auto" which is a "trailer" is connected to another vehicle, the Covered Autos Liability Coverage this Coverage Form provides for the "trailer" is:

Excess while it is connected to a motor vehicle you do not own; or

Primary while it is connected to a covered "auto" you own.

For Hired Auto Physical Damage Coverage, any covered "auto" you lease, hire, rent or borrow is deemed to be a covered "auto" you own. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto".

Regardless of the provisions of Paragraph a. above, this Coverage Form's Covered Autos Liability Coverage is primary for any liability assumed under an "insured contract".

d. When this Coverage Form and any other Coverage Form or policy covers on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the limits of all the Coverage Forms and policies covering on the same basis.

Premium Audit

The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy began. We will compute the final premium due when we determine your actual exposures. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the balance, if any. The due date for the final premium or retrospective premium is the date shown as the due date on the bill. If the estimated total premium exceeds the final premium due, the first Named Insured will get a refund.

If this policy is issued for more than one year, the premium for this Coverage Form will be computed annually based on our rates or premiums in effect at the beginning of each year of the policy.

Policy Period, Coverage Territory

Under this Coverage Form, we cover "accidents" and "losses" occurring:

During the policy period shown in the Declarations; and

Within the coverage territory.

The coverage territory is:

The United States of America;

The territories and possessions of the United States of America;

Puerto Rico;

Canada; and

CA 00 01 10 13© Insurance Services Office, Inc., 2011

POLICY NUMBER: 01-0030-657

Liability Coverage Extensions Included or Limit of Insurance

A. Who Is An Insured-Broadened Additional Insured by Contract or Agreement Board Members Newly Acquired Entities Employees as Insureds Lessor of Leased Autos

Included Included Included Included Included

B. Supplementary Payments Coverage Extensions Bail Bonds Loss of Earnings

$5,000 $500 per day

C. Fellow Employee Coverage Included

Physical Damage Coverage Extensions Included or Limit of Insurance

A. Towing $100 per disablement B. Glass Repair – No Deductible Included

$100 per day/$2,000 maximum

C. Transportation Expenses

$100 per day/$1,000 maximum

D. Hired Auto Physical Damage-Loss of Use

E. Rental Reimbursement $100 per day for 30 days

F. Personal Effects Coverage $500 ACV/Cost to Repair or

Replace/$50,000 G. Hired Auto Physical Damage

H. Safety Equipment Coverage $500 I. Vehicle Return Coverage $500

J. Lock Recalibration $1,000 K. Auto Loan / Lease Gap Included L. Accidental Airbag Discharge Included M. Electronic Equipment – Broadened Coverage $1,000

O. Physical Damage Deductible With Vehicle Tracking System Included Exception

Business Auto Conditions Included A. Blanket Waiver of Subrogation Included

B. Two Or More Coverage Forms Or Policies Issued By Us Included

N. Original Equipment Manufacturer (OEM) Parts Replacement Included

GuideVantagesm Auto Enhancement

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE PART

Following is a summary of the Limits of Insurance and additional coverage provided by this endorsement. This summary identifies the maximum amount of coverage for each coverage extension shown below. For complete details on coverage, refer to the actual provisions of this endorsement and the entire policy.

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

Copyright 2019 GuideOne Insurance

GCA 23 00 02 19

A.

c.

(1)

(2) d.

e.

(1)

(2)

(3) f.

g.

Coverage extensions under this endorsement only apply in the event that no other specific coverage for these extensions are provided under this policy. If such specific coverage apply, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted in this endorsement.

LIABILITY COVERAGE EXTENSIONS

WHO IS AN INSURED – BROADENED

Paragraph A.1.c. of Section II – Covered Autos Liability Coverage is replaced by the following:

Anyone liable for the conduct of an "insured" described above but only to the extent of that liability.

In addition:

Any person or organization is included as an additional "insured" when you have agreed in a written contract or agreement to include such person or organization as an additional "insured".

Such person or organization is an additional "insured" only to the extent such person or organization is liable for "bodily injury" or "property damage" because of the conduct of an "insured" under Paragraphs a. or b. under Paragraph A.1. Who Is An Insured of Section II – Covered Autos Liability Coverage, caused by an "accident" and resulting from the ownership, maintenance or use of a covered "auto".

The following are added to Paragraph A.1. Who Is An Insured of Section II – Covered Autos Liability Coverage:

Board Members

When any symbol is indicated in the Declarations for Liability Coverage, board members (or their spouses) while renting an "auto" while conducting business for the insured.

Newly Acquired Entities

Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company or any organization excluded either by this Coverage Part or by endorsement, and over which you maintain ownership or majority interest of more than 50 percent will qualify as a Named Insured. However:

This insurance does not apply to any newly acquired or formed organization that is an "insured" under any other automobile policy or would be an "insured" under such policy but for its termination or the exhaustion of its Limit of Insurance.

Coverage under this provision does not apply to "bodily injury", "property damage", expense or "loss" that occurred before you acquired or formed the organization.

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.

Employees as Insureds

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.

Lessor of Leased Autos

The lessor of a "leased auto" is an "insured" only for "bodily injury" or "property damage" resulting from the covered acts or omissions by:

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

Copyright 2019 GuideOne Insurance

A.

a.

b.

c.

D. Deductible

For each covered "auto", our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by the applicable deductible shown in the Declarations. Any Comprehensive Coverage deductible shown in the Declarations:

1. Does not apply to "loss" caused by fire or lightning; and

2. Will be reduced by 50% for any "loss" caused by theft if the vehicle is equipped with a radio frequency tracking device and that device was the method of recovery of the vehicle.

BUSINESS AUTO CONDITIONS

BLANKET WAIVER OF SUBROGATION

The following is added to Paragraph A.5. Transfer of Rights of Recovery Against Other To Us of Section IV – Business Auto Conditions:

However, we waive any right of recovery we may have against a person or organization because of payments we make for "bodily injury" or "property damage" when you and such person or organization have agreed in writing in a contract or agreement to waive such right of recovery, provided:

Such written contract or agreement was:

(1) Made prior to the "accident" or "loss" resulting in the covered "bodily injury" or "property damage"; and

(2) Was in effect at the time of the covered "bodily injury" or "property damage".

The covered "bodily injury" or "property damage" must arise out of the operations specified in such written contract or agreement.

At our request you must provide us with a copy of the aforementioned written contract or agreement.

B. TWO OR MORE COVERAGE FORMS OR POLICIES ISSUED BY US

The following is added to Paragraph B.8. of Section IV – Business Auto Conditions:

If a "loss" covered under this Coverage Part also involves a "loss" to another property from the same "accident", which is covered under a Commercial Property Coverage Part or Inland Marine Coverage Part issued by us or any other member company of ours for you, only the highest deductible applicable to those coverages will be applied to the "accident".

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

Copyright 2019 GuideOne Insurance

POLICY NUMBER: 01-0030-657 COMMERCIAL AUTO

CA 20 48 10 13

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1

DESIGNATED INSURED FOR

COVERED AUTOS LIABILITY COVERAGE

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 this endorsement.

This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form.

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 Of Person(s) Or Organization(s):

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

Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II – Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I – Covered Autos Coverages of the Auto Dealers Coverage Form.

CIVITAN FOUNDATION INC

12/31/2022

State of Arizona, 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 (Civitan Foundation).

POLICY NUMBER: 01-0030-657

SCHEDULE

WAIVER OF TRANSFER OF RIGHTS OF

RECOVERY AGAINST OTHERS TO US

(WAIVER OF SUBROGATION)

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

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.

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

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 Others 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 "accident" or the "loss" under a contract with that person or organization.

Named Insured:

Endorsement Effective Date:

Civitan Foundation Inc

CA 04 44 10 13© Insurance Services Office, Inc., 2011

12/31/2022

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.

POLICY NUMBER:

ADDITIONAL INSURED –

DESIGNATED PERSON OR ORGANIZATION

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

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

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

A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) s hown in the Schedule, but only with respect to liability for "bodily injury", “property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf:

1. In the performance of your ongoing operations; or

2. In connection with your premises owned by or rented to you.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

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

III - Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the 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 Declarations;

whichever is less.

This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.

© Insurance Services Office, Inc., 2012 CG 20 26 04 13

State of Arizona, 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 .

010030656

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

Name Of Person Or Organization:

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

SCHEDULE

The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions:

We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard".

This waiver applies only to the person or organization shown in the Schedule above.

CG 24 04 05 09© Insurance Services Office, Inc., 2008

General Liability, Auto Liability (this is a separate policy) and Umbrella Liability coverage contains a waiver of subrogation in favor of the State of Arizona, its departments, agencies, boards, Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Name Of Person Or Organization:

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

SCHEDULE

The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions:

We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard".

This waiver applies only to the person or organization shown in the Schedule above.

CG 24 04 05 09© Insurance Services Office, Inc., 2008 commissions, universities and its officers, agents and employees for the losses arising from work performed by or on behalf of the Contractor.

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.

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.)

01/01/2023Endorsement Effective 1020240Policy No. 18Endorsement No.

Civitan Foundation IncInsured 0.00Premium $

CopperPoint Indemnity Insurance CompanyInsurance Company Countersigned by

This document may have been uploaded to the CopperPoint Portal.

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. 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.

1789 W Jefferson Ave. Suite 791-A Phoenix AZ 85007