CTR066196_-_COI.pdf

INSR ADDL SUBR

LTR INSR WVD

DATE (MM/DD/YYYY)

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 EXP

TYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)

COMMERCIAL GENERAL LIABILITY

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

INSURER(S) AFFORDING COVERAGE NAIC #

Y / N

N / A (Mandatory in NH)

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

EACH OCCURRENCE $

DAMAGE TO RENTED

$PREMISES (Ea occurrence)CLAIMS-MADE OCCUR

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GENERAL AGGREGATE $GEN'L AGGREGATE LIMIT APPLIES PER:

PRODUCTS - COMP/OP AGG $

PRO-

OTHER:

LOCJECT

COMBINED SINGLE LIMIT

$(Ea accident)

BODILY INJURY (Per person) $ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS

AUTOS ONLY

HIRED PROPERTY DAMAGE $

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 LIMIT $DESCRIPTION OF OPERATIONS below

POLICY

NON-OWNED

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 any 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.

The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03)

ACORDTM CERTIFICATE OF LIABILITY INSURANCE

Social Service Contractors Indemnity

CopperPoint Casualty Ins Co

Hudson Excess Insurance Company

9/15/2023

USI Insurance Services LLC 2375 E. Camelback Rd, Suite 250 Phoenix, AZ 85016

Isai Gomez

Isai.Gomez@usi.com

Housing Solutions of Northern Arizona Inc PO Box 30134 Flagstaff, AZ 86003

NONE

13210 14484

A X X

X

X X 60029421 03/03/2023 02/01/2024 1,000,000 1,000,000 10,000 1,000,000 3,000,000 3,000,000

A

X X X

X X 60029421 03/03/2023 02/01/2024 1,000,000

A X X

X 10,000

60029431 03/03/2023 02/01/2024 1,000,000 1,000,000

B

Y

X 1019752 07/01/2023 07/01/2024 X 1,000,000

1,000,000 1,000,000

A C A

Crime Cyber Liabilty Prof Liab /SAM

60029421

CYB303083601

60029421

03/03/2023 02/01/2023 03/03/2023

02/01/2024 02/01/2024 02/01/2024

*See Description of Ops *See Description of Ops *See Description of Ops

Cyber Liability: $500,000 Each Claim, $500,000 Aggregate Retro date: 12-10-18 Employee Dishonesty: $25,000 Limit - Deductible: $1,000 Forgery & Alteration: $25,000 Limit - Deductible: $1,000 Professional Liability: $1,000,000 Each Occurrence / $3,000,000 Aggregate Sexual Abuse & Molestation: $1,000,000 Each Occurrence / $3,000,000 Aggregate (See Attached Descriptions)

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

#S41820929/M40500276

HOUSISOL1Client#: 1273307

IXGJD

#S41820929/M40500276

SAGITTA 25.3 (2016/03)

DESCRIPTIONS (Continued from Page 1)

RE: Contract: CTR066196 - Domestic Violence Statewide.

The General Liability and Automobile Liability policies includes an automatic Additional Insured endorsement that provides Additional Insured status to the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees, only when there is a written contract that requires such status, and only with regard to work performed by or on behalf of the named insured. The General Liability policy contains a special endorsement with Primary and Noncontributory wording, when required by written contract. The General Liability, Automobile Liability and Workers Compensation policies include a Waiver of Subrogation endorsement in favor of 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. Sexual Abuse and Molestation coverage is included.

#S41820929/M40500276

Social Service Contractors Indemnity Pool

WHO IS AN INSURED - ADDITIONAL INSURED_SSCOMMAIAZ_08/21

SSCOMMAIAZ (08-21) Includes wording © ISO Properties, Inc., used with permission Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WHO IS AN INSURED - ADDITIONAL INSURED

Policy Number: 6002942-1 Effective Date: 03/03/2023 This endorsement modifies insurance provided under the following:

SOCIAL SERVICE AGENCY PROFESSIONAL LIABILITY COVERAGE FORM

SEXUAL OR PHYSICAL ABUSE OR MOLESTATION COVERAGE FORM

BUSINESS AUTO COVERAGE FORM (coverage applies to owned, leased, hired or borrowed vehicles) COMMERCIAL GENERAL LIABILITY COVERAGE FORM (including Products-Completed Operations Coverage)

Schedule:

Name Of Additional Insured Entities:

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

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

The section entitled “Who is an Insured” in each of the coverage forms set forth above is amended to include as an insured the person or organization shown in the schedule, but only with respect to liability for injury or damage resulting from your operations performed for that insured and caused by your acts or omissions.

All other terms and conditions remain unchanged.

WAIVER OF TRANSFER RIGHTS OF RECOVERY_SSCOMMWOSAZ_08/21

SSCOMMWOSAZ (08-21) Includes wording © ISO Properties, Inc., used with permission Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WAIVER OF TRANSFER RIGHTS OF RECOVERY

Policy Number: 6002942-1 Effective Date:03/03/2023

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

SOCIAL SERVICE AGENCY PROFESSIONAL LIABILITY COVERAGE FORM

SEXUAL ABUSE LIABILITY COVERAGE FORM

SCHEDULE

Name of Person or Organization: the State of Arizona, its departments, agencies, boards, commissions, universities and all officers, officials, agents, and employees of these entities, for losses arising from work performed by or on behalf of the contractor.

1. The TRANSFER OF RIGHTS OF RECOVERY Condition (Section IV COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following:

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 damages arising out of your ongoing operations or "your work" done under a contract for 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.

2. The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV BUSINESS AUTO CONDITIONS) is amended by the addition of the following:

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 damages for “bodily injury” or “property damage” to which this insurance applies.

3. The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV PROFESSIONAL LIABILITY CONDITIONS) is amended by the addition of the following:

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 “damages” resulting from a “wrongful act” to which this insurance applies.

4. The TRANSFER OF RIGHTS OF RECOVERY Condition (Section D., SEXUAL OR PHYSICAL ABUSE OR MOLESTATION CONDITIONS) is amended by the addition of the following:

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 damages due to “abuse” to which this insurance applies.

All other terms and conditions remain unchanged.

SSGLCOV (01/21) Includes wording © ISO Properties, Inc. Used with Permission. Page 14 of 26 within the applicable limit of insurance. These payments will not reduce the limits of insurance.

Supplementary payments may, with regard to certain types of covered claims and damages, erode the applicable Limit of Liability.

2. If we defend an insured against a “suit” and an indemnitee of the insured is also named as a party to the “suit”, we will defend that indemnitee if all of the following conditions are met:

a. The “suit” against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an “insured contract”;

b. This insurance applies to such liability assumed by the insured;

c. The obligation to defend, or the cost of the defense of, that indemnitee, has also been assumed by the insured in the same “insured contract”;

d. The allegations in the “suit” and the information we know about the “occurrence” are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee;

e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such “suit” and agree that we can assign the same counsel to defend the insured and the indemnitee; and

f. The indemnitee:

(1) Agrees in writing to:

(a) Cooperate with us in the investigation, settlement or defense of the “suit”;

(b) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the “suit”;

(c) Notify any other insurer whose coverage is available to the indemnitee; and

(d) Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee; and

(2) Provides us with written authorization to:

(a) Obtain records and other information related to the “suit”; and

(b) Conduct and control the defense of the indemnitee in such “suit”.

So long as the above conditions are met, attorneys' fees incurred by us in the defense of that indemnitee, necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.(2) of Section I - Coverage A - Bodily Injury And Property Damage Liability, such payments will not be deemed to be damages for “bodily injury” and “property damage” and will not reduce the limits of insurance.

Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary litigation expenses as Supplementary Payments ends when:

(a) We have used up the applicable limit of insurance in the payment of judgments or settlements; or

(b) The conditions set forth above, or the terms of the agreement described in

Paragraph f. above, are no longer met.

SECTION II - WHO IS AN INSURED

1. If you are designated in the Declarations as:

a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner.

b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business.

c. A limited liability company, you are an insured. Your members are also insureds, but only

SSGLCOV (01/21) Includes wording © ISO Properties, Inc. Used with Permission. Page 15 of 26 with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers.

d. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders.

e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees.

2. Each of the following is also an insured:

a. Your “volunteer workers” only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business.

However, none of these "employees" or “volunteer workers” are insureds for:

(1) “Bodily injury” or “personal and advertising injury”:

(a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), or to a co-”employee” while in the course of his or her employment or performing duties related to the conduct of your business, or to your other “volunteer workers” while performing duties related to the conduct of your business;

(b) To the spouse, child, parent, brother or sister of that co-“employee” or “Volunteer worker” as a consequence of Paragraph (1)(a) above;

(c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1)(a) or (b) above; or

(d) Arising out of his or her providing or failing to provide professional health care services.

(2) “Property damage” to property:

(a) Owned, occupied or used by;

(b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by;

you, any of your "employees", “volunteer workers”, any partner or member

(if you are a partnership or joint venture), or any member (if you are a limited liability company).

b. Any person (other than your “employee” or “volunteer worker”), or any organization while acting as your real estate manager.

c. Any person or organization having proper temporary custody of your property if you die, but only:

(1) With respect to liability arising out of the maintenance or use of that property; and

(2) Until your legal representative has been appointed.

d. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part.

e. However, none of these persons is an insured for:

(1) “Bodily injury” to:

(a) You, your partners or members (if you are a partnership or joint venture), or your members (if you are a limited liability company); or

(b) Your “employee”, your “volunteer worker” or a co-participant in the athletic activity; or

SSGLCOV (01/21) Includes wording © ISO Properties, Inc. Used with Permission. Page 16 of 26

(2) “Property damage” to property:

(a) Owned, occupied or used by, or

(b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by you, any of your "employees", “volunteer workers”, any partner or member (if you are a partnership or joint venture), any member (if you are a limited liability company), or any co- participant in the athletic activity.

f. Any person or organization from whom you lease or rent premises, or upon whose premises a “special event” is held, if you are required to add such person or organization as an insured under this policy by:

(1) A written contract or agreement; or

(2) An oral contract or agreement where a Certificate of Insurance has been issued showing that person or organization as an insured under this policy.

However, such person or organization:

(1) Is an insured only with respect to that person’s or organization’s vicarious liability for actual damages:

(a) Caused solely by you or by “your work”; and

(b) Arising out of the ownership, maintenance or use of that portion of the premises leased, rented or occupied by you while you are a tenant in the premises or using it for a “special event”.

(2) Is not an insured:

(a) With respect to structural alterations, new construction or demolition operations performed by or on behalf of that person or organization; or

(b) If that person or organization caused or contributed to the “occurrence” resulting in liability.

g. Any other person or organization with whom you have a written “insured contract” that requires you to add such person or organization as an insured under this policy, but only with respect to that person’s or organization’s vicarious liability for actual damages caused solely by you or by “your work” and arising out of:

(1) Your premises;

(2) Your ongoing operations, other than the manufacture or assembly of goods or products, performed for that person or organization;

(3) That person’s or organization’s financial control of you;

(4) The maintenance, operation, or use by you of equipment leased to you by that person or organization; or

(5) A permit issued to you by a state or political subdivision.

The Limits of Insurance applicable to Paragraphs f. and g. above are the lesser of those specified in the “insured contract” or in the Declarations.

3. With respect to “mobile equipment” registered in your name under any motor vehicle registration law, any person is an insured while driving such equipment along a public highway with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the equipment, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to:

a. “bodily injury” to a co-“employee”; or

b. “Property damage” to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision.

4. 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 interest, will qualify as an insured if

SSGLCOV (01/21) Includes wording © ISO Properties, Inc. Used with Permission. Page 17 of 26 there is no other similar insurance available to that organization. However:

a. Coverage under this provision is afforded only until the 120th day after you acquire or form the organization or the end of the policy period, whichever is earlier;

b. Coverage A does not apply to “bodily injury” or “property damage” that occurred before you acquired or formed the organization; and

c. Coverage B does not apply to “personal and advertising injury” arising out of an offense committed before you acquired or formed the organization.

No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations.

SECTION III - LIMITS OF INSURANCE

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

a. Insureds;

b. Claims made or "suits" brought; or

c. Persons or organizations making claims or bringing "suits".

2. Except as limited below, the General Aggregate Limit is the most we will pay for the sum of:

a. Medical expenses under Coverage C;

b. Damages under Coverage A, except damages because of “bodily injury” or “property damage” included in the “products-completed operations hazard”;

c. Damages under Coverage B; and

d. Damages or “defense expenses” under Coverage D.

3. The Products-Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of “bodily injury” and “property damage” included in the “products-completed operations hazard”.

4. Subject to 2. above, the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all “personal and advertising injury” sustained by any one person or organization.

5. Subject to 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of:

a. Damages under Coverage A; and

b. Medical expenses under Coverage C because of all “bodily injury” and “property damage” arising out of any one “occurrence”.

6. Subject to 5. above, the Damage to Premises Rented to You Limit is 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 you or temporarily occupied by you with the permission of the owner.

7. Subject to 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of “bodily injury” sustained by any one person.

8. The Data Security Breach Aggregate Limit is the most we will pay under Coverage D for all damages and “defense expenses" attributable to all “data security breaches” or “related data security breaches” reported to us during the policy period.

The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance.

SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS

SSGLCOV (01/21) Includes wording © ISO Properties, Inc. Used with Permission. Page 18 of 26

1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part.

2. Duties In The Event Of Occurrence, Offense, Claim Or Suit

a. You must see to it that we are notified as soon as practicable of an “occurrence” or an offense which may result in a claim. To the extent possible, notice should include:

(1) How, when and where the “occurrence” or offense took place;

(2) The names and addresses of any injured persons and witnesses; and

(3) The nature and location of any injury or damage arising out of the “occurrence” or offense.

b. If a claim is made or “suit” is brought against any insured, you must:

(1) Immediately record the specifics of the claim or “suit” and the date received; and

(2) You must see to it that we receive written notice of the claim or “suit” as soon as practicable.

c. You and any other involved insured must:

(1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or “suit”;

(2) Authorize us to obtain records and other information;

(3) Cooperate with us in the investigation or settlement of the claim or defense against the “suit”; and

(4) Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply.

d. Your obligation to notify us under Paragraphs a. through c. above is satisfied if you send us written notice as soon as practicable after any of your “executive officers”, directors, partners, agents, insurance managers, or legal representatives becomes aware of, or should have become aware of, the “occurrence ”, offense, claim or “suit ”.

e. If you report an “occurrence ” or offense to your Workers’ Compensation insurer which later becomes a claim under this Coverage Part, failure to report the “occurrence ” or offense to us at the time of the “occurrence ” or offense will not be considered a breach of this Condition if you notify us as soon as practicable after you become aware that the “occurrence ” or offense has become a liability claim.

f. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent.

3. Legal Action against Us No person or organization has a right under this Coverage Part:

a. To join us as a party or otherwise bring us into a “suit” asking for damages from an insured;

or

b. To sue us on this Coverage Part unless all of its terms have been fully complied with.

A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative.

4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A, B or D of this Coverage Part, our obligations are limited as follows:

a. Primary Insurance

SSGLCOV (01/21) Includes wording © ISO Properties, Inc. Used with Permission. Page 19 of 26

This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary.

Then, we will share with all that other insurance by the method described in Paragraph c.

below.

b. Excess Insurance

(1) This insurance is excess over:

(a) Any of the other insurance, whether primary, excess, contingent or on any other basis:

(i) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for “your work”;

(ii) That is fire insurance for premises rented to you or temporarily occupied by you with permission of the owner;

(iii) That is insurance purchased by you to cover your liability as a tenant for “property damage” to premises rented to you or temporarily occupied by you with permission of the owner;

(iv) That is liability insurance purchased by any person or organization qualifying as an insured under Paragraph 2.f. or 2.g. of Section II

– Who Is An Insured, unless a written contractual arrangement specifically requires this insurance to be primary;

(v) If the loss arises out of the maintenance or use of aircraft or watercraft; or if the loss arises out of the maintenance or use "autos", to the extent not subject to Exclusion g. of Section I - Coverage A - bodily injury and Property Damage Liability.

(vi) If the loss arises from a “data security breach,” any Cyber Liability Insurance or other insurance purchased for the express purpose of providing primary liability coverage data or cyber security incidents.

(b) Any other primary insurance available to you covering liability for damages arising out of the premises or operations for which you have been added as an additional insured.

(2) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any “suit ” if any other insurer has a duty to defend the insured against that “suit ”. If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers.

(3) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of:

(a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and

(b) The total of all deductible and self-insured amounts under all that other insurance.

(4) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part.

c. Method of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first.

If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers.

SSGLCOV (01/21) Includes wording © ISO Properties, Inc. Used with Permission. Page 20 of 26

d. Insurance Under Two or More Coverages It is our stated intention that the various coverage parts or policies issued to you by us, or any company affiliated with us, do not provide any duplication or overlap of coverage for the same “claim” or “suit”. If this policy and any other coverage part or policy issued to you by us, or any company affiliated with us, apply to the same occurrence, offense, wrongful act, accident, loss or damages, the maximum Limit of Insurance under all such coverage parts or policies combined shall not exceed the highest applicable Limit of Insurance under any one coverage part or policy. This condition does not apply to any Excess or Umbrella Policy issued by us specifically to apply as excess insurance over this policy.

5. Premium Audit

a. We will compute all premiums for this Coverage Part in accordance with our rules and rates.

b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured named in the Declarations.

The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured.

c. The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request.

6. Representations

By accepting this policy, you agree:

a. The statements in the Declarations are accurate and complete;

b. Those statements are based upon representations you made to us; and

c. We have issued this policy in reliance upon your representations.

7. Separation of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured named in the Declarations, this insurance applies:

a. As if each Named Insured were the only Named Insured; and

b. Separately to each insured against whom claim is made or “suit” is brought.

8. Transfer of Rights of Recovery

a. If the insured has rights to recover all or part of any payment we have made under this

Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring “suit” or transfer those rights to us and help us enforce them.

b. If required by written “insured contract”, we will waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of:

(1) Your ongoing operations; or

(2) “Your work” done under a contract for that person or organization and included in the “products- completed operations hazard”.

9. When We Do Not Renew

If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 90 days before the expiration date.

If notice is mailed, proof of mailing will be sufficient proof of notice.

SECTION V - DEFINITIONS

1. “Abuse” means actual, threatened, attempted or alleged acts of physical abuse, sexual abuse, sexual molestation, sexual assault, sexual exploitation, or any other sexual misconduct performed by a

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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PLATINUM EXPANSION ENDORSEMENT

This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM

With respect to the coverages provided by this endorsement, the provisions of the Business Auto Coverage Form apply unless modified by this endorsement.

A. NEWLY ACQUIRED OR FORMED ORGANIZATIONS

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

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:

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

2. Coverage does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and

3. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period, whichever is earlier.

B. ADDITIONAL INSURED BY CONTRACT OR AGREEMENT

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

When you have agreed in a written contract or agreement to include a person or organization as an additional "insured", such person or organization is included as an "insured" subject to the following:

1. 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";

2. The written contract or agreement described above must have been executed prior to the "accident" that caused the "bodily injury" or "property damage" and be in effect at the time of such "accident";

3. The insurance afforded to any such additional "insured" does not apply to any "accident" beyond the period of time required by the written contract or agreement described above;

4. The most we will pay on behalf of such additional "insured(s)" is the lesser of:

a) The coverage or l im it specified in the written contract or agreement described above;

or

b) The Limits of Insurance shown in the Declarations for this policy.

c) This provision shall not increase the Limit of Insurance shown in the Declarations in this policy or coverage part.

5. The following changes are made to Paragraph 5. Other Insurance of B. General Conditions under

Section IV - Business Auto Conditions:

a. The following is added to Paragraph 5.a.:

If required by the written contract or agreement described above, the insurance afforded to

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SSAPLAT (01/23) Includes wording © ISO Properties, Inc., used with permission Page 2 of 6 the additional insured under this provision will be primary to, and will not seek contribution from, the additional insured’s own insurance.

b. Paragraph 5.c. is deleted in its entirety.

6. Paragraph A.1.c. under Section II – Covered Autos Liability Coverage is deleted in its entirety.

7. The definition of H. "Insured contract" under Section V - Definitions is amended to add the following: An "insured contract" does not include that part of any contract or agreement:

That pertains to the ownership, maintenance or use of an "auto" and which indemnifies a person or organization for other than the vicarious liability of such person or organization for "bodily injury" or "property damage" caused by your operation or use of a covered "auto".

However, a person or organization is an additional "insured" under this provision only to the extent such person or organization is not named as an "insured" by separate endorsement to this policy.

C. EMPLOYEES AS INSUREDS

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

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.

D. INCREASED COVERAGE - BAIL BONDS

a. Supplementary Payments under 2. Coverage Extensions of Section II - Covered Autos Liability

Coverage is amended as follows:

The Limit of Insurance in paragraph A.2.a.(2) is increased to $5,000.

E. INCREASED COVERAGE - LOSS OF E ARN INGS

a. Supplementary Payments under Coverage Extensions of Section II – Covered Autos Liability

Coverage is amended as follows:

The Limit of Insurance in paragraph A.2.a.(4) is increased to $1,000.

F. FELLOW EMPLOYEE COVERAGE

5. Fellow Employee under B. Exclusions of Section II – Covered Autos Liability Coverage does not apply. This coverage is excess over any other collectable insurance.

G. COVERAGE EXTENSION - TRANSPORTATION EXPENSES

Paragraph A.4.a. Transportation Expenses of Section III - Physical Damage Coverage is amended as follows:

1. The Limits of Insurance are increased to $75 per day to a maximum of $2,500.

2. We will also pay reasonable and necessary expenses to facilitate the return of the stolen "auto" to you.

3. It is agreed and understood and it is our stated intent that expenses incurred by you under the

Transportation Expenses Coverage Extension will not also be covered or paid under the Rental Reimbursement Coverage provided by this endorsement or any rental reimbursement coverage added by separate endorsement to this policy.

H. EXTENDED COVERAGE – AIRBAGS

The following is added to Exclusion B.3.a. of Section III - Physical Damage Coverage: However, this exclusion does not apply to the unintended discharge of an airbag.

This coverage is excess over any other collectible insurance or warranty providing such airbag coverage.

I. AUTO LOAN/LEASE GAP COVERAGE

The following is added to Section III - Physical Damage Coverage, Paragraph C. Limits of Insurance,

4. In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered "auto", less:

a. The amount under Section III - Physical Damage Coverage section of the policy; and

b. Any:

(1) Overdue lease/loan payments at the time of the "loss";

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(2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage;

(3) Security deposits not returned by the lessor;

(4) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability

Insurance purchased with the loan or lease; and

(5) Carry-over balances from previous loans or leases.

J. GLASS REPAIR - NO DEDUCTIBLE

The following is added to Paragraph D. Deductible of Section III - Physical Damage Coverage:

Any Comprehensive Coverage deductible shown in the Declarations does not apply to "loss" to glass when you elect to patch, repair, or replace the glass.

K. EXTENDED COVERAGE - PERSONALPROPERTY

The following is added to Paragraph A.4. Coverage Extensions of Section III - Physical Damage Coverage:

Physical Damage Coverage on a covered "auto" may be extended to "loss" to your personal property or, if you are an individual, the personal property of a family member, that is in the covered "auto" at the time of "loss" and caused by an "accident" and resulting from the ownership, maintenance or use of a covered "auto".

The insurance provided by this coverage extension is excess over any other collectible insurance. The most we will pay for any one "loss" under this coverage extension is $500. However, our payment for "loss" to personal property will only be for the account of the owner of the property.

Under this provision, personal property does not include and we will not pay for "loss" of currency, coins, securities or contraband.

No deductible applies to this coverage extension.

L. TOWING

Paragraph A.2. Towing of Section II I - Physical Damage Coverage, is replaced by the following:

If a private passenger type covered “auto” or light truck “auto” (0-10,000 Lbs. GVW) is provided both Comprehensive and Collision Coverage, we will pay up to $150 for towing and labor costs incurred each time such “auto” is disabled, as caused by a covered “loss”. If a medium, heavy or extra-heavy truck or extra-heavy Truck-tractor covered “auto” (greater than 10,000 Lbs. GVW) is provided both Comprehensive and Collision Coverage, we will pay up to $250 for towing and labor costs incurred each time such “auto” is disabled, as caused by a covered “loss”. However, the labor must be performed at the place of disablement.

M. FIRE EXTINGUISHER RECHARGE

The following is added to Paragraph A.4. Coverage Extensions of Section III - Physical Damage Coverage:

When fire extinguishers are kept in your covered "auto" and any are discharged in an attempt to extinguish a fire, we will pay the lesser of the actual cost of recharging or replacing such fire extinguisher(s).

No deductible applies to this coverage.

N. HIRED AUTO PHYSICAL DAMAGE COVERAGE

The following is added to Paragraph A.4. Coverage Extensions of Section III - Physical Damage Coverage:

If hired "autos" are covered "autos" for Section II – Covered Autos Liability Coverage and if Section III - Physical Damage Coverage is provided for any "auto" you own, then the Physical Damage coverages provided are extended to "autos" you lease, rent, hire or borrow from someone other than your "employees", partners or members of their households subject to the following:

1. The most we will pay in any one "loss" is the lesser of:

a. The actual cash value of the "auto";

b. The cost to repair or replace the "auto"; or

c. $100,000.

2. Paragraph 1. directly above is subject to a deductible. The deductible shall be equal to the amount of the highest deductible shown for any owned "auto" of the same classification for that coverage. In

SSAPLAT (01/23) Includes wording © ISO Properties, Inc., used with permission Page 4 of 6 the event there is no owned “auto” of the same classification, the highest deductible for any owned “auto” will apply for that coverage.

No deductible will apply to "loss" caused by fire or lightning.

3. Hired Auto Physical Damage Coverage is subject to the following:

a. If symbol 8 is shown in Section I - Covered Autos on of the Declarations page for any of the Physical Damage coverages, then the Hired Auto Physical Damage coverage described in this endorsement does not apply.

b. Other than indicated in Paragraph a. directly above, coverage provided under this provision will be excess over any other collectible insurance or coverage.

4. In addition to the limit set forth in Paragraph 1. above we will pay up to $500 per day, to a maximum of $3,500 per "loss" for:

a. Any costs or fees associated with the "loss" to a hired "auto"; and

b. Loss of use of the hired "auto", provided it is the consequence of an "accident" for which you are legally liable, and as a result of which a monetary loss is sustained by the leasing or rental concern.

However, Paragraph A.4.b. Loss of Use Expenses under Section III - Physical Damage Coverage does not apply.

O. RENTAL REIMBURSEMENT COVERAGE

We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto".

1. Payment applies in addition to the otherwise applicable amount of each coverage you have on the covered "auto".

2. No deductible applies to this coverage.

3. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the expiration date of the policy, with the lesser of the following number of days:

a. The number of days when the covered "auto" has been repaired or replaced, or

b. 30 days.

4. Our payment is limited to the lesser of the following amounts:

a. Necessary and actual expenses incurred; or

b. Not more than $100 for any one day;

5. We will pay up to an additional $300 for the reasonable and necessary expenses you incur to remove your materials and equipment from the covered "auto" and replace such materials and equipment on the rental "auto".

6. This coverage does not apply while there are spare or reserve "autos" available to you for your operations.

7. If "loss" results from the total theft of a covered "auto" of the "private passenger type", we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under Section III - Physical Damage Coverage or any endorsements.

However, this provision does not apply to the extent that rental reimbursement is provided by separate endorsement to this policy.

P. DRIVE OTHER CAR COVERAGE

1. The following is added to Section II - Covered Autos Liability Coverage:

a. Any "auto" you don't own, hire or borrow is a covered "auto" for Liability Coverage while being used by:

(1) You, if you are designated in the Declarations as an individual;

(2) Your partners or members, if you are designated in the Declarations as a partnership or joint venture; Your members or managers, if you are designated in

SSAPLAT (01/23) Includes wording © ISO Properties, Inc., used with permission Page 5 of 6 the Declarations as a limited liability company;

(3) Your executive officers if you are designated in the Declarations as an organization other than an individual, partnership, joint venture or limited liability company; and

(4) The spouse of any person named in Paragraphs 1.a.(1). through 1.a.(4) while a resident of the same household;

Except:

(a) Any "auto" owned by that individual or by any member of his or her household.

(b) Any "auto" used by that individual or his or her spouse while working in a business of selling, servicing, repairing or parking "autos".

2. Changes to Section III -Physical Damage Coverage

Any private passenger type "auto" you don't own, hire or borrow is a covered "auto" while in the care, custody or control of any individual named in P.1.a. directly above or his or her spouse while a resident of the same household except:

a. Any "auto" owned by that individual or by any member of his or her household; or

b. Any "auto" used by that individual or his or her spouse while working in a business of selling, servicing, repairing or parking "autos".

3. The most we will pay for the total of all dam ages under Covered Autos Liability Uninsured Motorists

Coverage and Underinsured Motorists Coverage is the Limit Of Insurance shown in the Declarations as applicable to owned "autos".

4. Our obligation to pay for, repair, return or re place damaged or stolen property under Physical Damage Coverage, will be reduced by a deductible equal to the amount of the highest deductible shown for any owned private passenger type "auto" applicable to that cover- age. If there are no owned private passenger type "autos", the deductible shall be $250 for Comprehensive Coverage and $500 for Collision Coverage. No deductible will apply to "loss" caused by fire or lightning.

5. Additional Definition As used in P. DRIVE OTHER CAR COVERAGE:

"Family member" means a person related to the individual named in 1.a. by blood, marriage or adoption who is a resident of the individual's household, including a ward or foster child.

Q. KNOWLEDGE OF AN ACCIDENT, CLAIM, SUIT OR LOSS

The following is added to Paragraph A.2. of Section VII - Business Auto Conditions:

Your obligation to provide prompt notice of an “accident", claim, "suit" or "loss" is satisfied if you or a person designated by you to be responsible for insurance matters is notified of, or in any manner made aware of an "accident", claim, "suit" or "loss" and provides us such notice as soon as practicable.

R. WAIVER OF SUBROGATION BY CONTRACT OR AGREEMENT

The following is added to Paragraph A.5 of Section IV- Business Auto Conditions:

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:

1. Such written contract or agreement was:

a. Made prior to the "accident" or "loss" resulting in the covered "bodily injury" or "property damage"; and

b. Was in effect at the time of the covered "bodily injury" or "property damage".

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

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

S. UNINTENTIONAL OMISSIONS

The following is added Paragraph B.2. of Section IV- Business Auto Conditions:

If you fail to disclose any hazards existing at the inception date of this policy, such failure will not prejudice

SSAPLAT (01/23) Includes wording © ISO Properties, Inc., used with permission Page 6 of 6 the coverage provided to you. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or…