CTR075488 CONTRACTORS POLL 01.27.25-01.27.26.pdf

01/31/2025

NBS Insurance Agency, Inc.

In CA, DBA Triple I Insurance Agency of Ohio PO Box 182500 Columbus, OH 43218

Desert Veteran's LLC

5610 N 51st Ave Glendale, AZ 85301

(800) 444-1744 (877) 444-4094

The State of Arizona/ADOT 206 S 17th Ave Phoenix, AZ 85007

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 activities performed by or on behalf of the contractor.

Contractors Pollution Laibility

Each Condition 1,000,000 Aggregate

A X G4865244A-001 01/27/2025 01/27/2026 2,000,000

Westchester Surplus Lines Insurance Co 10172

DS#48167072

Cindy Lewis Accepted

ENV-3250 (12/18)

(221012.1)

Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 2

ADDITIONAL INSURED ENDORSEMENT – ONGOING WORK OR OPERATIONS

Named Insured Desert Veteran's LLC

Endorsement Number

Policy Symbol

CPW

Policy Number G4865244A 001

Policy Period 01/27/2025 to 01/27/2026

Effective Date of Endorsement 01/27/2025

Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company

Insert the policy number. The remainder of the information is 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.

THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING:

CONTRACTORS POLLUTION LIABILITY COVERAGE PART

SCHEDULE:

Name of Person(s) or Organization(s): As required by written contract, prior to a loss to which this insurance applies.

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)

A. SECTION II - WHO IS AN INSURED is amended to include as an additional insured the persons or organizations shown in the Schedule, but only with respect to liability for injury or damage, to which this insurance applies, caused in ,whole or in part, by:

1. Your acts or omissions; or

2. The acts or omissions of those acting on your behalf;

in the performance of your ongoing operations for the additional insureds.

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 exclusion is added:

Exclusions

This insurance does not apply to injury or damage occurring after:

a. All work or operations, including materials, parts or equipment furnished in connection with such work or operations, on the project (other than service, maintenance or repairs) to be performed by you or on your behalf at the site of the covered operations has been completed; or

b. That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for the additional insured as a part of the same project.

ENV-3250 (12/18)

(221012.1)

Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 2 of 2

C. 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.

All other terms and conditions of this policy remain unchanged.

ENV-3143 (03-05) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1

Named Insured Desert Veteran's LLC

Endorsement Number

Policy Symbol

CPW

Policy Number G4865244A 001

Policy Period 01/27/2025 to 01/27/2026

Effective Date of Endorsement 01/27/2025

Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company

Insert the policy number. The remainder of the information is 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.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

CONTRACTORS POLLUTION LIABILITY COVERAGE PART

SCHEDULE

Name of Person or Organization: As required by written contract, prior to a loss to which this insurance applies.

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)

The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition 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 damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products-completed operations hazard.

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

All other terms and conditions remain the same.