CTR076255-_coi_expires_10-14-25.pdf

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

INSR ADDL SUBR

LTR INSD WVD

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

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

EACH OCCURRENCE $

DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT

OTHER: $

COMBINED SINGLE LIMIT

$(Ea accident)

ANY AUTO BODILY INJURY (Per person) $

OWNED SCHEDULED

BODILY INJURY (Per accident) $AUTOS ONLY AUTOS

HIRED NON-OWNED PROPERTY DAMAGE

$AUTOS ONLY 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 LIMITDESCRIPTION OF OPERATIONS below

INSURER(S) AFFORDING COVERAGE NAIC #

COMMERCIAL GENERAL LIABILITY

Y / N N / A

(Mandatory in NH)

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 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.ACORD 25 (2016/03)

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)

The ACORD name and logo are registered marks of ACORD

10/10/2024

(928) 536-2989 (928) 536-3089

10677

Perkins Cinders, Inc Attn: Kay Perkins 1950 E Adams Suite C Show Low, AZ 85901

13210

A 1,000,000

X X EPP 0107537 10/14/2024 10/14/2025 500,000

10,000

1,000,000 2,000,000 2,000,000

1,000,000A

X X EPP 0107537 10/14/2024 10/14/2025

3,000,000A

EPP 0107537 10/14/2024 10/14/2025 3,000,000

B

X 1007864 11/1/2024 11/1/2025 1,000,000 1,000,000 1,000,000

A Rented equipment EPP 0107537 10/14/2024 $1,000,000 / 1,000,000 A Riggers Liability EPP 0107537 10/14/2024 10/14/2025 Deductible $2,500 250,000

Holder includes: The State of arizona, its departments, agencies, boards, commission, universities and its officers, officials, agents and employees. Additional insured and waiver of subrogation per attached form. Additional insured with Completed Ops per attached form. Primary and Noncontributory per attached form. Auto additional insured, waiver of subrogation and primary and noncontributory per attached form. Workers Compensation Waiver of Subrogation per attached form. Umbrella follows form.

Arizona Game and Fish Purchasing Office 5000 W Carefree highway Phoenix, AZ 85086

PERKCIN-02 JLYMAN

The Mahoney Group - Snowflake 1835 South Extension Road Mesa, AZ 85210

Cincinnati Insurance Company CopperPoint Casualty Insurance Company

X

10/14/2025

X X

X

X

X X

X

Includes copyrighted material of ISO AA 288 06 20 Properties, Inc., with its permission. Page 1 of 4

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CinciPlus®

BUSINESS AUTO XC+®

(EXPANDED COVERAGE PLUS)

ENDORSEMENT

This endorsement modifies insurance provided by the following:

BUSINESS AUTO COVERAGE FORM

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

A. Blanket Waiver of Subrogation

SECTION IV - BUSINESS AUTO CONDI-

TIONS, A. Loss Conditions, 5. Transfer of Rights of Recovery Against Others to Us is amended by the addition of the following:

We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury" or "property damage" arising out of the operation of a covered "auto" when you have assumed liability for such "bodily injury" or "property damage" under an "insured contract", provid-ed the "bodily injury" or "property damage" oc-curs subsequent to the execution or the "in-sured contract".

B. Noncontributory Insurance

SECTION IV - BUSINESS AUTO CONDI-

TIONS, B. General Conditions, 5. Other In-surance c. is deleted in its entirety and re-placed by the following:

c. Regardless of the provisions of Par-agraph a. above, this Coverage Form's Liability Coverage is primary and we will not seek contribution from any other insurance for any lia-bility assumed under an "insured contract" that requires liability to be assumed on a primary noncontributo-ry basis.

C. Additional Insured by Contract

SECTION II - LIABILITY COVERAGE, A.

Coverage, 1. Who is an Insured is amended to include as an insured any person or organi-zation for whom you have agreed in a valid written contract to provide insurance as af-forded by this policy.

This provision is limited to the scope of the valid written contract.

This provision does not apply unless the valid written contract has been:

1. Executed prior to the accident causing "bodily injury" or "property damage"; and

2. Is still in force at the time of the "accident" causing "bodily injury" or "property dam-age".

D. Employee Hired Auto

1. Changes in Liability Coverage

The following is added to the SECTION II

- LIABILITY COVERAGE, A. Coverage,

1. Who is an Insured:

An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business.

2. Changes in General Conditions

SECTION IV - BUSINESS AUTO CON-

DITIONS, B. General Conditions, 5.

Other Insurance is deleted in its entirety and replaced by the following:

b. For Hired Auto Physical Damage Coverage the following are deemed to be covered "autos" you own:

(1) Any covered "auto" you lease, hire, rent or borrow; and

(2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "em-ployee's" name, with your per-mission, while performing duties related to the conduct of your business.

AA 288 06 20 Properties, Inc., with its permission. Page 2 of 4

However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto".

E. Audio, Visual and Data Electronic Equip-ment

SECTION III - PHYSICAL DAMAGE COV-

ERAGE, C. Limit of Insurance is amended by adding the following:

4. The most we will pay for all "loss" to au-dio, visual or data electronic equipment and any accessories used with this equipment as a result of any one "acci-dent" is the lesser of:

a. The actual cash value of the dam-aged or stolen property as of the time of the "accident";

b. The cost of repairing or replacing the damaged or stolen property with oth-er property of like kind and quality; or

c. $2,500.

Provided the equipment, at the time of the "loss" is:

a. Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment;

b. Removable from a permanently in-stalled housing unit as described in Paragraph 2.a. above; or

c. An integral part of such equipment.

F. Who is an Insured - Amended

SECTION II - LIABILITY COVERAGE, A.

Coverage, 1. Who is an Insured is amended by adding the following:

The following are "insureds":

1. Any subsidiary which is a legally incorpo-rated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this cover-age form.

However, the insurance afforded by this provision does not apply to any subsidiary that is an "insured" under any other au-tomobile liability policy or would be an "in-sured" under such policy but for termina-tion of such policy or the exhaustion of such policy's limits of insurance.

2. Any organization that is newly acquired or formed by you and over which you main-tain majority ownership. The insurance provided by this provision:

a. Is effective on the date of acquisition or formation, and is afforded for 180 days after such date;

b. Does not apply to "bodily injury" or "property damage" resulting from an "accident" that occurred before you acquired or formed the organization;

c. Does not apply to any newly acquired or formed organization that is a joint venture or partnership; and

d. Does not apply to an insured under any other automobile liability policy or would be an insured under such a policy but for the termination of such policy or the exhaustion of such poli-cy's limits of insurance.

3. Any of your "employees" while using a covered "auto" in your business or your personal affairs, provided you do not own, hire or borrow that "auto".

G. Liability Coverage Extensions - Supple-mentary Payments - Higher Limits

SECTION II - LIABILITY COVERAGE, A.

Coverage, 2. Coverage Extensions, a. Sup-plementary Payments is amended by:

1. Replacing the $2,000 Limit of Insurance for bail bonds with $4,000 in (2); and

2. Replacing the $250 Limit of Insurance for reasonable expenses with $500 in (4).

H. Amended Fellow Employee Exclusion

SECTION II - LIABILITY COVERAGE, B. Ex-clusions, 5. Fellow Employee is modified as follows:

Exclusion 5. Fellow Employee is deleted.

I. Hired Auto - Physical Damage

If hired "autos" are covered "autos" for Liability Coverage, then Comprehensive and Collision Physical Damage Coverages as provided un-der SECTION III - PHYSICAL DAMAGE COVERAGE of this Coverage Part are ex-tended to "autos" you hire, subject to the fol-lowing:

1. The most we will pay for "loss" to any hired "auto" is $50,000 or the actual cash value or cost to repair or replace, which-ever is the least, minus a deductible.

2. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage, or $1,000, whichever is less.

3. Hired Auto - Physical Damage coverage is excess over any other collectible insur-ance.

AA 288 06 20 Properties, Inc., with its permission. Page 3 of 4

4. Subject to the above limit, deductible, and excess provisions we will provide cover-age equal to the broadest coverage appli-cable to any covered "auto" you own in-sured under this policy.

Coverage includes loss of use of that hired au-to, provided it results from 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. The most we will pay for any one "accident" is $3,000.

If a limit for Hired Auto - Physical Damage is shown in the Schedule, then that limit replac-es, and is not added to, the $50,000 limit indi-cated above and the deductibles shown in the Schedule are applicable.

J. Rental Reimbursement

SECTION III - PHYSICAL DAMAGE COV-

ERAGE is amended by adding the following:

1. We will pay for rental reimbursement ex-penses incurred by you for the rental of an "auto" because of a "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of each cov-erage you have on a covered "auto". No deductible applies to this coverage.

2. We will pay only for those expenses in-curred during the policy period beginning 24 hours after the "loss" and ending, re-gardless of the policy's expiration, with the lesser of the following number of days:

a. The number of days reasonably re-quired to repair the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you; or

b. 30 days.

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

a. Necessary and actual expenses in-curred; or

b. $50 per day.

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

5. We will pay under this coverage only that amount of your rental reimbursement ex-penses which is not already provided for under SECTION III - PHYSICAL DAM- AGE COVERAGE, A. Coverage, 4.

Coverage Extensions.

K. Transportation Expense - Higher Limits

SECTION III - PHYSICAL DAMAGE COV-

ERAGE, A. Coverage, 4. Coverage Exten-sions is amended by replacing $20 per day with $50 per day, and $600 maximum with $1,500 maximum in Extension a. Transpor-tation Expenses.

L. Airbag Coverage

SECTION III - PHYSICAL DAMAGE COV-

ERAGE, B. Exclusions, 3.a. is amended by adding the following:

However, the mechanical and electrical breakdown portion of this exclusion does not apply to the accidental discharge of an airbag.

This coverage for airbags is excess over any other collectible insurance or warranty.

M. Loan or Lease Gap Coverage

1. SECTION III - PHYSICAL DAMAGE

COVERAGE, C. Limit of Insurance is deleted in its entirety and replaced by the following, but only for private passenger type "autos" with an original loan or lease, and only in the event of a "total loss" to such a private passenger type "auto":

a. The most we will pay for "loss" in any one "accident" is the greater of:

(1) The amount due under the terms of the lease or loan to which your covered private passenger type "auto" is subject, but will not include:

(a) Overdue lease or loan pay-ments;

(b) Financial penalties imposed under the lease due to high mileage, excessive use or abnormal wear and tear;

(c) Security deposits not re-funded by the lessor;

(d) Costs for extended warran-ties, Credit Life Insurance, Health, Accident or Disabil-ity Insurance purchased with the loan or lease; and

(e) Carry-over balances from previous loans or leases, or

(2) Actual cash value of the stolen or damaged property.

b. An adjustment for depreciation and physical condition will be made in de-termining actual cash value at the time of "loss".

AA 288 06 20 Properties, Inc., with its permission. Page 4 of 4

2. SECTION V - DEFINITIONS is amended by adding the following, but only for the purposes of this Loan or Lease Gap Coverage:

"Total loss" means a "loss" in which the cost of repairs plus the salvage value ex-ceeds the actual cash value.

N. Glass Repair - Waiver of Deductible

SECTION III - PHYSICAL DAMAGE COV-

ERAGE, D. Deductible is amended by adding the following:

No deductible applies to glass damage if the glass is repaired in a manner acceptable to us rather than replaced.

O. Duties in the Event of an Accident, Claim, Suit or Loss - Amended

SECTION IV - BUSINESS AUTO CONDI-

TIONS, A. Loss Conditions, 2. Duties in the Event of Accident, Claim, Suit or Loss, a. is amended by adding the following:

This condition applies only when the "acci-dent" or "loss" is known to:

1. You, if you are an individual;

2. A partner, if you are a partnership;

3. An executive officer or insurance manag-er, if you are a corporation; or

4. A member or manager, if you are a lim-ited liability company.

P. Unintentional Failure to Disclose Hazards

SECTION IV - BUSINESS AUTO CONDI-

TIONS, B. General Conditions, 2. Conceal-ment, Misrepresentation or Fraud is amended by adding the following:

However, if you unintentionally fail to disclose any hazards existing on the effective date of this Coverage Form, we will not deny cover-age under this Coverage Form because of such failure.

Q. Mental Anguish Resulting from Bodily Inju-ry

SECTION V - DEFINITIONS, C. "Bodily inju-ry" is deleted in its entirety and replaced by the following:

"Bodily injury" means bodily injury, sickness or disease sustained by a person, including men-tal anguish and death sustained by the same person that results from such bodily injury, sickness or disease. "Bodily injury" does not include mental anguish or death that does not result from bodily injury, sickness or disease.

R. Coverage for Certain Operations in Con-nection with Railroads

With respect to the use of a covered "auto" in operations for or affecting a railroad:

1. SECTION V - DEFINITIONS, H. "Insured contract", 1.c. is deleted in its entirety and replaced by the following:

c. An easement or license agreement;

2. SECTION V - DEFINITIONS, H. "Insured contract", 2.a. is deleted.

CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1

COMMERCIAL GENERAL LIABILITY

CG 20 01 12 19

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PRIMARY AND NONCONTRIBUTORY -

OTHER INSURANCE CONDITION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

The following is added to the Other Insurance Condi-tion and supersedes any provision to the contrary:

Primary And Noncontributory Insurance

This insurance is primary to and will not seek con-tribution from any other insurance available to an additional insured under your policy 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.

Includes copyrighted material of Insurance GA 4316 AZ 05 20 Services Office, Inc., with its permission. Page 1 of 3

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS

AND AUTOMATIC WAIVER OF SUBROGATION

WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT -

(COMPLETED OPERATIONS) - ARIZONA

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

A. Additional Insured - Owners, Lessees Or Contractors - Automatic Status For Other Parties When Required In Written Con-struction Agreement (Completed Opera-tions)

1. Section II - Who Is An Insured is amended to include as an additional in-sured any person or organization you have agreed in writing in a contract or agreement to add as an additional in-sured on this Coverage Part. Such per-son(s) or organization(s) is an additional insured only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" performed under that written contract or written agreement and included in the "products-completed operations hazard", but only if:

a. The Coverage Part to which this en-dorsement is attached provides cov-erage for "bodily injury" or "property damage" included within the "prod-ucts-completed operations hazard";

and

b. The written contract or written agreement requires you to provide additional insured coverage included within the "products-completed oper-ations hazard" for that person or or-ganization.

If the written contract or written agree-ment requires you to provide additional insured coverage included within the "products-completed operations hazard" for a specified length of time for that per-son or organization, the "bodily injury" or "property damage" must occur prior to the expiration of that period of time in order for this insurance to apply.

If the written contract or written agree-ment requires you to provide additional insured coverage for a person or organi-zation per only ISO additional insured en-dorsement form number CG 20 10, with-out specifying an edition date, and without specifically requiring additional insured coverage included within the “products-completed operations hazard”, coverage does not apply to that person or organiza-tion.

2. With respect to the insurance afforded to the additional insureds described in Para-graph A.1., the following additional exclu-sions apply:

This insurance does not apply to

a. "Bodily injury" or "property damage" arising out of the rendering of, or the failure to render, any professional ar-chitectural, engineering or surveying services, including:

(1) The preparing, approving or fail-ing to prepare or approve, maps, shop drawings, opinions, re-ports, surveys, field orders, change orders or drawings and specifications; or

(2) Supervisory, inspection, archi-tectural or engineering activities.

This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the ren-dering of, or the failure to render, any professional architectural, engineer-ing or surveying services.

b. "Bodily injury" or "property damage" arising out of "residential" construc-tion.

B. The insurance afforded to additional insureds described in Paragraph A.:

GA 4316 AZ 05 20 Services Office, Inc., with its permission. Page 2 of 3

1. Only applies to the extent permitted by law; and

2. Will not be broader than that which you are required by the written contract or written agreement to provide for such ad-ditional insured; and

3. Does not apply to any person or organiza-tion specifically named as an additional insured for the same project in the sched-ule of an endorsement added to this Cov-erage Part.

C. With respect to the insurance afforded to the additional insureds described in Paragraph A., the following is added to Section III - Limits Of Insurance:

The most we will pay on behalf of the addi-tional insured is the amount of insurance:

1. Required by the written contract or written agreement described in Paragraph A. For the purpose of determining the required amount of insurance only, we will include the minimum amount of any Umbrella Li-ability or Excess Liability coverage re-quired for that additional insured in that written contract or written agreement; or

2. Available under the applicable limits of in-surance;

whichever is less.

This endorsement shall not increase the appli-cable limits of insurance.

D. Section IV - Commercial General Liability Conditions is amended to add the following:

Automatic Additional Insured Provision

This insurance applies only if the "bodily inju-ry" or "property damage" occurs:

1. During the policy period; and

2. Subsequent to your execution of the writ-ten contract or written agreement de-scribed in Paragraph A.

E. Except when F. below applies, the following is added to Section IV - Commercial General Liability Conditions, Other Insurance, and supersedes any provision to the contrary:

When Other Additional Insured Coverage Applies On An Excess Basis

This insurance is primary to other insurance available to the additional insured described in Paragraph A. except:

1. As otherwise provided in Section IV - Commercial General Liability Condi-tions, Other Insurance, b. Excess In-surance; or

2. For any other valid and collectible insur-ance available to the additional insured as an additional insured on another insur-ance policy that is written on an excess basis. In such case, this insurance is also excess.

F. The following is added to Section IV - Com-mercial General Liability Conditions, Other Insurance, and supersedes any provision to the contrary:

Primary Insurance When Required By Writ-ten Contract Or Agreement

Except when wrap-up insurance applies to the claim or "suit" on behalf of the additional in-sured, this insurance is primary to any other insurance available to the additional insured described in Paragraph A. provided that:

1. The additional insured is a Named In-sured under such other insurance; and

2. You have agreed in writing in a contract or agreement described in Paragraph A.

that this insurance would be primary to any other insurance available to the addi-tional insured.

As used in this endorsement, wrap-up insur-ance means a centralized insurance program under which one party has secured either in-surance or self-insurance covering some or all of the contractors or subcontractors perform-ing work on one or more specific projects(s).

Primary And Noncontributory Insurance When Required By Written Contract Or Agreement

Except when wrap-up insurance applies to the claim or "suit" on behalf of the additional in-sured, this insurance is primary to and will not seek contribution from any other insurance available to the additional insured described in Paragraph A. provided that:

1. The additional insured is a Named In-sured under such other insurance; and

2. You have agreed in writing in a contract or agreement described in Paragraph A.

that this insurance would be primary and would not seek contribution from any oth-er insurance available to the additional in-sured.

As used in this endorsement, wrap-up insur-ance means a centralized insurance program under which one party has secured either in-surance or self-insurance covering some or all of the contractors or subcontractors perform-ing work on one or more specific projects(s).

GA 4316 AZ 05 20 Services Office, Inc., with its permission. Page 3 of 3

G. Section IV – Commercial General Liability Conditions, Transfer Of Rights Of Recov-ery Against Others To Us is amended by the addition of the following:

Waiver of Subrogation

We waive any right of recovery against any additional insured under this endorsement, because of any payment we make under this endorsement, to whom the insured has waived its right of recovery in a written con-tract or written agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such addi-tional insured prior to loss.

H. Section V – Definitions is amended to in-clude:

1. "Residential" means:

a. A structure used, or intended, in whole or in part, for the purpose of human habitation, and includes, but is not limited to, single-family hous-ing, multi-family housing, tract homes, condominiums, cooperatives, townhomes, townhouses, planned-unit developments and timeshares;

b. A structure converted, or being con-verted, in whole or in part, into con-dominiums or cooperatives; and

c. Common areas and grounds, appur-tenant structures and facilities, of the structures described in H.1.a. and b.

above, except a public street, public road, public right of way, or public utility easement located on or near such common areas and grounds.

"Residential" does not include:

a. Hospitals, jails or prisons; and

b. Provided there is no individual own-ership of units and that such was not, in whole or in part, at any time, mar-keted, sold, occupied or used as sin-gle-family housing, multi-family hous-ing, or as a condominium, coopera-tive, townhouse, townhome or timeshare:

(1) Government housing on military bases;

(2) College/university dormitories;

(3) Apartments;

(4) Long-term care facilities;

(5) Assisted-living facilities;

(6) Nursing homes; and

(7) Hotels or motels.

GA 233 09 20 Services Office, Inc., with its permission. Page 1 of 17

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CONTRACTORS' COMMERCIAL GENERAL LIABILITY

BROADENED ENDORSEMENT

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

A. Endorsement - Table of Contents:

Coverage: Begins on Page:

1. Employee Benefit Liability Coverage

2. Unintentional Failure To Disclose Hazards

3. Damage To Premises Rented To You

4. Supplementary Payments

5. Medical Payments

6. 180 Day Coverage For Newly Formed Or Acquired Organizations

7. Waiver Of Subrogation

8. Automatic Additional Insured - Specified Relationships:

(a) Managers Or Lessors Of Premises

(b) Lessor Of Leased Equipment

(c) Vendors

(d) State Or Governmental Agency Or Subdivision Or Political Subdivision -

Permits Or Authorizations Relating To Premises

(e) Mortgagee, Assignee Or Receiver

9. Property Damage To Borrowed Equipment

10. Employees As Insureds - Specified Health Care Services And Good Samaritan

Services

11. Broadened Notice Of Occurrence

12. Nonowned Aircraft

13. Bodily Injury Redefined

14. Expected Or Intended Injury Redefined

15. Former Employees As Insureds

16. Voluntary Property Damage Coverage and Care, Custody Or Control Liability

Coverage

17. Broadened Contractual Liability - Work Within 50' Of Railroad Property

18. Alienated Premises

B. Limits Of Insurance:

The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse-ment, except as provided below:

1. Employee Benefit Liability Coverage

Each Employee Limit: $1,000,000 Aggregate Limit: $3,000,000 Deductible Amount: $ 1,000

3. Damage To Premises Rented To You

The lesser of:

a. The Each Occurrence Limit shown in the Declarations; or

b. $500,000 unless otherwise stated $

4. Supplementary Payments

a. Bail Bonds: $ 2,500

b. Loss Of Earnings: $ 500

GA 233 09 20 Services Office, Inc., with its permission. Page 2 of 17

5. Medical Payments

Medical Expense Limit: $10,000

9. Property Damage To Borrowed Equipment

Each Occurrence Limit: $10,000 Deductible Amount: $ 250

16. Voluntary Property Damage Coverage (Coverage D) and Care, Custody Or Control Liability Coverage

Limits Of Insurance Voluntary Property Damage Coverage:

$1,000 Each Occurrence $5,000 Aggregate Care, Custody Or Control Liability Coverage:

$5,000 Each Occurrence unless otherwise stated $

Deductible Amount (Each Occurrence) Voluntary Property Damage Coverage: $250 Care, Custody Or Control Liability Coverage: $250 unless otherwise stated $

COVERAGE

PREMIUM BASIS

(a) Area

(b) Payroll

(c) Gross Sales

(d) Units

(e) Other

RATE

(For Limits in Excess of $5,000)

ADVANCE PREMIUM

(For Limits in Excess of $5,000)

Care, Custody Or Control

Liability

TOTAL ANNUAL PREMIUM $

C. Coverages

1. Employee Benefit Liability Coverage

a. The following is added to Section I - Coverages:

EMPLOYEE BENEFIT LIABILITY

COVERAGE

(1) Insuring Agreement

(a) We will pay those sums that the insured becomes legally obligated to pay as damag-es caused by any act, error or omission of the insured, or of any other person for whose acts the insured is legally liable, to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend against any "suit" seeking damages to which this in-surance does not apply. We may, at our discretion, in-vestigate any report of an act, error or omission and settle any claim or "suit" that may result. But:

1) The amount we will pay for damages is limited as described in C. Cov-erages, 1. Employee Benefit Liability Cover-age, c. Limits Of Insur-ance of this endorse-ment; and

2) Our right and duty to defend ends when we have used up the appli-cable limit of insurance in the payment of judg-ments or settlements.

No other obligation or liabil-ity to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Pay-ments.

(b) This insurance applies to damages only if the act, er-ror or omission is negligently committed in the "admin-istration" of your "employee benefit program"; and

1) Occurs during the policy period; or

GA 233 09 20 Services Office, Inc., with its permission. Page 3 of 17

2) Occurred prior to the "first effective date" of this endorsement pro-vided:

a) You did not have knowledge of a claim or "suit" on or before the "first ef-fective date" of this endorsement.

You will be deemed to have knowledge of a claim or "suit" when any insured listed under C.

Coverages, 1.

Employee Benefit Liability Coverage,

b. Who Is An In-sured, (1) of this endorsement or any "employee" authorized by you to give or receive notice of a claim or "suit":

i) Reports all, or any part, of the act, error or omission to us or any other insurer;

ii) Receives a written or ver-bal demand or claim for dam-ages because of the act, er-ror or omis-sion; and

b) There is no other applicable insur-ance.

(2) Exclusions

This insurance does not apply to:

(a) Bodily Injury, Property Damage Or Personal And Advertising Injury

"Bodily injury", "property damage" or "personal and advertising injury".

(b) Dishonest, Fraudulent, Criminal Or Malicious Act

Damages arising out of any intentional, dishonest, fraudulent, criminal or mali-cious act, error or omission, committed by any insured, including the willful or reck-less violation of any statute.

(c) Failure To Perform A Con-tract

Damages arising out of fail-ure of performance of con-tract by any insurer.

(d) Insufficiency Of Funds

Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the "employee benefit program".

(e) Inadequacy Of Perfor-mance Of Invest-ment/Advice Given With Respect To Participation

Any claim based upon:

1) Failure of any invest-ment to perform;

2) Errors in providing in-formation on past per-formance of investment vehicles; or

3) Advice given to any person with respect to that person's decision to participate or not to par-ticipate in any plan in-cluded in the "employee benefit program".

(f) Workers' Compensation And Similar Laws

Any claim arising out of your failure to comply with the mandatory provisions of any workers' compensation, un-employment compensation insurance, social security or disability benefits law or any similar law.

(g) ERISA

Damages for which any in-sured is liable because of li-ability imposed on a fiduci-ary by the Employee Re-tirement Income Security Act of 1974, as now or hereafter amended, or by any similar federal, state or local laws.

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(h) Available Benefits

Any claim for benefits to the extent that such benefits are available, with reasonable effort and cooperation of the insured, from the applicable funds accrued or other col-lectible insurance.

(i) Taxes, Fines Or Penalties

Taxes, fines or penalties, in-cluding those imposed un-der the Internal Revenue Code or any similar state or local law.

(j) Employment-Related Prac-tices

Any liability arising out of any:

1) Refusal to employ;

2) Termination of employ-ment;

3) Coercion, demotion, evaluation, reassign-ment, discipline, defa-mation, harassment, humiliation, discrimina-tion or other employ-ment-related practices, acts or omissions; or

4) Consequential liability as a result of 1), 2) or 3) above.

This exclusion applies whether the insured may be held liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the in-jury.

(3) Supplementary Payments

Section I - Supplementary Pay-ments - Coverages A and B also apply to this Coverage, however 1.b. and 2. of the Supplementary Payments provision do not apply.

b. Who Is An Insured

As respects Employee Benefit Liabil-ity Coverage, Section II - Who Is An Insured is replaced by the following:

(1) If you are designated in the Dec-larations as:

(a) An individual, you and your spouse are insureds, but on-ly with respect to the con-duct of a business of which you are the sole owner.

(b) A partnership or joint ven-ture, you are an insured.

Your members, your part-ners, 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 with respect to the conduct of your business.

Your managers are in-sureds, but only with respect to their duties as your man-agers.

(d) An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "execu-tive 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 re-spect to their liability as stockholders.

(e) A trust, you are an insured.

Your trustees are also in-sureds, but only with respect to their duties as trustees.

(2) Each of the following is also an insured:

(a) Each of your "employees" who is or was authorized to administer your "employee benefit program";

(b) Any persons, organizations or "employees" having prop-er temporary authorization to administer your "employ-ee benefit program" if you die, but only until your legal representative is appointed;

or

(c) Your legal representative if you die, but only with re-spect to duties as such. That representative will have all your rights and duties under this Coverage Part.

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(3) Any organization you newly ac-quire or form, other than a part-nership, joint venture or limited liability company, and over which you maintain ownership or major-ity interest, will qualify as a Named Insured if no other similar insurance applies to that organi-zation. However, coverage under this provision:

(a) Is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and

(b) Does not apply to any act, error or omission that was committed before you ac-quired or formed the organi-zation.

c. Limits Of Insurance

As respects Employee Benefit Liabil-ity Coverage, Section III - Limits Of Insurance is replaced by the follow-ing:

(1) The Limits of Insurance shown in Section B. Limits Of Insurance,

1. Employee Benefit Liability Coverage of this endorsement and the rules below fix the most we will pay regardless of the number of:

(a) Insureds;

(b) Claims made or "suits" brought;

(c) Persons or organizations making claims or bringing "suits";

(d) Acts, errors or omissions; or

(e) Benefits included in your "employee benefit program".

(2) The Aggregate Limit shown in Section B. Limits Of Insurance,

1. Employee Benefit Liability Coverage of this endorsement is the most we will pay for all dam-ages because of acts, errors or omissions negligently committed in the "administration" of your "employee benefit program".

(3) Subject to the limit described in

(2) above, the Each Employee Limit shown in Section B. Limits Of Insurance, 1. Employee Bene-fit Liability Coverage of this en-dorsement is the most we will pay for all damages sustained by any one "employee", including damages sustained by such "employee's" dependents and beneficiaries, as a result of:

(a) An act, error or omission; or

(b) A series of related acts, er-rors or omissions, regard-less of the amount of time that lapses between such acts, errors or omissions;

negligently committed in the "administration" of your "employ-ee benefit program".

However, the amount paid under this endorsement shall not ex-ceed, and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the "employee benefit program."

(4) Deductible Amount

(a) Our obligation to pay dam-ages on behalf of the in-sured applies only to the amount of damages in ex-cess of the Deductible Amount shown in Section B.

Limits Of Insurance, 1. Em-ployee Benefit Liability Cov-erage of this endorsement as applicable to Each Em-ployee. The limits of insur-ance shall not be reduced by the amount of this de-ductible.

(b) The Deductible Amount shown in Section B. Limits Of Insurance, 1. Employee Benefit Liability Coverage of this endorsement applies to all damages sustained by any one "employee", includ-ing such "employee's" de-pendents and beneficiaries, because of all acts, errors or omissions to which this in-surance applies.

(c) The terms of this insurance, including those with respect to:

1) Our right and duty to defend the insured against any "suits" seeking those damag-es; and

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2) Your duties, and the du-ties of any other in-volved insured, in the event of an act, error or omission, or claim;

apply irrespective of the ap-plication of the Deductible Amount.

(d) We may pay any part or all of the Deductible Amount to effect settlement of any claim or "suit" and, upon no-tification of the action taken, you shall promptly reim-burse us for such part of the Deductible Amount as we have paid.

d. Additional Conditions

As respects Employee Benefit Liabil-ity Coverage, Section IV - Commer-cial General Liability Conditions is amended as follows:

(1) Item 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit is replaced by the following:

2. Duties In The Event Of An Act, Error, Omission, Claim Or Suit

a. You must see to it that we are notified as soon as practicable of an act, error or omission which may result in a claim.

To the extent possible, notice should include:

(1) What the act, error or omission was and when it oc-curred; and

(2) The names and addresses of any-one who may suf-fer damages as a result of the act, error or omission.

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) Notify us as soon as practicable.

You must see to it that we receive written no-tice of the claim or "suit" as soon as practicable.

c. You and any other in-volved insured must:

(1) Immediately send us copies of any demands, notices, summonses or le-gal papers re-ceived in connec-tion with the claim or "suit";

(2) Authorize us to ob-tain 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 en-forcement of any right against any person or organi-zation which may be liable to the in-sured because of an act, error or omission to which this insurance may also apply.

d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense without our consent.

(2) Item 4. Other Insurance is re-placed by the following:

4. Other Insurance

If other valid and collectible insurance is available to the insured for a loss we cover under this Employee Benefit Liability Coverage, our obli-gations are limited as fol-lows:

a. Primary Insurance

This insurance is prima-ry except when c. below applies. If this insurance

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ry. Then, we will share with all that other insur-ance by the method de-scribed in Paragraph b.

below.

b. Method Of Sharing

If all of the other insur-ance permits contribu-tion by equal shares, we will follow this meth-od also. Under this ap-proach 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 in-surance does not permit contribution by equal shares, we will contrib-ute 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 insur-ers.

c. No Coverage

This insurance shall not cover any loss for which the insured is entitled to recovery under any other insurance in force previous to the effective date of this Employee Benefit Liability Cover-age.

e. Additional Definitions

As respects Employee Benefit Liabil-ity Coverage, Section V - Definitions is amended as follows:

(1) The following definitions are added:

1. "Administration" means:

a. Providing information to "employees", including their dependents and beneficiaries, with re-spect to eligibility for or scope of "employee benefit programs";

b. Interpreting the "em-ployee benefit pro-grams";

c. Handling records in connection with the "employee benefit pro-grams"; or

d. Effecting, continuing or terminating any "em-ployee's" participation in any benefit included in the "employee benefit program".

However, "administration" does not include:

a. Handling payroll deduc-tions; or

b. The failure to effect or maintain any insurance or adequate limits of coverage of insurance, including but not limited to unemployment insur-ance, social security benefits, workers' com-pensation and disability benefits.

2. "Cafeteria plans" means plans authorized by applica-ble law to allow "employees" to elect to pay for certain benefits with pre-tax dollars.

3. "Employee benefit pro-grams" means a program providing some or all of the following benefits to "em-ployees", whether provided through a "cafeteria plan" or otherwise:

a. Group life insurance;

group accident or health insurance; dental, vision and hearing plans; and flexible spending ac-counts; provided that no one other than an "em-ployee" may subscribe to such benefits and such benefits are made generally available to those "employees" who satisfy the plan's eligibil-ity requirements;

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b. Profit sharing plans, employee savings plans, employee stock ownership plans, pen-sion plans and stock subscription plans, pro-vided that no one other than an "employee" may subscribe to such benefits and such bene-fits are made generally available to all "employ-ees" who are eligible under the plan for such benefits;

c. Unemployment insur-ance, social security benefits, workers' com-pensation and disability benefits; and

d. Vacation plans, includ-ing buy and sell pro-grams; leave of ab-sence programs, includ-ing military, maternity, family, and civil leave;

tuition assistance plans;

transportation and health club subsidies.

4. "First effective date" means the date upon which cover-age was first effected in a series of uninterrupted re-newals of insurance cover-age.

(2) The following definitions are de-leted in their entirety and re-placed by the following:

5. "Employee" means a person actively employed, formerly employed, on leave of ab-sence or disabled, or retired.

"Employee" includes a "leased worker". "Employee" does not include a "tempo-rary worker".

18. "Suit" means a civil proceed-ing in which money damag-es because of an act, error or omission to which this in-surance applies are alleged.

"Suit" includes:

a. An arbitration proceed-ing in which such dam-ages are claimed and to which the insured must submit or does submit with our consent;

b. Any other alternative dispute resolution pro-ceeding in which such damages are claimed and to which the in-sured submits with our consent; or

c. An appeal of a civil pro-ceeding.

2. Unintentional Failure To Disclose Haz-ards

Section IV - Commercial General Liabil-ity Conditions, 6. Representations is amended by the addition of the following:

Based on our dependence upon your rep-resentations as to existing hazards, if un-intentionally you should fail to disclose all such hazards at the inception date of your policy, we will not reject coverage under this Coverage Part based solely on such failure.

3. Damage To Premises Rented To You

a. The last paragraph of 2. Exclusions under Section I - Coverage A - Bod-ily Injury And Property Damage Li-ability is replaced by the following:

Exclusions c. through n. do not apply to damage by fire, explosion, light-ning, smoke or soot to premises while rented to you or temporarily occupied by you with permission of the owner, for which the amount we will pay is limited to the Damage To Premises Rented To You Limit as described in Section III - Limits Of Insurance.

b. The insurance provided under Sec-tion I - Coverage A - Bodily Injury And Property Damage Liability applies to "property damage" arising out of wa-ter damage to premises that are both rented to and occupied by you.

As respects Water Damage Legal Li-ability, as provided in Paragraph 3.b.

above:

The exclusions under Section I - Coverage A - Bodily Injury And Prop-erty Damage Liability, 2. Exclusions, other than i. War and the Nuclear Energy Liability Exclusion (Broad Form), are deleted and the following are added:

This insurance does not apply to:

(a) "Property damage":

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(i) Assumed in any contract or agreement; or

(ii) Caused by or resulting from any of the following:

1) Wear and tear;

2) Rust or other corrosion, de-cay, deterioration, hidden or latent defect or any quality in property that causes it to damage or destroy itself;

3) Smog;

4) Mechanical breakdown, in-cluding rupture or bursting caused by centrifugal force;

5) Settling, cracking, shrinking or expansion;

6) Nesting or infestation, or discharge or release of waste products or secre-tions, by insects, birds, ro-dents or other animals; or

7) Presence, growth, prolifera-tion, spread or any activity of fungus, including mold or mildew, and any mycotoxins, spores, scents or byproducts produced or released by fungi.

(b) "Property damage" caused di-rectly or indirectly by any of the following:

(i) Earthquake, volcanic erup-tion, landslide or any other earth movement;

(ii) Water that backs up or over-flows or is otherwise dis-charged from a sewer, drain, sump, sump pump or related equipment;

(iii) Water under the ground sur-face pressing on, or flowing or seeping through:

1) Foundations, walls, floors or paved surfac-es;

2) Basements, whether paved or not; or

3) Doors, windows or other openings.

(c) "Property damage" caused by or resulting from water that leaks or flows from plumbing, heating, air conditioning, fire protection sys-tems, or other equipment, caused by or resulting from freezing, unless:

(i) You did your best to main-tain heat in the building or structure; or

(ii) You drained the equipment and shut off the water supply if the heat was not main-tained.

(d) "Property damage" to:

(i) Plumbing, heating, air condi-tioning, fire protection sys-tems, or other equipment or appliances; or

(ii) The interior of any building or structure, or to personal property in the building or structure, caused by or re-sulting from rain, snow, sleet or ice, whether driven by wind or not.

c. Limit Of Insurance

With respect to the insurance afford-ed in Paragraphs 3.a. and 3.b. above, the Damage To Premises Rented To You Limit as shown in the Declara-tions is amended as follows:

(1) Paragraph 6. of Section III - Lim-its Of Insurance is…