Leona_Connected_25-26_CERT_Schools_-_State_of_Arizona.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

10/3/2025

License # 0C36861

(949) 660-8192

18058

Kaizen Education Foundation American Charter School Foundation 6150 N 16th Street, Suite A Phoenix, AZ 85016-1774

29424

A 1,000,000

X X PHPK2609147-010 9/29/2025 9/29/2026 1,000,000

15,000

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

X Per Campus SAM OCC/AGG 1,000,000 1,000,000A

X X PHPK2609147-010 9/29/2025 9/29/2026

B

X 72WE PH6721 9/29/2025 9/29/2026 1,000,000

1,000,000 1,000,000

A Educators Legal Liab PHPK2609157-008 9/29/2025 *See Remarks (ACSF) 11,000,000 A Educators Legal Liab PHPK2609154-008 9/29/2025 9/29/2026 *See Remarks (KSF) 11,000,000

Contract No.: CTR078860 - Adult Workforce Diploma Program General Liability Additional Insured Primary and Non-Contributory Insurance Policy form # PI-GL-005 07-012 General Liability Deluxe Endorsement Schools - includes Additional Insured, Waiver of Subrogation Policy form # PI-GLD-VS 05-17

Commercial Automobile Elite Endorsement - Blanket Waiver of Subrogation Policy form # PI-CA-001 09/15; Commercial Auto Blanket Additional Insured form

PI-CA-003 04-14

SEE ATTACHED ACORD 101

State of Arizona Arizona Office of Economic Opportunity ATTN: Stephen Sifuentes, Finance Administrator Senior 1400 W Washington St, 3rd Floor Phoenix, AZ 85007

LEONMAS-01 CDAMSTRALEPLEY

Irvine - Alliant Insurance Services, Inc.

18100 Von Karman Ave 10th Fl Irvine, CA 92612

Cathy Damstra-Lepley cathy.damstra-lepley@alliant.com

Philadelphia Indemnity Insurance Company Hartford Casualty Insurance Company

X

9/29/2026

X X

X

FORM NUMBER:

EFFECTIVE DATE:

The ACORD name and logo are registered marks of ACORD

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE

FORM TITLE:

Page of

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

ACORD 101 (2008/01)

AGENCY CUSTOMER ID:

LOC #:

AGENCY NAMED INSURED

POLICY NUMBER

CARRIER NAIC CODE

© 2008 ACORD CORPORATION. All rights reserved.

Irvine - Alliant Insurance Services, Inc.

LEONMAS-01

SEE PAGE 1

SEE PAGE 1

ACORD 25 Certificate of Liability Insurance

License # 0C36861

SEE P 1

Kaizen Education Foundation American Charter School Foundation 6150 N 16th Street, Suite A Phoenix, AZ 85016-1774

SEE PAGE 1

CDAMSTRALEPLEY

Description of Operations/Locations/Vehicles:

Worker Compensation Waiver of Subrogation Policy Form #WC0003 13

General Liability - Additional insured - Designated Person or Organization, Form CG 2026 04-13 Attached Auto Liability - Designated Insured for Covered Auto Liability Coverage, Form CA2048 10-13 Attached Philadelphia Cancellation Notice to Scheduled Additional or Certificate of holder - Form PI-CANXAICG 05-11

American Charter Schools Foundations – Schools Alta Vista High School - 5040 S. Campbell Avenue, Tucson, AZ 85706 Apache Trail High School - 945 W. Apache Trail, Apache Trail, AZ 85120 Crestview Preparatory High School - 2616 E. Greenway Rd., Phoenix, AZ 85032 Desert Hills High School - 1515 S. Val Vista Drive, Gilbert, AZ 85296 Estrella High School - 510 N. Central Ave, Avondale, AZ 85323 Peoria Accelerated High School - 8885 W. Peoria Avenue, Peoria, AZ 85345 Ridgeview College Preparatory High School - 1645 W Skyline Dr, San Tan Valley, AZ 85142 South Pointe High School - 8325 S. Central Ave., Phoenix AZ 85042 South Ridge High School - 1122 S. 67th Ave, Phoenix, AZ 85043 Sun Valley High School - 1143 S. Lindsay Road, Mesa, AZ 85204 West Phoenix High School - 3835 W. Thomas Road, Phoenix, AZ 85019

Kaizen Education Foundation – Schools Advance U Elementary/South Mountain Preparatory Academy Public Charter Elementary - 449 E. Southern Avenue, Phoenix, AZ 85040 Discover U Elementary - 13226 N 113th Street, Youngtown, AZ 85363 El Dorado High School - 3000 N Alma School Rd, Chandler, AZ 85224 Gilbert Arts Academy - 862 E Elliot Rd, Gilbert, AZ 85234 Glenview College Preparatory High School - 4386 W Bethany Home Road, Phoenix, AZ 85301 Havasu Preparatory Academy - 3155 Maricopa Avenue A, B, C, D, E, Lake Havasu City, AZ 86406 Liberty Arts Academy - 3015 S Power Rd, Mesa, AZ 85212 Maya High School - 3660 W Glendale Ave, Phoenix, AZ 85051 Mission Heights Preparatory High School Quest High School - 217 E Olympic Dr, Phoenix, AZ 85042 Skyview High School - 4290 S Miller Rd, Buckeye, AZ 85326 South Pointe Elementary School - 2033 S Southern Rd, Phoenix, AZ 85042 South Pointe Junior High School - 217 E Olympic, Phoenix, AZ 85042 Summit High School - 728 E McDowell Rd, Phoenix, AZ 85006 Vista Grove Preparatory Academy - 2929 E McKellips Rd, Mesa, AZ 85213 Colegio Petite Elementary - 850 Morley Ave, Nogales, AZ 85621 Leona Connected High School - 6150 N 16th St, Phoenix, AZ 85016

PI-CA-001 (09/15)

© 2015 Philadelphia Indemnity Insurance Company Includes copyrighted material of Insurance Services Office, Inc., with its permission.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

COMMERCIAL AUTOMOBILE ELITE ENDORSEMENT

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE PART

Following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording.

Coverage extensions under this endorsement only apply in the event that no other specific coverage for these extensions is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted in this endorsement.

Any deductible listed in the Auto Declarations Page will apply unless specific deductible provisions are set forth under a coverage enhancement below.

Coverage Applicable

Limit of Insurance

Page

Who is An Insured Board Members Newly Acquired Entities Designated Insured Lessor of Leased Autos

Included Included Included Included

Cost of Bail Bonds $5,000 2 Reasonable Expenses – Loss of Earnings $500 per day 2 Fellow Employee Coverage Amended 3 Towing $100 per disablement 3 Glass Breakage (Windshields and Windows) No deductible applies 3 Transportation Expenses $100 per day / $3,000 maximum 3 Hired Auto Physical Damage – Loss of Use $100 per day / $1,000 maximum 3 Hired Auto Physical Damage ACV or repair or replacement of the vehicle whichever is less

Personal Effects $500 4 Rental Reimbursement $100 per day / 30 days 4 Accidental Discharge – Air Bag Amended 4 Electronic Equipment $1000 5 Original Equipment Manufacturer Parts Replacement

Included 5

Auto Loan / Lease Gap Coverage Amended 5 One Comprehensive Coverage Deductible Per Occurrence

Amended 6

Notice of and Knowledge of Occurrence Amended 7 Blanket Waiver of Subrogation Amended (as required by written contract) 7 Unintentional Errors or Omissions Amended 7 Mental Anguish – Bodily Injury Redefined Amended 7

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

I. LIABILITY COVERAGE EXTENSIONS

A. Who Is An Insured

SECTION II – LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured is amended by adding the following:

The following are also "insureds":

1. Board Members – Board members (or their spouses) while renting a vehicle while on business for the named insured.

2. Newly Acquired Entities – Any business entity newly acquired or formed by you during the policy period, provided you own 50% or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following the acquisition or the formation of the business entity.

3. Designated Insured – Any person or organization designated by the “insured” is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in SECTION II of the Coverage Form.

4. Lessor of Leased Autos – The lessor of a “leased auto” is an “insured" only for "bodily injury" or "property damage" resulting from the acts or omissions by:

a. You;

b. Any of your "employees" or agents; or

c. Any person, except the lessor or any "employee" or agent of the lessor, operating a “leased auto” with the permission of any of the above.

Any “leased auto” in the policy schedule will be considered a covered "auto" you own and not a covered "auto" you hire or borrow.

The coverages provided under this endorsement apply to any “leased auto” in the policy schedule until the expiration date of the lease, or when the lessor or his or her agent takes possession of the “leased auto,” whichever occurs first.

“Leased auto” means an “auto” leased or rented to you, including any substitute, replacement or extra “auto” needed to meet seasonal or other needs, under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor.

B. Cost of Bail Bonds

SECTION II – LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a.

Supplementary Payments, Item (2) is deleted in its entirety and replaced with the following:

(2) Up to $5,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds.

C. Reasonable Expenses

SECTION II – LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a.

Supplementary Payments, Item (4) is deleted in its entirety and replaced with the following:

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

(4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work.

D. Fellow Employee Coverage

SECTION II – LIABILITY COVERAGE, B. Exclusions, 5. Fellow Employee is deleted in its entirety and replaced by the following:

"Bodily injury" to any fellow "employee" of the "insured" arising out of and in the course of the fellow "employee's" employment or while performing duties related to the conduct of your business.

However, this exclusion does not apply to any manager or officer of your company.

II. PHYSICAL DAMAGE COVERAGE EXTENSIONS

A. Towing

SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 2. Towing is deleted in its entirety and replaced with the following:

2. Towing

We will pay up to $100 for towing and labor costs incurred each time a covered "auto" is disabled. However, the labor must be performed at the place of disablement. No deductible applies to this enhancement.

B. Glass Breakage

SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 3. Glass Breakage – Hitting A Bird Or Animal – Falling Objects Or Missiles is amended by adding the following:

No deductible applies to "loss" to glass used in the windshield or windows.

C. Transportation Expenses

SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a.

Transportation Expenses is deleted in its entirety and replaced with the following:

a. Transportation Expenses

We will pay up to $100 per day to a maximum of $3,000 for temporary transportation expenses incurred by you because of a “loss” to a covered “auto.” We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the “loss” and ending, regardless of the policy’s expiration, when the covered “auto” is returned to use or we pay for its “loss.”

D. Hired Auto Physical Damage – Loss of Use

The last sentence of SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 4.

Coverage Extensions, b. Loss of Use Expenses is deleted in its entirety and replaced with the following:

However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of $1,000.

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

E. Hired Auto Physical Damage

SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is amended by adding the following extension:

Hired Auto Physical Damage

Any "auto" you lease, hire, rent or borrow from someone other than your “employees” or partners, or members of their household is a covered "auto" for each of your physical damage coverages.

The most we will pay for any “loss” in any one “accident” is the ACV or the cost for repair or replacement of the vehicle, whichever is less.

For each covered “auto” our obligation to pay will be reduced by a deductible of $500 for Comprehensive Coverage and $1000 for Collision Coverage.

F. Personal Effects Coverage

SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is amended by adding the following extension:

Personal Effects Coverage

We will pay up to $500 for “loss” to personal effects, which are:

1. Owned by an “insured”; and

2. In or on your covered “auto.”

This coverage applies only in the event of the total theft of your covered “auto.” No deductible applies to this coverage.

G. Rental Reimbursement

SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is amended by adding the following extension:

Rental Reimbursement Coverage

We will pay up to $100 per day, for up to 30 days, for rental reimbursement expenses incurred by you for the rental of an “auto” because of “loss” to a covered “auto.”

We will also pay up to $300 for reasonable and necessary expenses incurred by you to remove and replace your materials and equipment from the covered “auto.”

If “loss” results from the total theft of a covered “auto,” we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Item III. C.

Transportation Expenses of this endorsement.

H. Accidental Discharge – Airbag Coverage

SECTION III – PHYSICAL DAMAGE COVERAGE, B. Exclusions, Paragraph 3. is amended by adding the following exception:

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

This exclusion does not apply to the accidental discharge of an airbag. This coverage is excess of any other collectible insurance or warranty. No deductible applies to this coverage.

I. Electronic Equipment Coverage

The following supersedes anything to the contrary in SECTION III – PHYSICAL DAMAGE COVERAGE, B. Exclusions, Paragraph 4.

Exclusions 4.c. and 4.d. do not apply to:

Any risk management or monitoring equipment and electronic equipment that receives or transmits audio, visual or data signals and that is not designed solely for the reproduction of sound. This coverage applies only if the equipment is permanently installed in the covered "auto" at the time of the "loss" or the equipment is removable from a housing unit which is permanently installed in the covered "auto" at the time of the "loss," and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto."

The most we will pay for all “loss” to risk management or monitoring equipment, audio, visual or data electronic equipment that is not designed solely for the reproduction of sound and any accessories used with this equipment as a result of any one “accident” is the least of:

a. The actual cash value of the damaged or stolen property at the time of the “loss”;

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

c. $1,000.

This coverage will not apply if there is other insurance provided by this policy for the above-described electronic equipment. We will, however, pay any deductible, up to $500, that is applicable under the provisions of the other insurance.

J. Original Equipment Manufacturer (OEM) Parts Replacement

SECTION III – PHYSICAL DAMAGE COVERAGE, C. Limit of Insurance, Paragraph 1. is amended to include:

However, if the covered “auto” has less than 20,000 miles on its odometer, then the following condition will apply:

We will pay the cost to replace the damaged parts (excluding glass and mechanical parts) with new Original Equipment Manufacturer replacement parts if the damaged parts cannot be repaired.

K. Auto Loan / Lease Gap Protection

SECTION III – PHYSICAL DAMAGE COVERAGE, C. Limit of Insurance is amended to include the following:

4. In the event of “loss” to a covered “auto” that is loaned or leased to an “insured”:

a. The most we will pay for “loss” in any one “accident” is the lesser of:

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

(1) The actual cash value of the damaged or stolen property as of the time of the “loss”;

or

(2) The cost of repairing or replacing the damaged or stolen property with other property of like, kind and quality.

b. Our Limit of Insurance for “total loss” will be the greater of:

(1) The balance due under the terms of the lease or loan, to which your "auto" is subject but not including:

(a) Past due payments;

(b) Financial penalties imposed under the lease;

(c) Security deposits not refunded;

(d) Costs for extended warranties or insurance; or

(e) Final payment due under a “balloon loan”; or

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

An adjustment for depreciation and physical condition will be made in determining actual cash value at the time of “loss.”

c. Additional Definitions

(1) “Total loss” for the purpose of this coverage, means a loss in which the estimated cost of repairs, plus the salvage value, exceeds the actual cash value.

(2) “Balloon loan” is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment.

d. Additional Conditions

This coverage will apply only to the original lease or loan written on your covered “auto.”

In order for this coverage to apply, leased “autos” must be leased or rented to you under a leasing or rental agreement, for a period of not less than six months, which requires you to provide direct primary insurance for the benefit of the lessor.

L. One Comprehensive Coverage Deductible

SECTION III – PHYSICAL DAMAGE COVERAGE, D. Deductible is amended by adding the following:

Only one Comprehensive Coverage Deductible per occurrence will apply to any “loss” resulting from a covered peril.

For the purpose of this extension, occurrence means a single incident, including continuous or repeated exposure to substantially the same general harmful conditions within a 24-hour period.

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

III. BUSINESS AUTO CONDITIONS

A. Notice and Knowledge of Occurrence

SECTION IV – BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit Or Loss, Paragraph a. is deleted in its entirety and replaced with the following:

a. In the event of “accident,” claim, “suit” or “loss,” you must give us, or our authorized representative, prompt notice of the “accident” or “loss.” Include:

(1) How, when and where the “accident” or “loss” occurred;

(2) The “insured’s” name and address; and

(3) To the extent possible, the names and addresses of any injured persons and witnesses.

Your duty to give us or our authorized representative prompt notice of the “accident” or “loss” applies only when the “accident” or “loss” is known to:

(1) You, if you are an individual;

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

(3) An executive officer or insurance manager, if you are a corporation.

B. Blanket Waiver Of Subrogation

SECTION IV – BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer Of Rights Of Recovery Against Others To Us, is amended by adding the following exception:

However, 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.”

C. Unintentional Errors or Omissions

SECTION IV – BUSINESS AUTO CONDITIONS, B. General Conditions, 2. Concealment, Misrepresentation, Or Fraud is amended by adding the following:

The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal.

IV. DEFINITIONS

A. Mental Anguish

SECTION V – DEFINITIONS, C. "Bodily injury" is amended by adding the following:

“Bodily injury” also includes mental anguish but only when the mental anguish arises from other bodily injury, sickness, or disease.

Philadelphia Indemnity Insurance Company

PI-GLD-VS (05/17)

PI-GLD-VS (05/17)

GENERAL LIABILITY DELUXE ENDORSEMENT

SCHOOLS

COMMERCIAL GENERAL LIABILITY COVERAGE

It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording.

Coverage Applicable Limit of Insurance Page # Damage to Premises Rented to You $300,000 2

Extended Property Damage included 2

Non-Owned Watercraft Less than 58 feet 2

Supplementary Payments – Bail Bonds $2,500 2

Supplementary Payment – Loss of Earnings $500 per day 2

Medical Payments $15,000 3

Medical Payments – Extended Reporting Period 3 years 3

Employee Indemnification Defense Coverage for Employee $25,000 3

Additional Insured – Medical Directors and Administrators Included 3

Additional Insured – Managers and Supervisors Included 3

Additional Insured – Broadened Named Insured Included 3

Additional Insured – Funding Source Included 3

Additional Insured – Managers or Lessors of Premises Included 4

Additional Insured – By Contract, Agreement or Permit Included 4

Additional Insured – Broad Form Vendors Included 4

General Aggregate – Per Campus Included 5

Duties in the Event of Occurrence, Claim or Suit Included 6

Other Insurance – Primary Additional Insured Included 6

Other Insurance – You Are An Additional Insured On Another Person’s Or Organization’s Policy

Included 7

Unintentional Failure to Disclose Hazards Included 8

Liberalization Included 8

Bodily Injury – includes Mental Anguish Included 8

Personal and Advertising Injury – includes Abuse of Process, Discrimination

Included 8

Transfer of Rights of Recovery Against Others To Us Clarification 9

Science Laboratory “Occurrence” $50,000 9

Medical Incident Liability – Nurse and Athletic Trainer Included 9

PI-GLD-VS (05/17)

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

A. Damage to Premises Rented to You

1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word “fire” is changed to “fire, lightning, explosion, smoke, or leakage from automatic fire protective systems” where it appears in:

a. The last paragraph of SECTION I – COVERAGES, COVERAGE A BODILY INJURY AND

PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions;

b. SECTION III - LIMITS OF INSURANCE, Paragraph 6.;

c. SECTION V – DEFINITIONS, Paragraph 9.a.

2. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the words “Fire insurance” are changed to “insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems” where it appears in:

a. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other

Insurance, Paragraph b. Excess Insurance

3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of:

a. $300,000; or

b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit.

This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof.

B. Extended “Property Damage”

SECTION I - COVERAGES. COVERAGE A, COVERAGE A BODILY INJURY AND PROPERTY

DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted and replaced by the

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.

C. Non-Owned Watercraft

SECTION I – COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE

LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is amended to read as follows:

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

(a) Less than 58 feet long; and

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

This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent.

D. Supplementary Payments

Under the SUPPLEMENTARY PAYMENTS - COVERAGE A AND B provision, Items 1.b. and 1.d.

PI-GLD-VS (05/17)

are amended as follows:

1. The limit for the cost of bail bonds is changed from $250 to $2,500; and

2. The limit for loss of earnings is changed from $250 a day to $500 a day.

E. Medical Payments - Limit Increased to $15,000, Extended Reporting Period

If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part:

1. The Medical Expense Limit is changed subject to all of the terms of SECTION III - LIMITS OF INSURANCE to the greater of:

a. $15,000; or

b. The Medical Expense Limit shown in the Declarations of this Coverage Part.

2. SECTION I – COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, the second part of Paragraph a. is amended to read:

provided that:

(2) The expenses are incurred and reported to us within three years of the date of the accident;

F. Employee Indemnification Defense Coverage

Under the SUPPLEMENTARY PAYMENTS - COVERAGES A AND B provision, the following is added:

3. We will pay, on your behalf, defense costs incurred by an “employee” in a criminal proceeding.

The most we will pay for any “employee” who is alleged to be directly involved in a criminal proceeding is $25,000 regardless of the numbers of “employees”, claims or “suits” brought or persons or organizations making claims or bringing “suits”.

G. SECTION II - WHO IS AN INSURED is amended as follows:

1. If coverage for newly acquired or formed organizations is not otherwise excluded from this Coverage Part, Paragraph 3.a. is changed to read:

a. Coverage under this provision is afforded until the end of the policy period.

2. Each of the following is also an insured:

a. Medical Directors and Administrators - Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such.

b. Managers and Supervisors - If you are an organization other than a partnership or joint venture, your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors.

c. Broadened Named Insured - Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance.

d. Funding Source - Any person or organization with respect to their liability arising out of:

(1) Their financial control of you; or

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

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

e. Managers or Lessors of Premises - Any person or organization with respect to their 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 that person or organization.

f. By Contract, Agreement or Permit - Any person or organization with whom you agreed, because of a written contract or agreement or permit, to provide insurance such as is afforded under this policy, but only with respect to your operations, “your work” or facilities owned or used by you.

(1) This provision does not apply:

(a) Unless the written contract or agreement has been executed or permit has been issued prior to the “bodily injury,” “property damage,” “personal and advertising injury”:

(b) To any person or organization included as an insured under g. Broad Form Vendors below; or

(c) To any person or organization included as an insured by an endorsement issued by us and made a part of this Coverage Part.

(2) When an engineer, architect or surveyor becomes an insured under this Coverage Part, the following additional exclusion applies:

(a) “Bodily injury”, “property damage”, “personal and advertising injury” arising out of the rendering of or the failure to render any professional services by or for you, including:

(i) The preparing, approving, or failing to approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; and

(ii) Supervisory, inspection, or engineering services.

(3) When a lessor of leased equipment becomes an insured under this Coverage Part, the following additional exclusions apply:

(a) To any “occurrence” which takes place after the equipment lease expires; or

(b) To “bodily injury” or “property damage” arising out of the sole negligence of the lessor.

(4) When owners or other interests from whom land has been leased become an insured under this Coverage Part, the following additional exclusions apply:

(a) Any “occurrence” which takes place after you cease to lease that land; or

(b) Structural alterations, new construction or demolition operations performed by or on behalf of the owners or other interests from whom land has been leased.

g. Broad Form Vendors - Any person or organization with whom you agreed, because of a written contract or agreement to provide insurance, but only with respect to “bodily injury” or “property damage” arising out of “your products” which are distributed or sold in the regular course of the vendor’s business, subject to the following additional exclusions.

(1) The insurance afforded the vendor does not apply to:

(a) “Bodily injury” or “property damage” for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement;

(b) Any express warranty unauthorized by you;

(c) Any physical or chemical change in the product made intentionally by the vendor;

(d) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing or substitution of parts under instructions from the manufacturer, and then repackaged in the original container;

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(e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products;

(f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor’s premises in connection with sale of the product;

(g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor.

(2) This provision does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products.

(3) This provision does not apply to any vendor included as an insured by an endorsement issued by us and made a part of this Coverage Part.

(4) This provision does not apply if “bodily injury” or “property damage” included within the “products-completed operations hazard” is excluded either by the provisions of the Coverage Part or by endorsement.

H. Per Campus – General Aggregate

SECTION III – LIMITS OF INSURANCE is amended to include the following provisions:

1. For all sums which the insured becomes legally obligated to pay as damages caused by “occurrences” under SECTION I – COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and for all medical expenses caused by accidents under SECTION I – COVERAGE, COVERAGE C MEDICAL PAYMENTS which can be attributed only to operations at a single designated “campus” shown in the Declarations:

a. A separate Per Campus General Aggregate Limit is applicable to each single designated “campus” shown in the Declarations and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations.

b. The Per Campus General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of “bodily injury” or “property damage” included in the “products-completed operations hazard,” and for medical expenses under COVERAGE C regardless of the number of:

(1) Insureds;

(2) Claims made or “suits” brought; or

(3) Persons or organizations making claims or bringing “suits.”

c. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Per Campus General Aggregate Limit for that designated “campus.” Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Per Campus General Aggregate Limit for any other designated “campus” shown in the Declarations.

d. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Per Campus General Aggregate Limit.

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2. For all sums which the insured becomes legally obligated to pay as damages caused by “occurrences” under SECTION I – COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABIITY, and for all medical expenses caused by accidents under SECTION I – COVERAGE, COVERAGE C MEDICAL PAYMENTS which cannot be attributed only to operations at a single designated “campus” shown in the Declarations:

a. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and

b. Such payments shall not reduce any separate designated “campus” General Aggregate Limit.

3. When coverage for liability arising out of the “products-completed operations hazard” is provided, any payment for damages because of “bodily injury” or “property damage” included in the “products-completed operations hazard” will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Per Campus General Aggregate Limit.

4. SECTION V – DEFINITIONS is amended by adding the following:

“Campus” is defined as premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad.

5. The provisions of SECTION III – LIMITS OF INSURANCE not otherwise modified by the above shall continue to apply as stipulated.

I. Duties in the Event of Occurrence, Claim or Suit

1. The requirement in Paragraph 2.a. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS that you must see to it that we are notified as soon as practicable of an “occurrence” or an offense, applies only when the “occurrence” or offense is known to:

a. You, if you are an individual;

b. A partner, if you are a partnership; or

c. An executive officer or insurance manager, if you are a corporation.

2. The requirement in Paragraph 2.b. of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS that you must see to it that we receive notice of a claim or “suit” as soon as practicable will not be considered breached unless the breach occurs after such claim or “suit” is known to:

a. You, if you are an individual;

b. A partner, if you are a partnership; or

c. An executive officer or insurance manager, if you are a corporation.

J. Other Insurance – Primary Additional Insured

1. If the written contract or agreement or permit requires this insurance to be primary for any person or organization with whom you agree to include in SECTION II - WHO IS AN INSURED, then SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance is replaced by the following:

If other valid and collectible insurance is available for a loss we cover under COVERAGE A of this Coverage Part, our obligations are limited as follows:

a. Primary Insurance - This insurance is primary. We will not seek contributions from other

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insurance available to the person or organization with whom you agree to include in SECTION II - WHO IS AN INSURED, except when 2. below applies.

b. Excess Insurance -This insurance is excess over any of the other insurance whether primary, excess, contingent or any other basis:

(1) That is Fire, Extended Coverage, Builder’s Risk, Installation Risk or similar coverage for “your work”;

(2) That is Fire, lightning or explosion insurance for premises rented to you; or temporarily occupied by you with permission of the owner; or

(3) If the loss arises out of the maintenance or use of aircraft, “autos” or watercraft to the extent not subject to SECTION I – COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g.

When this insurance is excess, we will have no duty under Coverages A or B to defend any claim or “suit” that any other insurer has a duty to defend. If no other insurer defends, we will undertake to do so, but we will be entitled to the insured’s rights against all those other insurers.

When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of:

(1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and

(2) The total of all deductible and self-insured amounts under all other insurance.

We will share the remaining loss, if any, with any other insurance that is not described in this excess insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part.

c. Method of Sharing - If all the other insurance permits contribution by equal shares, we will follow this method also. Under this approach 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 or the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer’s contribution is based on the ratio of its applicable limits of insurance of all insurers.

2. This provision only applies with respect to your operations, “your work” or facilities owned or used by you.

K. Other Insurance – You Are An Additional Insured On Another Person’s Or Organization’s

Policy

If you are an insured under SECTION II - WHO IS AN INSURED, then SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. OTHER INSURANCE, Paragraph b. Excess Insurance is replaced by the following:

This insurance is excess over any other insurance, whether primary, excess, contingent or on any other basis:

1. That is Fire, Extended Coverage, Builders Risk, Installation Risk or similar coverage for “your work”;

2. That is Fire, lightning or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner;

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3. If the loss arises out of the maintenance or use of aircraft, “autos” or watercraft to the extent not subject to SECTION I – COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g.; or

4. When any of the Named Insureds, under this Coverage Part, are additional insureds under a commercial general liability policy or similar insurance of another party.

When this insurance is excess, we will have no duty under Coverages A or B to defend any claim or “suit” that any other insurer has a duty to defend. If no other insurer defends, we will undertake to do so, but we will be entitled to the insured’s rights against all those other insureds.

When this insurance is excess or other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of:

1. The total amount that all such other insurance would pay for the loss in the absence of this insurance; and

2. The total of all deductible and self-insured amounts under all that other insurance.

We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part.

L. Unintentional Failure To Disclose Hazards

It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure.

M. Liberalization

If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state.

N. Bodily Injury - Mental Anguish

SECTION V – DEFINITIONS, Paragraph 3. is changed to read:

“Bodily Injury”:

a. Means bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and

b. Except for mental anguish, includes death resulting from the foregoing (item a. above) at any time.

O. Personal and Advertising Injury – Abuse of Process, Discrimination

If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of “personal and advertising injury” is amended as follows:

1. SECTION V – DEFINITIONS, Paragraph 14. b. is revised to read:

b. Malicious prosecution or abuse of process:

2. SECTION V – DEFINITIONS, Paragraph 14. is amended to include the following:

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“Personal Injury” also means discrimination based on race, color, religion, sex, age or national origin, except when:

a. Done intentionally by or at the direction of, or with the knowledge or consent of:

(1) Any insured; or

(2) Any executive officer, director, stockholder, partner or member of the insured; or

b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; or

c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured; or

d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling.

The above does not apply to fines or penalties imposed because of discrimination.

P. Transfer of Rights of Recovery Against Others To Us

As a clarification, the following is added to SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 8. Transfer of Rights of Recovery Against Others To Us:

Therefore, the insured can waive the insurer’s Rights of Recovery prior to the occurrence of a loss, provided the waiver is made in a written contract.

Q. Science Laboratory “Occurrence”

SECTION I – COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE

LIABILITY, Subsection 2. Exclusions, Paragraph f. does not apply to any “bodily injury” or “physical damage” arising out of a fire or “occurrence” in any of your science laboratories while teaching is being conducted in that laboratory, subject to a $50,000 per policy limit.

R. Medical Incident Liability-Nurse and Athletic Trainer

1. SECTION II – WHO IS AN INSURED, Subparagraph 2.a. (1) (d) is deleted and replaced by the

(d) Arising out of his or her providing or failing to provide professional medical services. This paragraph does not apply to a registered or practical nurse or athletic trainer, while acting within the scope of his or her duties for the Named Insured and arising out of a “medical incident”.

2. SECTION V – DEFINITIONS, 13. is deleted and replaced by the following:

“Occurrence” means an accident, including continuous or repeated exposure to substantially the same general harmful conditions, and “medical incident”.

3. The following definition is added to SECTION V – DEFINITIONS:

“Medical Incident” means any act or omission in the furnishing or failure to furnish professional medical services by the insured or any person acting under the personal direction, control, or supervision of the insured. Any such act or omission together with all related acts or omissions in the furnishing of such services to any one person shall be considered one “medical incident”.

“Medical incident” does not include any actual, alleged or threatened emotional, physical, or sexual abuse of any patient or professional medical services recipient.

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BLANKET ADDITIONAL INSURED

BUSINESS AUTO COVERAGE FORM

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

A. SECTION II – COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured is amended by adding the following:

The following are also "insureds":

Any person or organization for whom you are required by an “insured contract” to procure “bodily injury” or “property damage” liability insurance arising out of the operation of a covered "auto'' with your permission. However, this additional insurance does not apply to:

1. The owner or anyone else from whom you hire or borrow a covered "auto." This exception does not apply if the covered "auto" is a "trailer” connected to a covered "auto” you own;

2. Your "employee” if the covered “auto" is owned by that "employee” or a member of his or her household;

3. Anyone using a covered "auto” while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is…