CTR066285_Community_Bridges_Inc_25-26_COI.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

7/7/2025

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

Lindsey Brundage 602-385-0535 602-956-2258 lindsey.brundage@marshmma.com

Ironshore Specialty Insurance Company 25445 COMMBRI-C1 Alaska National Insurance Company 38733

Community Bridges, Inc.

1855 W. Baseline Road, Suite 101 Mesa AZ 85202

Allied World Assurance Company (US) Inc 19489

1127323055

A X 1,000,000 X 1,000,000

X 100,000 10,000

1,000,000

3,000,000 X

Y Y HC7SAC3B0I002 5/31/2025 5/31/2026

1,000,000

B 1,000,000

X

Y Y 25EAY13561 5/31/2025 5/31/2026

C 2,000,000 X X

03147197 5/31/2025 5/31/2026

2,000,000

B XY 25CWS13561 3/1/2025 3/1/2026

1,000,000

1,000,000

1,000,000 A Professional Liability

Sexual Abuse & Molestation Ded: $100,000

HC7SAC3B0I002 5/31/2025 5/31/2026 1,000,000

1,000,000

3,000,000 3,000,000

Professional Liability Claims Made Retroactive Date: 03/14/1994; Sexual Abuse/Molestation Liability Claims Made Retroactive Date: 05/31/2022

Effective 5/31/2025-2026:

Excess Policy # 03147197/ Allied World Assurance Company (US) Inc: Excess General Liability, Professional Liability, Sexual Abuse and Molestation Liability – Limit $2,000,000 Excess Policy #IXG680151A/ General Star Indemnity Company: Excess of Auto Liability - Limit $2,000,000 Excess Policy #140001896/ QBE Specialty Insurance Company: Excess of General Liability, Professional Liability, Sexual Abuse and Molestation Liability, Automobile Liability - Limit $3,000,000 See Attached...

The State of Arizona, Department of Economic Security c/o: myCOI P.O. Box 501970, 8710 Bash Street Indianapolis IN 46256

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:

COMMBRI-C1

1 1

Marsh & McLennan Agency LLC Community Bridges, Inc.

1855 W. Baseline Road, Suite 101 Mesa AZ 85202

25 CERTIFICATE OF LIABILITY INSURANCE

Contract: ADES - CTR066285 General Liability: The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees are named additional insured with respect to liability arising out of the activities performed by or on behalf of the Contractor. Policy contains a waiver of subrogation in favor of the State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor. The insurance afforded the Contractor is primary and any insurance carried by the Department, its agents, officials, employees or the State of Arizona shall be excess and not contributory insurance. Automobile Liability: The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees are named additional insured with respect to liability arising out of the activities performed by or on behalf of the Contractor, involving automobiles owned, leased, hired or borrowed by the Contractor. Policy contains a waiver of subrogation in favor of the State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor. The insurance afforded the Contractor is primary and any insurance carried by the Department, its agents, officials, employees or the State of Arizona shall be excess and not contributory insurance. Worker's Compensation: Policy contains a waiver of subrogation in favor of the State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor.

MMF.END.037 (03/11) Page: 1 of 1

IRONSHORE SPECIALTY INSURANCE COMPANY

175 Berkeley Street Boston, MA 02116

Toll Free: (877) IRON411

Endorsement # 20

Policy Number: HC7SAC3B0I002 Effective Date of Endorsement: May 31, 2025 Insured Name: Community Bridges, Inc

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED ENDORSEMENT

In consideration of the premium charged:

1. The term “Insured,” as defined in the Policy, shall be deemed to include each person or entity listed below (each an “Additional Insured”), but only with respect to liability of any such Additional Insured that is based on or arises out of a Claim for which coverage would otherwise be afforded to the original Insured under this Policy.

Additional Insured(s):

The Government of the District of Columbia Office of Contracting and Procurement

Mercy Care, the City of Phoenix, City of Phoenix Human Service Department, Attention: Procurement

The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees are named additional insured with respect to liability arising out of the activities performed by or on behalf of the Contractor.Policy contains a waiver of subrogation in favor of the State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor.

2. It is understood and agreed that each Additional Insured listed above is being afforded coverage under this Policy for any liability incurred solely as a result of the acts, errors or omissions of the original Insured. No coverage will be available under this Policy for any Claim based on or arising out of any actual or alleged independent or direct liability of any Additional Insured.

3. The coverage afforded any Additional Insured under this endorsement shall be primary to any other insurance or self-insurance maintained by such Additional Insured, and without contribution from any such other insurance or self-insurance within the applicable Limit of Liability of the Policy.

4. The Underwriter will provide the Additional Insured(s) identified above with at least ten (10) days’ written notice of cancellation or non-renewal of this Policy if such cancellation or non-renewal is for non-payment of premium, or sixty

(60) days’ written notice of cancellation or non-renewal if such cancellation or non-renewal is for any other reason.

All other terms, conditions and limitations of this Policy shall remain unchanged.

The surplus lines policy or evidence of coverage is issued by a domestic surplus lines insurer: If the insurer that issued this policy becomes insolvent, insureds or claimants will not be eligible for insurance guaranty fund protection pursuant to title 20, Arizona Revised Statutes.

MMF.P.015 (09/10) Page: 1 of 1

IRONSHORE SPECIALTY INSURANCE COMPANY

175 Berkeley Street Boston, MA 02116

Toll Free: (877) IRON411

Endorsement # 21

Policy Number: HC7SAC3B0I002 Effective Date of Endorsement: May 31, 2025 Insured Name: Community Bridges, Inc

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WAIVER OF SUBROGATION RIGHTS FOR GENERAL LIABILITY PAYMENTS

In consideration of the premium charged, the Underwriter agrees to waive its right to be subrogated to the extent of any payment s under INSURING AGREEMENT (B) of this Policy to rights of recovery of the Insured against the following third party(ies):

Third Party(ies):

The Government of the District of Columbia Office of Contracting and Procurement

Mercy Care, the City of Phoenix, City of Phoenix Human Service Department, Attention: Procurement

The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees are named additional insured with respect to liability arising out of the activities performed by or on behalf of the Contractor. Policy contains a waiver of subrogation in favor of the State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor.

GENERAL CONDITION (K) will be deemed amended to effect the purpose and intent of this endorsement.

All other terms, conditions and limitations of this Policy shall remain unchanged.

The surplus lines policy or evidence of coverage is issued by a domestic surplus lines insurer: If the insurer that issued this policy becomes insolvent, insureds or claimants will not be eligible for insurance guaranty fund protection pursuant to title 20, Arizona Revised Statutes.

© Insurance Services Office, Inc., 2019

CA 04 22 11 20

EARLIER NOTICE OF CANCELLATION PROVIDED BY US

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.

Named Insured: Community Bridges, Inc.

Endorsement Effective Date: May 31, 2025

SCHEDULE

Number Of Days’ Notice: 30

The State of Arizona and Dept of Economic Security C/O: myCOI P.O. Box# 501970, 8710 Bash Street Indianapolis, IN

46256 Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in Paragraph 2.

of either the Cancellation Common Policy Condition or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above.

This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy.

Endorsement Effective May 31, 2025 Policy No. 25E AY 13561

Insured Community Bridges, Inc. Endorsement No. 3

Countersigned By Marc E. Schmittlein Lovitt & Touche, Inc. / Scottsdale

© Insurance Services, Office, Inc., 2011

CA 20 48 10 13

DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE

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.

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

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

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.

This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy.

Endorsement Effective May 31, 2025 Policy No. 25E AY 13561

Insured Community Bridges, Inc. Endorsement No. 2

© Insurance Services Office, Inc., 2016

CA 04 49 11 16

PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION

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

A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance – Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary:

This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that:

1. Such "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 such "insured".

B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary:

This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that:

1. Such "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 such "insured".

This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy.

Endorsement Effective May 31, 2025 Policy No. 25E AY 13561

Insured Community Bridges, Inc. Endorsement No. 4

© Insurance Services, Office, Inc., 2011

CA 04 44 10 13

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF

SUBROGATION)

With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified

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

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