CTR066191_-_Renewal_COI_and_Endorsements__1_.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

8/6/2024

Arthur J. Gallagher Risk Management Services, LLC 595 Market Street Suite 2100 San Francisco CA 94105

415-536-8499

License#: 0D69293 Federal Insurance Company 20281 American Alternative Insurance Corp 19720

Roman Catholic Church Diocese of Tucson Catholic Community Services of Southern Arizona, I 268 W. Adams Street Tucson AZ 85705

Arch Insurance Company 11150

1735928530

B X 5,000,000 X Included

X *Sexual Abuse Excluded X Prof Liability Included

5,000,000 X

Y Y R2-A2-0000005-00 7/1/2024 7/1/2025

Included

Self Insured Limit 1,000,000 B 2,000,000

X Y Y R2-A2-0000005-00 7/1/2024 7/1/2025

Self Insured Limit 1,000,000

C X

N

Y WCX 0068135 02 7/1/2024 7/1/2025 SIR $500,000

1,000,000

1,000,000

1,000,000 A Crime 81221058 7/1/2024 7/1/2025 Employee Theft

Retention $1,000,000 $50,000

* Sexual Abuse : Self Insured Retention $1,000,000 -Specific/Agg Limit $4,000,000 Limit / Claims-Made Coverage Retroactive Date: 7/01/2003 General Liability and Automobile Liability – Self-Insured Retention $1,000,000 Excess Workers Comp - – Self-Insured Retention $500,000

RE: Contract #CTR066191The State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, agents and employees shall be named as Additional Insureds for ongoing and completed operations with respect to liability arising out of the activities performed by or on behalf of the Contractor for General Liability and Auto Liability. Waiver of Subrogation applies to General Liability, Auto Liability and Workers Comp policies.

The State of Arizona and Dept of Economic Security C/O: myCOI 1075 Broad Ripple Ave, Suite 313 Indianapolis IN 46220

USA

RL 2032 07 24 Copyright, 2024 Munich Reinsurance America, Inc. Includes copyrighted material of Insurance Services Office, Inc. with its permission.

AMERICAN ALTERNATIVE

INSURANCE CORPORATION

RETAINED LIMIT POLICY CHANGES

Date Issued: 07/29/2024 Named Insured The Roman Catholic Church of the Diocese of Tucson

Endorsement Number

Policy Number

R2-A2-RL-0000005-00

Endorsement Effective 07/01/2024

Ignacio Rivera Catherine B. Smith

Assistant Deputy General Counsel President and Assistant Secretary

The above is required to be completed only when this endorsement is issued subsequent to the preparation of the policy.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED FOR SPECIFIED ACTIVITY(IES) OR

OPERATIONS AT DESIGNATED PREMISES

This endorsement modifies insurance provided under the following:

GENERAL LIABILITY COVERAGE PART

AUTOMOBILE LIABILITY COVERAGE PART

WRONGFUL ACTS COVERAGE PART

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

Schedule

Person or Organization (Additional Insured):

The State of Arizona, Department of Economic Security 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 Named Insured

Description of Your Activity(ies) or Operations:

For both ongoing and completed operations of Catholic Community Services of Southern Arizona, Inc. for any contract with The State of Arizona.

Designated Premises:

All premises associated with activities or operations as a part of any contract between Catholic Community Services of Southern Arizona, Inc. and The State of Arizona.

A. The definition of Insured in the Liability Claims Administration, Exclusions, Conditions and

Definitions section of this policy is amended to include as an Insured the Additional Insured shown in the above Schedule with whom you have agreed in a written contract or written agreement that such Person or Organization be added as an Additional Insured in your policy for your specified activity(ies) or operations described in the above Schedule at the Designated Premises described in the above Schedule.

The Person or Organization's status as an Additional Insured under this endorsement ends when this policy terminates, the contract or agreement terminates, or your specified activity or operation at the Designated Premises terminates, whichever occurs first.

B. With respect to the General Liability Coverage Part:

1. The Additional Insured described in Paragraph A. above is an Insured only with respect to their liability assumed by you that would otherwise be imposed by law in the absence of any contract or agreement relating to or arising out of your specified activity(ies) or operations described in the above Schedule at the Designated Premises described in the above Schedule.

2. The contract or agreement described above must be:

a. In effect at the inception of the Policy Period or becomes effective during the Policy

Period; and

b. Executed prior to the Bodily Injury, Property Damage, Personal Injury or Advertising

Injury covered under this Coverage Part.

3. Coverage is provided by this endorsement to the Additional Insured shown in the above Schedule only with respect to liability for Bodily Injury, Property Damage, Personal Injury or Advertising Injury caused, in whole or part, by your specified activity(ies) or operations described in the above Schedule and at the Designated Premises described in the above Schedule.

C. With respect to the Automobile Liability Coverage Part:

1. The Person or Organization described in Paragraph A. above is an Insured only with respect to their liability assumed by you relating to or arising out of your specified activity(ies) or operations described in the above Schedule at the designated Premises. However, no coverage applies to an Insured’s obligation to pay by reason of the assumption of liability in a contract or agreement, except for liability for damages:

a. That an Insured would have in the absence of the above described contract or agreement; or

b. Assumed in the above described contract or agreement that is an Insured Contract provided the Bodily injury or Property Damage occurs subsequent to the execution of the contract or agreement; and such contract or agreement was in effect at the inception of the Policy Period or becomes effective during the Policy Period.

2. Coverage is provided by this endorsement to the Additional Insured shown in the above Schedule only with respect to liability for Bodily Injury or Property Damage caused, in whole or part, by your specified activity(ies) or operations described in the above Schedule and at the Designated Premises described in the above Schedule.

D. With respect to the Wrongful Act Coverage Part only,

1. the Additional Insured described in Paragraph A is an Insured only with respect to the liability relating to the activities described in the Schedule for Wrongful Acts caused in whole or in part by:

a. Your acts, errors or unintentional omissions; or

b. The acts, errors or unintentional omissions of those Insured(s) acting on your behalf pursuant to the contract with the Additional Insured shown in the above Schedule;

for your specified activity(ies) or operations described in the above Schedule and at the Designated Premises described in the above Schedule.

2. The contract or agreement referred to in Paragraph A. above must be:

a. In effect at the inception of the Policy Period or becomes effective during the Policy Period;

and

b. Executed prior to the Wrongful Act covered under this Coverage Part.

3. The coverage provided by this endorsement to the additional Insured shown in the above Schedule does NOT apply to any Wrongful Act arising out of the sole negligence of such Additional Insured.

E. We will endeavor to send notice of cancellation to the Additional Insured shown in the above Schedule at the described address at least 30 days in advance (10 days in the event of non-payment of premium).

F. The following is added to Paragraph E. Our Right To Recover Payment Condition in the Liability Claims Administration, Exclusions, Conditions and Definitions:

We waive any right of recovery we may have against the Additional Insured shown in the above Schedule because of payments we make for injury or damage arising out of the your specified activity(ies) or operations described in the above Schedule at the Designated Premises described in the above Schedule, but only to the extent such subrogation is waived prior to the Occurrence, Accident, Wrongful Act or loss, under a written contract or written agreement with such Additional Insured.

This waiver only applies to the Additional Insured for your specified activity(ies) or operations described in the above Schedule at the Designated Premises described in the above Schedule.

However, this waiver does not apply if the applicable Bodily Injury, Property Damage, Personal Injury or Advertising Injury is due to the sole negligence of such scheduled Organization, and such Bodily Injury, Property Damage, Personal Injury or Advertising Injury is NOT caused, in whole or part, by liability associated with your specified activity(ies) or operations described in the above Schedule at the Designated Premises described in the above Schedule. This waiver does also not apply if any applicable Wrongful Act arises out of the sole negligence of such of such scheduled Organization.

G. The following is added to Condition D. Other Insurance in the Liability Claims Administration, Exclusions, Conditions and Definitions section of the policy, and supersedes any provision to the contrary:

For the additional Insured under your policy shown in the above Schedule, and subject to Paragraph A. above, this insurance is primary to and will not seek contribution from any other insurance available to such additional Insured 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 for amounts payable under the insurance provided by this endorsement.

All other terms and conditions remain unchanged.

00 ML0207 00 11 03 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

This endorsement modifies insurance provided under the following:

EXCESS WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY

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 below. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.

SCHEDULE

The State of Arizona, Department of Economic Security

The 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.

Address:

1789 W. Jefferson Street, Mail Drop 6271 Phoenix, AZ 85007

All other terms and conditions of this Policy remain unchanged.

Issued By: Arch Insurance Company

Endorsement Number: 7

Policy Number: WCX 0068135 01

Named Insured: Roman Catholic Church Diocese of Tucson

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

Endorsement Effective Date: July 1, 2023

President

WCX 0068135 02

July 01, 2024