CTR058022_-_AI_Endorsement__1_.pdf

PI-AI-SCH (08/20)

Page of

Additional Insured Schedule

Policy Number:

Philadelphia Indemnity Insurance Company

PHPK2661586

State of Arizona

Additional Insured and the Department of Economic Security The State of Arizona, its departments, Live Oak Banking Company, ISAOA agencies, boards, commissions, universities and its officers, officials, agents

PO Box 6123

CA2048 - Commercial Automobile

Additional Insured

1741 Tiburon Dr and employees

Wilmington, NC 28403-6244

PO Box 6123

Phoenix, AZ 85005-6123

CG2026 - General Liability

Phoenix, AZ 85005-6123

CG2026 - General Liability

CG2026 - General Liability

Additional Insured

Additional Insured

State of Arizona and the Department of Economic Security

Knowledge Services &

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

9800 Crosspoint Blvd and employees

Indianapolis, IN 46256-3300

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Additional Insured

The State of Arizona and Department of Economic Security the State of Arizona,and its departments c/o myCOI

Pueblo Plaza II, LLC

Flagstaff, AZ 86004-6860

CG2011 - AZ - Loc #7

Additional Insured agencies,boards,commissions,universities

1075 Broad Ripple Ave Ste 313 officers, officials,agents,and employees

Indianapolis, IN 46220-2034

3955 N Arosa Way

[as additional insureds] with respect to liability arising out of the activities performed by, or on behalf of, the Contractor involving

CA2048 - Commercial Automobile automobiles owned, hired and/or non-owned by the Contractor.

LOAN # CTR044676

PO Box 6123 Phoenix, AZ 85005-6123

CA2048 - Commercial Automobile

Additional Insured

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Additional Insured

The State of Arizona and Department of Economic Security c/o myCOI 1075 Broad Ripple Ave Ste 313 Indianapolis, IN 46220-2034

CG2026 - General Liability

LOAN # CTR044676

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POLICY NUMBER: COMMERCIAL GENERAL LIABILITY

CG 20 26 04 13

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

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

ADDITIONAL INSURED – DESIGNATED

PERSON OR ORGANIZATION

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) shown 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.

PHPK2661586

Knowledge Services & the State of Arizona

1 4

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

organization(s) shown 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.

PHPK2661586

State of Arizona and the Department of Economic Security The State of Arizona, its departments, 3 4

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

organization(s) shown 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.

PHPK2661586

The State of Arizona and Department of Economic Security

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PI-MANU-1 (01/00)

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY

All other terms and conditions of this Policy remain unchanged.

To the fullest extent permitted by law, Contractor shall defend, indemnify, and hold harmless the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees (hereinafter referred to as "Indemnitee") from and against any and all claims, actions, liabilities, damages, losses, or expenses (including court costs, attorneys' fees, and costs of claim processing, investigation and litigation) (hereinafter referred to as "Claims") for bodily injury or personal injury (including death), or loss or damage to tangible or intangible property caused, or alleged to be caused, in whole or in part, by the negligent or willful acts or omissions of Contractor or any of its owners, officers, directors, agents, employees or subcontractors. This indemnity includes any claim or amount arising out of, or recovered under, the Workers' Compensation Law or arising out of the failure of such

Contractor to conform to any federal, state, or local law, statute, ordinance, rule, regulation, or court decree. It is the specific intention of the parties that the Indemnitee shall, in all instances, except for

Claims arising solely from the negligent or willful acts or omissions of the

Indemnitee, be indemnified by Contractor from and against any and all claims. It is agreed that Contractor will be responsible for primary loss investigation, defense, and judgment costs where this indemnification is applicable. In consideration of the award of this contract, the Contractor agrees to waive all rights of subrogation against the State of Arizona, its officers, officials, agents, and employees for losses arising from the work performed by the Contractor for the State of Arizona.

Additional Insured-State of Arizona