CTR076220_COI_ACCEPTED_ANY_ALL_GL_AL_WC_04.01.25-04.01.26.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

3/4/2025

Reseco Insurance Advisors, LLC 7901 N. 16th Street, Suite 100 Phoenix AZ 85020

602-753-4250 602-419-2242 certificates@resecoadvisors.com

National Union Fire Ins Co of PA 19445 6934 Endurance American Insurance Co 10641

Sunland Asphalt & Construction, LLC dba Sunland Asphalt 1625 E. Northern Avenue Phoenix AZ 85020

Homesite Insurance Company of Florida 11156 Travelers Excess and Surplus Lines Company 29696 Travelers Property Casualty Co of Amer 25674

848945634

A X 2,000,000 X 500,000

25,000

2,000,000

4,000,000 X

Y Y GL9925617 4/1/2025 4/1/2026

4,000,000

A 2,000,000

X

X X

Y Y CA9775927 4/1/2025 4/1/2026

C D

X X 15,000,000Y CXP 016711 01

EX-2T42594A-24-NF

4/1/2025 4/1/2025

Y 4/1/2026 4/1/2026

15,000,000 X $10,000

A XY WC011569704 4/1/2025 4/1/2026

2,000,000

2,000,000

2,000,000 B E

Prof/Poll Liabilty Bldrs Risk Installation Floater Aviation Liability

Y

Y PNV10015397700

QT-630-3S841370-TIL-24

4/1/2025 8/1/2024

4/1/2026 8/1/2025

Aggregate/Each Claim Any One Jobsite

$5,000,000 $2,000,000

Certificate holder is hereby included as Additional Insured with respects to the General Liability, Automobile Liability and Umbrella Liability on a primary and non-contributory basis if required by written contract subject to all provisions and limitations of the policies. Waiver of Subrogation in favor of Certificate Holder applies to the General Liability, Automobile Liability and Employers Liability/Workers Compensation if required by written contract subject to all provisions and limitations of the policies. The above referenced Excess/Umbrella Liability policy is follow-form and provides additional limits of insurance for General Liability, Automobile Liability and Employers Liability/Workers Compensation.

The $100,000 is the limit for hired auto physical damage. Deductibles are $250/$500.

See Attached...

The State of Arizona - ADOT 1324 N 22nd Ave Phoenix AZ 85016

Cindy Lewis Accepted

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:

1 1

Reseco Insurance Advisors, LLC Sunland Asphalt & Construction, LLC dba Sunland Asphalt 1625 E. Northern Avenue Phoenix AZ 85020

25 CERTIFICATE OF LIABILITY INSURANCE

Leased/Rented Equipment – Limit Per Item/Deductible: $1,500,000 / $5,000 Carrier/NAIC #: Travelers Property Casualty Co of America / 31194 Policy Number: QT-630-3S841370-TIL-24 Policy Term: 8/1/2024 – 8/1/2025

Cyber Liability – Each Occurrence/Aggregate Limit $5,000,000 Carrier/NAIC #: Palomar Excess and Surplus Insurance Company / 16754 Policy Number: PLM-CB-S5KOFRQYX-003 Policy Term: 04/01/2025 - 04/01/2026 Cyber Liability includes Privacy, Network Security and Data Breach.

Crime/Employee Dishonesty – Limit/Deductible: $1,000,000 / $10,000 Carrier/NAIC #: Hudson Insurance Company / 25054 Policy Number: SXS31210420 Policy Term: 1/13/2021 – 1/13/2027

Aviation Liability – Limit: $1,000,000 Carrier/NAIC #: American Alternative Ins Corp / 19720 Policy Number: 9044202 Policy Term: 04/01/2025 - 04/01/2026

Technology Errors & Omissions: Limit $5,000,000 Carrier/NAIC #: Endurance American Insurance Co / 10641 Policy Number: PNV10015397700 Policy Term: 04/01/2025 - 04/01/2026

Primary Excess Liability: Limit Per Occurrence/Aggregate: $5,000,000 Carrier/NAIC#: Homesite Insurance Company of Florida/11156 Policy Number: CXP 016711 01 Policy Term: 04/01/2025-04/01/2026

Second Layer Excess Liability Limit: Limit Per Occurrence/Aggregate: $10,000,000 Carrier/NAIC#: Travelers Excess and Surplus Lines Company/29696 Policy#: EX-2T42594A-24-NF Policy Term: 04/01/2025-04/01/2026

Builders Risk/Installation Floater Travelers NAIC 29696 Policy# QT-630-35841370 Effective 08/01/2024-08/01/2025 RE: Any and All Projects

Cindy Lewis Highlight

POLICY NUMBER: GL 992-56-17 COMMERCIAL GENERAL LIABILITY

CG 20 10 12 19

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED - OWNERS, LESSEES OR

CONTRACTORS - SCHEDULED PERSON OR

ORGANIZATION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name Of Additional Insured Person(s) Or OrQanization(s) Location(s) Of Covered Operations

Any person or organization whom you Per the contract or agreement.

become obligated to include as an additional insured as a result of any contract or agreement you have entered into.

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

CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 □

POLICY NUMBER: GL 992-56-17 COMMERCIAL GENERAL LIABILITY

CG 20 37 12 19

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED - OWNERS, LESSEES OR

CONTRACTORS - COMPLETED OPERATIONS

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

SCHEDULE

Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations

Any person or organization whom you Per the contract or agreement.

become obligated to include as an additional insured as a result of any contract or agreement you have entered into.

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" or

"property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard".

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 Ill - 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;

whichever is less.

This endorsement shall not increase the applicable limits of insurance.

CG 20 37 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 1

POLICY NUMBER: GL 992-56-17

EFFECTIVE: 4-1-2024

COMMERCIAL GENERAL LIABILITY

CG 24 04 12 19

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US (WAIVER OF SUBROGATION)

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

ELECTRONIC DATA LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES

POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

RAILROAD PROTECTIVE LIABILITY COVERAGE PART

UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS

SCHEDULE

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

any person or organization required per contract

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

The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions:

We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above.

GL

policy No issued to Sunland Asphalt & Construction Inc by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

SCHEDULE

ADDITIONAL INSURED:

ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY

BOUND TO PROVIDE ADDITIONAL INSURED STATUS BUT ONLY TO THE

EXTENT OF SUCH PERSON OR ORGANIZATIONS LIABILITY ARISING OUT OF

THE USE OF A COVERED AUTO.

I. SECTION II - COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to add:

d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of:

(1) The coverage and/or limits of this policy, or

(2) The coverage and/or limits required by said contract or agreement.

AUTHORIZED REPRESENTATIVE

87950 (9/14)

CA9775927

ENDORSEMENT

This endorsement, effective 12:01 A.M. 04/01/2024 forms a part of

Sun land Aspha l t & Cons t ruc t ion , LLC

ENDORSEMENT

This endorsement, effective 12:01 A.M. 04/01/2024 forms a part of Policy No. CA 977-59-27 issued to SUNLAND ASPHALT & CONSTRUCTION by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA.

BUSINESS AUTO COVERAGE FORM

AUTHORIZED REPRESENTATIVE

This endorsement modifies insurance provided under the following:

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US

(2)

(1)

The contract or agreement was entered into prior to any " accident" or " loss" .

No waiver of the right of recovery will directly or indirectly apply to your employees or employees of the person or organization, and we reserve our rights or lien to be reimbursed from any recovery funds obtained by any injured employee.

Section IV - Business Auto Conditions, A. - Loss Conditions, 5. - Transfer of Rights of Recovery

Against Others to Us, is amended to add:

The " accident" or " loss" is due to operations undertaken in accordance with the contract existing between you and such person or organization; and

However, we will waive any right of recover we have against any person or organization with whom you have entered into a contract or agreement because of payments we make under this Coverage Form arising out of an " accident" or " loss" if:

62897 (6/95) Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 1

Covered States:

AZ

CO

NM

NV

TX

GA