CTR078192_COI_CL_BA_exp_7.28.26.pdf

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Attached to
AZ|CTR078192
Contract number
CTR078192
Issued by
Arizona

About this file

This document is a Certificate of Liability Insurance issued by Shepherd Insurance, LLC. for Matforce Yavapai County Substance Abuse Coalition, located in Prescott Valley, Arizona. The insurance is provided through Secura Insurance (NAIC 22543) and United Financial Casualty Co (NAIC 11770), with the certificate being issued to the Arizona Department of Administration State Procurement Office in Phoenix, Arizona.

The insurance certificate covers multiple liability categories including commercial general liability, automobile liability, and umbrella/excess liability. The policy periods run from 07/28/2025 to 07/28/2026, with coverage limits including $1,000,000 per occurrence for general liability, $1,000,000 for automobile liability, and $1,000,000 for uninsured motorist coverage. The policy includes additional insured provisions, automatic coverage extensions, and various supplementary payment provisions such as business travel accident benefits, catastrophe employee care costs, and emergency evacuation expenses. The contract number referenced is CTR078192, and the certificate number is CL258674599.

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Text version

08/29/2025

Shepherd Insurance, LLC.

400 White Spar Road

Prescott AZ 86303

Shepherd CCS

(928) 445-4600 certs@shepherdins.com

Matforce Yavapai County Substance Abuse Coalition 8056 E Valley Rd Ste B

Prescott Valley AZ 86314

Secura Insurance 22543 United Financial Casualty Co 11770

CL258674599

A CP3182019 07/28/2025 07/28/2026

1,000,000 100,000 10,000 1,000,000 2,000,000 2,000,000

Liquor Liability Exclusion

B 959897840 08/01/2025 08/01/2026

1,000,000

Uninsured motorist combined single limit

1,000,000

A CU3182020 07/28/2025 07/28/2026

1,000,000 1,000,000

Automatic Additional Insured applies to General Liability coverages where required by written contract subject to policy terms, conditions & exclusions. The coverage extensions referenced on this certificate are achieved through the following forms which are included on the policy & attached to this certificate:

CGT2000 2008.

Arizona Dept of Administration State Procurement Office 100 N. 15th Ave, Suite 305 Phoenix AZ 85007

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

Matforce Yavapai County Substance Abuse Coalition

00104272

Shepherd Insurance, LLC.

25 Certificate of Liability Insurance: Notes

Re: Contract #CTR078192

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:

CGT 2000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 12 2008 © 2020 SECURA Insurance Company

THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY.

ELITE GENERAL LIABILITY WRAP

This Endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

The following is a summary of the coverages provided in this Endorsement. This Endorsement is applicable only to those premises described in the Declarations.

SCHEDULE

Coverage Limit

I. COVERAGE EXTENSIONS

A. BROADENED MEDICAL PAYMENTS Amended B. EXTENDED PROPERTY DAMAGE Included C. NON-OWNED AIRCRAFT HIRED WITH CREW Included D. NON-OWNED WATERCRAFT Less than 65 feet E. PERSONAL AND ADVERTISING INJURY – BROAD FORM Included

II. AUTOMATIC ADDITIONAL INSUREDS

A. ADDITIONAL INSURED BY WRITTEN AGREEMENT Included B. BUILDING OWNER Included C. CO-OWNER OF INSURED PREMISES Included D. CONCESSIONAIRES TRADING UNDER YOUR NAME Included E. FRANCHISOR Included F. FUNDING SOURCE Included G. GRANTOR OF PERMITS Included H. LESSOR OF LEASED EQUIPMENT Included I. MORTGAGEE, ASSIGNEE OR RECEIVER Included J. OWNERS OR OTHER INTERESTS FROM WHOM LAND HAS BEEN LEASED Included K. STATE OR POLITICAL SUBDIVISIONS Included

III. BROADENED DEFINITION OF INSURED

A. BROADENED NAMED INSURED Included B. LIMITED FELLOW EMPLOYEE Included

IV. SUPPLEMENTARY PAYMENTS INCREASED LIMITS Included

V. SUPPLEMENTARY PAYMENTS EXTENSIONS

A. BUSINESS TRAVEL ACCIDENT BENEFIT $75,000

B. CATASTROPHE EMPLOYEE CARE COSTS $150,000

C. CONFERENCE CANCELLATION $25,000

D. EMERGENCY REAL ESTATE CONSULTING FEE $75,000

E. EMPLOYEE OR VOLUNTEER INDEMNIFICATION DEFENSE COVERAGE $25,000

F. FUNDRAISING EVENT BLACKOUT $50,000

G. IDENTITY THEFT EXPENSE $75,000

H. IMAGE RESTORATION AND COUNSELING $75,000

I. KIDNAP EXPENSE $75,000

J. POLITICAL UNREST $75,000

K. TEMPORARY MEETING SPACE EXPENSE $50,000

L. TERRORISM TRAVEL REIMBURSEMENT $75,000

M. TRAVEL DELAY REIMBURSEMENT $3,000

N. UNPAID DONATION PLEDGES $75,000

VI. CONDITIONS

A. DUTIES AFTER LOSS REDEFINED Included B. PRIMARY AND NONCONTRIBUTORY Included C. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Included

VII. DEFINITIONS

A. BODILY INJURED REDEFINED Included B. MOBILE EQUIPMENT AMENDMENT Included

VIII.UNINTENTIONAL FAILURE TO DISCLOSE Included

CGT 2000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 12

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

I. COVERAGE EXTENSIONS

A. BROADENED MEDICAL PAYMENTS

If Medical Expense Payments coverage applies:

1. SECTION I – COVERAGES; COVERAGE C MEDICAL PAYMENTS on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended as follows:

The reporting period as shown in paragraph 1.a.(3)(b) of the Insuring Agreement, is amended to be reported within three years of the date of accident, in lieu of one year.

2. The Medical Expense Limit is amended to the amount shown on the Declarations.

B. EXTENDED PROPERTY DAMAGE

1. SECTION I – COVERAGES; COVERAGE A BODILY INJURY AND PROPERTY DAMAGE

LIABILITY; 2. Exclusions; a. Expected Or Intended Injury on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is deleted and replaced by the following:

a. Expected Or Intended Injury “Bodily injury” or “property damage” expected or intended from the standpoint of the insured. This exclusion does not apply to “bodily injury” or “property damage” resulting from the use of reasonable force to protect persons or property.

2. The following is added to SECTION I – COVERAGES; COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY; 2. Exclusions; j. Damage to Property on the COMMERCIAL

GENERAL LIABILITY COVERAGE FORM:

Paragraphs (3), (4) and (6) of this exclusion do not apply if such “property damage” arises out of the use of elevators at premises you own, rent, lease or occupy. For the purposes of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations.

The insurance afforded by this provision is excess over any other valid and collectible insurance which applies to a loss because of “property damage” arising out of the use of elevators, whether such insurance is primary, excess, contingent or issued on any other basis.

C. NON-OWNED AIRCRAFT HIRED WITH CREW

1. SECTION I – COVERAGES; COVERAGE A BODILY INJURY AND PROPERTY DAMAGE

LIABILITY; 2. Exclusions; g. Aircraft, Auto Or Watercraft on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM does not apply to an aircraft that is:

a. Not owned by any insured; and

b. Hired or chartered by, or loaned to you, with a paid crew for the sole use of transporting your “employees”.

2. This coverage does not apply if there is any other insurance for “bodily injury” or “property damage” liability that would also apply to loss covered under this coverage, whether the other insurance is primary, excess, contingent, or on any other basis. A policy issued by us to apply specifically in excess of this policy is not considered other insurance.

D. NON-OWNED WATERCRAFT

1. SECTION I – COVERAGES; COVERAGE A BODILY INJURY AND PROPERTY DAMAGE

LIABILITY; 2. Exclusions; g. Aircraft, Auto or Watercraft; Paragraph (2) on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is deleted and replaced by the following:

(2) A watercraft you do not own that is:

(a) Less than 65 feet long; and

(b) Not being used to carry persons or property for a charge;

2. This coverage applies to any person who, with your expressed or implied consent, either uses or is

CGT 2000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 12 responsible for the use of a watercraft.

3. This coverage does not apply if there is any other insurance for “bodily injury” or “property damage” liability that would also apply to loss covered under this coverage, whether the other insurance is primary, excess, contingent or on any other basis. A policy issued by us to apply specifically in excess of this policy is not considered other insurance.

E. PERSONAL AND ADVERTISING INJURY – BROAD FORM

1. SECTION I – COVERAGES; COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY; 2.

Exclusions; e. Contractual Liability on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is deleted.

2. The following is added as item h. to SECTION V – DEFINITIONS; 14. “Personal and Advertising Injury” on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM:

h. Discrimination or humiliation (unless insurance thereof is prohibited by law) that results in injury to the reputation of a natural person, but only if such discrimination or humiliation is:

(1) Not done intentionally by or at the direction of:

(a) You; or

(b) Any of your officers, directors, stockholders, partners, managers, or members.

(2) Not directly or indirectly related to the employment, prospective employment or termination of employment of any person or persons by any insured.

3. SECTION V – DEFINITIONS; 14. “Personal and Advertising Injury”; Paragraph b. on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is deleted and replaced with the following:

b. Malicious prosecution or abuse of process;

II. AUTOMATIC ADDITIONAL INSUREDS

SECTION II – WHO IS AN INSURED on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to include as an additional insured:

A. ADDITIONAL INSURED BY WRITTEN AGREEMENT

1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for “bodily injury”, “property damage” or “personal and advertising injury” caused, in whole or in part, by:

a. Your acts or omissions; or

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

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

A person’s or organization's status as an additional insured under this Endorsement ends when your operations for that additional insured are completed.

2. With respect to the insurance afforded these additional insureds, the following additional exclusions apply:

This insurance does not apply to:

a. "Bodily injury", "property damage" or “personal and advertising injury” arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:

(1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or

(2) Supervisory, inspection, architectural or engineering activities.

b. Any of your Subcontractors, or any partner, officer, agent or employee of such Subcontractor.

c. “Bodily injury” or “property damage” occurring after:

CGT 2000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 12

(1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or

(2) 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 a principal as a part of the same project.

3. The limits of insurance applicable to such insurance shall be the lesser of the limits required by the written agreement between the parties or the limits provided by this policy.

B. BUILDING OWNER

The owner, manager, or lessor of premises but only with respect to liability arising out of the ownership, maintenance, or use of that part of the premises leased to you subject to the following additional exclusions:

This insurance does not apply to:

1. Any “occurrence” which takes place after you cease to be a tenant in that premises.

2. Structural alterations, new construction, or demolition operations performed by or on behalf of such additional insured.

C. CO-OWNER OF INSURED PREMISES

Any co-owner of a premises co-owned by you and covered under this insurance whom you agree in a written agreement to include as additional insured, but only with respect to the co-owner’s liability as co-owner of such premises.

D. CONCESSIONAIRES TRADING UNDER YOUR NAME

Any concessionaires trading under your name whom you agree in a written agreement to include as additional insured, but only with respect to their liability as a concessionaire trading under your name.

E. FRANCHISOR

Any person or organization whom you agree in a written agreement to include as additional insured, but only with respect to their liability as grantor of a franchise to you.

F. FUNDING SOURCE

Any person or organization whom you agree in a written agreement to include as additional insured, but only with respect to their liability arising out of:

1. Their financial control of you; or

2. Premises they own, maintain or control while you lease or occupy these premises.

This insurance does not apply to structural alterations, new construction or demolition operations performed by or for that person or organization.

G. GRANTORS OF PERMITS

Any state or governmental agency or subdivision or political subdivision whom you agree in a written agreement to include as additional insured, subject to the following provision:

This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies:

1. The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away operations, sidewalk vaults, street banners or decorations and similar exposures; or

2. The construction, erection or removal of elevators; or

3. The ownership, maintenance or use of any elevators covered by this insurance.

CGT 2000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 12

H. LESSOR OF LEASED EQUIPMENT

1. Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing that such person or organization be added as an additional insured on your policy. Such person or organization is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization.

A person’s or organization’s status as an additional insured under this Endorsement ends when their agreement with you for such leased equipment ends.

2. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires.

I. MORTGAGEE, ASSIGNEE OR RECEIVER

Any mortgagee, assignee or receiver whom you agree in a written agreement to include as additional insured, but only with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of the premises by you.

This insurance does not apply to structural alterations, new construction, or demolition operations performed by or for such additional insured.

J. OWNERS OR OTHER INTERESTS FROM WHOM LAND HAS BEEN LEASED

1. Any owners or other interests from whom land has been leased whom you agree in a written agreement to include as additional insured, but only with respect to “bodily injury”, “property damage” or “personal and advertising injury” caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the land leased to you.

2. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:

This insurance does not apply to:

a. Any “occurrence” which takes place after you cease to lease that land.

b. Structural alterations, new construction, or demolition operations performed by or on behalf of such additional insured.

K. STATE OR POLITICAL SUBDIVISIONS

Any state or governmental agency or subdivision or political subdivision whom you agree in a written agreement to include as additional insured, subject to the following provisions:

1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization.

2. This insurance does not apply to:

a. “Bodily injury”, “property damage” or “personal and advertising injury” arising out of operations performed for the federal government, state or municipality; or

b. “Bodily injury” or “property damage” included within the “products-completed operations hazard”.

III. BROADENED DEFINITION OF INSURED

SECTION II – WHO IS AN INSURED on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to add the following:

A. BROADENED NAMED INSURED

Any organization which you control and actively manage, and have agreed in writing on or after the effective date of this policy to name them as additional insured. However, no such organization is an insured under this Endorsement who is also an insured under another policy; or would have been an insured under another policy but for its termination or exhaustion of its limits of insurance.

B. LIMITED FELLOW EMPLOYEE

CGT 2000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 12

The who are not insureds in Item 2.a.(1)(a), with respect to co-“employee” does not apply to your managers and supervisors who are your “employees” while in the course of employment by you and performing duties related to the conduct of your business.

IV. SUPPLEMENTARY PAYMENTS INCREASED LIMITS

SECTION I – COVERAGES; SUPPLEMENTARY PAYMENTS – COVERAGES A AND B on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended as follows:

A. Item 1.b., the cost of bail bonds is changed to $5,000; and

B. Item 1.d., actual loss of earnings is changed to $1,000 a day.

V. SUPPLEMENTARY PAYMENTS EXTENSIONS

SECTION I – COVERAGES; SUPPLEMENTARY PAYMENTS – COVERAGES A AND B on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to add the following:

At the insured’s request, we will reimburse:

A. BUSINESS TRAVEL ACCIDENT BENEFIT

The insured if your current director or officer suffers injury or death while traveling on a common carrier for your business during the policy period.

For the purposes of this SUPPLEMENTARY PAYMENT, injury means:

1. Physical injury to the body caused by violence, fracture, or an accident that results in loss of life not later than 180 days after the policy expiration, the date of cancellation or the date of non-renewal;

2. Accidental loss of limbs or multiple fingers; or

3. Total loss of sight, speech or hearing.

The Business Travel Accident Benefit shall not be payable if the cause of the injury or death was:

1. An intentional act by the insured;

2. An act of suicide or attempted suicide;

3. An act of war; or

4. A disease process.

The most we will pay under this provision is shown on the SCHEDULE above for all insureds combined per policy period.

B. CATASTROPHE EMPLOYEE CARE COSTS

The insured for employee care expenses incurred, but not reimbursable by any other source, as described below for covered “catastrophic events” or by a fatal accident:

1. On premises you own or rent;

2. On ways next to premises you own or rent; or

3. Because of your operations;

Provided that:

a. The “catastrophic event” takes place in the “coverage territory” and during the policy period;

b. The expenses are incurred by you within 90 days of the accident and reported to us within 90 days of being incurred (90 day period for reporting expenses is not applicable in Missouri); and

c. The determination of “catastrophic event” is approved by us prior to incurring the covered employee care expenses.

We will make these payments for each “catastrophic event” as described in this provision. The most we will pay under this provision is shown on the SCHEDULE above for all insureds combined per policy period.

We will pay reasonable expenses for:

1. Counseling services for “employees” and “volunteer workers”;

CGT 2000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 12

2. Increased security guard services;

3. Public relations consultants;

4. Security consultant services; or

5. Any other applicable expense approved by us.

The above additional coverages are applicable at the location linked with the “catastrophic event”.

We will not pay for expenses resulting from “catastrophic events” if benefits are payable or must be provided to any person, whether they are an “employee” or not, under a workers’ compensation or disability benefits law or similar law.

Covered “catastrophic events” include violent or destructive events, other than natural catastrophe, that involve reckless acts by any person without regard for life, and involve physical harm or the threat of physical harm to individual victims who are connected with your operations; and causes emotional distress to “employees”, customers or other individuals directly connected with your operations.

C. CONFERENCE CANCELLATION

The insured for any business-related conference expenses, paid by the insured and not reimbursable by any other source, for a cancelled conference that an “employee” or “volunteer worker” was scheduled to attend and was scheduled to start during the policy period.

With respect to this coverage:

1. The insured “employee” or “volunteer worker” must have registered for the conference at least 30 days prior to the cancellation;

2. The cancellation must be ordered by a local, state or federal Board of Health or other governmental authority having jurisdiction over the location of the conference; and

3. The cancellation must be ordered during the policy period.

We will not pay for expenses resulting from a cancelled conference that the insured was hosting.

The most we will pay under this provision is shown on the SCHEDULE above for all insureds combined per policy period.

D. EMERGENCY REAL ESTATE CONSULTING FEE

The insured for any realtor’s fee or real estate consultant’s fee required because the insured must relocate due to damage to the insured’s primary location during the policy period, which makes that location unusable for more than 72 hours.

The most we will pay under this provision is shown on the SCHEDULE above for all insureds combined per policy period.

E. EMPLOYEE OR VOLUNTEER INDEMNIFICATION DEFENSE COVERAGE

The Named Insured, at the Named Insured’s request, for defense costs incurred by an “employee” or “volunteer worker” in a criminal proceeding if the alleged criminal wrongdoing occurred in the course of the “employee’s” or “volunteer worker’s” employment by you or while performing duties related to the conduct of your business.

The most we will pay for any “employee” or “volunteer worker” who is alleged to be directly involved in a criminal proceeding is shown on the SCHEDULE above regardless of the number of “employees” or “volunteer workers”, claims or “suits” brought or persons or organizations making claims or bringing “suits”.

F. FUNDRAISING EVENT BLACKOUT

The insured for fundraising event expenses that are incurred, and not reimbursable by any other source, due to the cancellation of a fundraising event caused by the lack of electric supply resulting in power outage, provided the fundraising event was originally scheduled to occur during the policy period and is not rescheduled. The fundraising event must have been planned at least 30 days prior to the power outage.

The most we will pay under this provision is shown on the SCHEDULE above for all insureds combined per policy period.

CGT 2000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 12

G. IDENTITY THEFT EXPENSE

Any current director or officer of the Named Insured for “identity theft expenses” incurred as the direct result of any “identity theft” first discovered and reported during the policy period. Any act or series of acts committed by one or more persons, or in which such person or persons are aiding or abetting others against the director or officer, is considered to be one “identity theft”, even if a series of acts continues into a subsequent policy period. The most we will pay under this provision is shown on the SCHEDULE above for all current directors and officers combined per policy period.

For the purposes of this SUPPLEMENTARY PAYMENT the following definitions apply:

“Identity theft” means the act of knowingly transferring or using, without lawful authority, a means of identification of any director or officer (or spouse thereof) of the Named Insured with the intent to commit, or to aid or abet another to commit, any unlawful activity that constitutes a violation of federal law or a felony under any applicable state or local law.

“Identity theft expenses” mean:

1. Costs for notarizing affidavits or similar documents attesting to “identity theft” required by financial institutions or similar credit grantors or credit agencies;

2. Costs for certified mail to law enforcement agencies, credit agencies, financial institutions or similar credit grantors related to the “identity theft”;

3. Loan application fees for re-applying for a loan or loans when the original application is rejected solely because the lender received incorrect credit information due to “identity theft”; or

4. Charges incurred for long distance telephone calls to merchants, law enforcement agencies, financial institutions or similar credit grantors, or credit agencies to report or discuss an actual “identity theft”.

H. IMAGE RESTORATION AND COUNSELING

The insured for expenses incurred for image restoration and counseling arising out of “improper acts” by any insured. Covered expenses are limited to:

1. The costs of rehabilitation and counseling for the accused Insured, partners, directors, officers, “employees” or “volunteer workers” provided the Insured is not ultimately found guilty of criminal conduct, said reimbursement to occur after acquittal of the Insured.

2. The costs, charged by a recruiter or expended on advertising, of replacing an officer as a result of “improper acts”; and

3. The costs of restoring the Named Insured’s reputation and consumer confidence through image consulting.

For the purposes of this SUPPLEMENTARY PAYMENT, the following definition applies:

“Improper acts” means any actual or alleged act of:

1. Sexual abuse;

2. Sexual intimacy;

3. Sexual molestation; and/or

4. Sexual assault;

committed by any Insured against any natural person who is not an Insured. Such “improper acts” must have been committed by the Insured while in his or her capacity as an insured.

The most we will pay under this provision is shown on the SCHEDULE above for all insureds combined per policy period.

I. KIDNAP EXPENSE

We will pay on behalf of any current director or officer of the Named Insured, reasonable fees incurred as a result of the kidnapping of them or their spouse, parent or child during the policy period. Coverage will not apply to any kidnapping by or at the direction of any present or former family member of the victim.

Reasonable fees will include:

1. Fees and costs of independent negotiators;

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2. Interest costs for any loan from a financial institution taken by you to pay a ransom demand or extortion threat;

3. Travel costs and accommodations incurred by the Named Insured;

4. Reward money paid to an informant which leads to the arrest and conviction of parties responsible for loss covered under this insurance; and

5. Salary, commissions and other financial benefits paid by you to your kidnapped director or officer.

Such compensation applies at the level in effect on the date of the kidnap and ends upon the earliest of:

a. Up to 30 days after their release, if the director or officer has not yet returned to work;

b. Discovery of their death;

c. 120 days after the last credible evidence following abduction that they are still alive; or

d. 12 months after the date of the kidnapping.

The most we will pay under this provision is shown on the SCHEDULE above for all insureds combined per policy period.

J. POLITICAL UNREST

Any current director, officer, “employee” or “volunteer worker” of the Named Insured while traveling outside the United States of America for “emergency evacuation expenses” directly related to the conduct of your business that are incurred as a result of an incident of “political unrest”. The “political unrest” must occur during the policy period. No coverage is granted for travel to countries in a state of “political unrest” at the time of departure of the travel.

For the purposes of this SUPPLEMENTARY PAYMENT, the following definitions apply:

“Emergency evacuation expense” means:

1. Additional lodging expenses;

2. Additional transportation expenses;

3. The cost of obtaining replacements of lost or stolen travel documents necessary for evacuation from the area of “political unrest”; and

4. Translation services, message transmittals and other communication expenses;

provided these expenses are not reimbursable by any other source.

“Political unrest” means:

1. A short-term condition of disturbance, turmoil or agitation within a foreign country that poses imminent risk to the security of citizens of the United States;

2. A long-term condition of disturbance, turmoil or agitation that makes a foreign country dangerous or unstable for citizens of the United States; or

3. A condition of disturbance, turmoil or agitation within a foreign country that constrains the United States Government’s ability to assist citizens of the United States, due to closure or inaccessibility of an embassy or consulate or because of a reduction of its staff;

for which either an alert or travel warning has been issued by the United States Department of State.

The most we will pay under this provision is shown on the SCHEDULE above for all insureds combined per policy period.

K. TEMPORARY MEETING SPACE RENTAL

The insured for rental of meeting space which is necessitated by the temporary unavailability of the insured’s primary office space due to the failure of a climate control system or leakage of a hot water heater during the policy period. Coverage will exist only for the renting of temporary meeting space required for meeting with parties who are not insured under this policy.

The most we will pay under this provision is shown on the SCHEDULE above for all insureds combined per policy period.

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L. TERRORISM TRAVEL REIMBURSEMENT

Any current director or officer of the Named Insured for any “emergency travel expenses” incurred, and not reimbursable by any other source, as a result of a “Certified Act of Terrorism” during the policy period.

For the purposes of this SUPPLEMENTARY PAYMENT, the following definitions apply:

“Certified Act of Terrorism” means any act so defined under the Terrorism Risk Insurance Act, including its amendments and extensions.

“Emergency travel expenses” means:

1. Hotel expenses incurred which directly result from the cancellation of a scheduled transport by a common carrier resulting directly from and within 48 hours of a Certified Act of Terrorism; and

2. The increased amount incurred in air or train fare which may result from rescheduling comparable transport cancelled by a common carrier in direct response to a Certified Act of Terrorism.

The most we will pay under this provision is shown on the SCHEDULE above for all insureds combined per policy period.

M. TRAVEL DELAY REIMBURSEMENT

Any current director or officer for any “non-reimbursable expenses” they incur as a result of the cancellation of any regularly scheduled business travel on a common carrier during the policy period.

For the purposes of this SUPPLEMENTARY PAYMENT, the following definition applies:

“Non-reimbursable expenses” means the following travel-related expenses incurred after a 72 hour waiting period, beginning from the time documented on the proof of cancellation, and for which your director or officer produces a receipt:

1. Meals and lodging;

2. Alternative transportation;

3. Clothing and necessary toiletries; and

4. Emergency prescription and non-prescription drug expenses.

The most we will pay under this provision is shown on the SCHEDULE above for all insureds combined per policy period.

N. UNPAID DONATION PLEDGES

The insured for “unpaid donation pledges”. The most we will pay under this provision is shown on the SCHEDULE above for all insureds combined.

With respect to any “unpaid donation pledge”, the following applies:

1. The donor must not have been in bankruptcy, or have filed for bankruptcy or reorganization in the past seven years prior to the time the pledge was made to the insured;

2. For non-cash donation, payment by us of an “unpaid donation pledge” will be based on the fair market value of the non-cash donation at the time of the request for reimbursement;

3. In the case of unemployment or incapacitation of a natural person donor and as a condition of payment of the “unpaid donation pledge”:

a. Neither the natural person donor nor the insured shall have reason to believe the donor would become unemployed or incapacitated subsequent to the pledge date;

b. The donor shall be unemployed or incapacitated for at least 60 days prior to us making payment;

and

c. The insured, at the time of the request for reimbursement, must provide written documentation of the donor’s unemployment status.

4. No payments will be made by us for any written pledge of funds or other valuable tangible property that is dated prior to the policy period; and

5. A donation amount which is to be collected by the insured over more than a 12 month period shall be deemed a single donation commencing from the date of the pledge.

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For the purposes of this SUPPLEMENTARY PAYMENT the following definition applies:

“Unpaid donations pledges” mean a written notice to the insured during the policy period of:

1. The bankruptcy or reorganization of any donor when such bankruptcy or reorganization prevents the donor from honoring a prior written pledge of funds or other valuable tangible property to the insured;

or

2. The unemployment or incapacitation of a natural person donor preventing such donor from honoring a prior written pledge of funds or other valuable tangible property of the insured.

The SUPPLEMENTARY PAYMENTS listed above will not reduce the limits of insurance. However, we will not be obligated to reimburse any insured for any SUPPLEMENTARY PAYMENTS listed above, after the limits of insurance of this policy have been exhausted by the payment of judgments or settlements.

VI. CONDITIONS

A. DUTIES IN THE EVENT OF AN OCCURRENCE, OFFENSE, CLAIM OR SUIT

1. Notice of Occurrence or an Offense

a. The requirement in SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS; 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit; Paragraph a. on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM that you must see to it that we are notified of an “occurrence” or an offense only applies when the “occurrence” or offense is known to:

(1) You, if you are an individual;

(2) A partner, if you are a partnership;

(3) An officer of the corporation or insurance manager, if you are a corporation; or

(4) A member or manager, if you are a limited liability company.

2. Notice of claim or suit

a. The requirement in SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS; 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit; Paragraph b. on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM that you must see to it that we receive notice of a claim or “suit” applies only when the claim or “suit” is known to:

(1) You, if you are an individual;

(2) A partner, if you are a partnership;

(3) An officer of the corporation or insurance manager, if you are a corporation; or

(4) A member or manager, if you are a limited liability company.

B. PRIMARY AND NONCONTRIBUTORY

As respects the coverage provided under this endorsement, SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS; 4. Other Insurance; Paragraph b. Excess Insurance on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is deleted and replaced with the following:

This insurance is excess over any other insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a written agreement with an additional insured described in SECTION II of this Endorsement specifically requires that this insurance be either primary or primary and noncontributory. Then this insurance is primary and, when required, not contributing with any other insurance available to the additional insured which covered that person or organization as a named insured.

C. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US

The following is added to SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS; 8. Transfer Of Rights Of Recovery Against Others To Us on the COMMERCIAL GENERAL LIABILITY COVERAGE

FORM:

We waive any right of recovery against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its rights in a written agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or

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VII. DEFINITIONS

A. BODILY INJURY REDEFINED

SECTION V – DEFINITIONS; 3. “Bodily injury” on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is deleted and replaced with the following:

3. “Bodily injury” means bodily injury, sickness, or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time.

B. MOBILE EQUIPMENT AMENDMENT

The following is added to the part of SECTION V – DEFINITIONS; 12. “Mobile Equipment” on the COMMERCIAL GENERAL LIABILITY COVERAGE FORM dealing with equipment designed primarily for snow removal, road maintenance, or street cleaning:

But, this section does not apply to self-propelled vehicles of less than 1,000 pounds gross vehicle weight regardless of whether or not they are subject to any compulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. Self-propelled vehicles of less than 1,000 pounds gross vehicle weight are considered “mobile equipment”.

VIII.UNINTENTIONAL FAILURE TO DISCLOSE

Any unintentional error or omission in the description of, or failure to completely describe, any premises or operations intended to be covered by the COMMERCIAL GENERAL LIABILITY COVERAGE FORM will not invalidate or affect coverage for those premises or operations. However, you must report such error or omissions to us as soon as practicable after its discovery.

All other terms and conditions of this policy not in conflict with the terms and conditions of this Endorsement shall continue to apply.

File details come from the government source that posted it. Updated .