260021-CONTRACT PHASE II GMP I.PDF

Maricopa County — Formal (2026-04-08)

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C-73-26-028-X-01

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
AUTOS
AUTOS ONLY
NON-OWNED
SCHEDULED
OWNED
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 NUMBER
TYPE OF INSURANCE
LTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES  (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB
$
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR
CLAIMS-MADE
DED
RETENTION $
$
PRODUCTS - COMP/OP AGG
$
GENERAL AGGREGATE
$
PERSONAL & ADV INJURY
$
MED EXP (Any one person)
$
EACH OCCURRENCE
DAMAGE TO RENTED
$
PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY
PRO-
JECT
LOC
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION.  All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
3/25/2026
ACIG Insurance Agency, Inc.
2600 N. Central Expwy. Suite 800
Richardson, TX  75080
972-702-9004
972-687-0601
www.acig.com
American Contractors Insurance Co RRG
12300
Continental Insurance Company
35289
Westchester Fire Insurance Company
10030
Admiral Insurance Company
24856
Evanston Insurance Company
35378
33138
Landmark American Insurance Company
A
10,000,000
CG25A49318
6/1/2025
6/1/2029
100,000
CG25C49318
6/1/2025
6/1/2029
A

5,000

10,000,000
10,000,000
10,000,000

B
CUE8033105742
6/1/2025
6/1/2029
35,000,000

35,000,000
C
G48609648001
6/1/2025
6/1/2029

D
Excess Liability
UX00000181101
6/1/2025
6/1/2029
Each Occurance: $40,000,000
E
MKLV5EUE104127
6/1/2025
6/1/2029
Aggregate: $40,000,000
F
LHA607041
6/1/2025
6/1/2029
Brian Callaghan
accountmanagers@acig.com
See addendum for add'l limits
Kitchell Contractors, Inc.; Owner as required by
contract; and all subcontractors enrolled in the
CCIP and their lower tier subcontractors unless
excluded by the Sponsor
89876917
Designated Project Site: 10420 W. Van Buren Street, Avondale, AZ 85323
25/26 Rolling - MC SW Regional Justice Center Phase 1A TI
Maricopa County
401 W Jefferson Street
Phoenix AZ  85003
Designated Project: 6947B MC SW Regional Justice Center Phase 1A TI
Designated Project Period: 3/25/2026 to 6/1/2027
89876917 | KITCCCIP | 25/26 Rolling CCIP | Coral Robles | 3/25/2026 4:42:00 PM (CST) | Page 1 of 2
This certificate cancels and supersedes ALL previously issued certificates.

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:
25/26 Rolling Addendum Excess Liability Coverage
06/01/2025 to 06/01/2029
----------------------------------------------------------
Insurer: Endurance American Insurance Company (NAIC #10641)
Policy No.: EXC30089200400
Limit: $10,000,000 x of $75,000,000
KITCCCIP
ACIG Insurance Agency, Inc.
Kitchell Contractors, Inc.; Owner as required by
contract; and all subcontractors enrolled in the
CCIP and their lower tier subcontractors unless
excluded by the Sponsor
CUE8033105742
6/1/2025
Continental Insurance Company
35289
25
Certificate of Liability Insurance (03/16)
ATTACHMENT
HOLDER:
ADDRESS:
Maricopa County
401 W Jefferson Street Phoenix AZ 85003
89876917 | KITCCCIP | 25/26 Rolling CCIP | Coral Robles | 3/25/2026 4:42:00 PM (CST) | Page 2 of 2
This certificate cancels and supersedes ALL previously issued certificates.

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
AUTOS
AUTOS ONLY
NON-OWNED
SCHEDULED
OWNED
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 NUMBER
TYPE OF INSURANCE
LTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES  (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB
$
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR
CLAIMS-MADE
DED
RETENTION $
$
PRODUCTS - COMP/OP AGG
$
GENERAL AGGREGATE
$
PERSONAL & ADV INJURY
$
MED EXP (Any one person)
$
EACH OCCURRENCE
DAMAGE TO RENTED
$
PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY
PRO-
JECT
LOC
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION.  All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
3/23/2026
ACIG Insurance Agency, Inc.
2600 N. Central Expwy. Suite 800
Richardson, TX  75080
972-702-9004
972-687-0601
www.acig.com
Brian Callaghan
accountmanagers@acig.com
Kitchell Contractors, Inc. of Arizona
1707 East Highland, Suite 100
Phoenix AZ  85016
89815575


As required per written contract
6947B - SW Justice Center Construction
Maricopa County
Campus Development & Facilities Bldg
401 W Jefferson St
Phoenix AZ  85003
6947B - SW Justice Center Construction
Professional liability retroactive date 11/11/1978.

B
WCA000006825
6/1/2025
6/1/2026
1,000,000
N
B
WCA000002025
6/1/2025
6/1/2026
1,000,000
1,000,000
F
Contr. Professional Pollution Liab.
PCAB-5028014-0625
6/1/2025
6/1/2026
Per Claim $5,000,000*Aggregate $5,000,000
ACIG Insurance Company
19984
Berkley Assurance Company
39462
89815575 | KITCHELL | 25/26 GL WC PL 5/5 | Excl:GL AU XS | Coral Robles | 3/23/2026 11:02:12 AM (CST) | Page 1 of 2
This certificate cancels and supersedes ALL previously issued certificates.

WC 00 03 13 
(Ed. 04-84)  
 
 1983 National Council on Compensation Insurance. 
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY 
WC 00 03 13 
 
 
(Ed. 04-84) 
 
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 
 
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against 
the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written 
contract that requires you to obtain this agreement from us.) 
 
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. 
 
Schedule 
 
 
Whomever the named insured is required by written contract executed prior to loss to waive rights of recovery 
against. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
This endorsement does not apply to policies in California, Kentucky, New Hampshire, New Jersey, Texas or Utah.  
This endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. 
This endorsement does not apply to policies in Kansas for private construction contracts unless the construction project involved 
is a consolidated or wrap-up program. 
 
 
 
 
 
 
 
 
 
 
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. 
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.) 
 
Endorsement Effective: Same as Policy Effective Date unless otherwise indicated above. 
Policy Effective Date:  
Policy No.    
Endorsement No. 
Insured 
 
Premium $ 
 
Insurance Company  ACIG Insurance Company 
 
 
 
 
Kitchell Contractors, Inc. of Arizona
WCA000006825
6/1/2025
89815575 | KITCHELL | 25/26 GL WC PL 5/5 | Excl:GL AU XS | Coral Robles | 3/23/2026 11:02:12 AM (CST) | Page 2 of 2
This certificate cancels and supersedes ALL previously issued certificates.

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
AUTOS
AUTOS ONLY
NON-OWNED
SCHEDULED
OWNED
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 NUMBER
TYPE OF INSURANCE
LTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES  (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB
$
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR
CLAIMS-MADE
DED
RETENTION $
$
PRODUCTS - COMP/OP AGG
$
GENERAL AGGREGATE
$
PERSONAL & ADV INJURY
$
MED EXP (Any one person)
$
EACH OCCURRENCE
DAMAGE TO RENTED
$
PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY
PRO-
JECT
LOC
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION.  All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
3/23/2026
IMA, Inc. - Kansas City
11350 Switzer Rd, Suite 200
Overland Park KS 66210
IMA Certificate Team
certificates@imacorp.com
National Fire Insurance Company of Hartford
20478
KITCCOR-01
Kitchell Contractors Inc of Arizona
1707 E Highland Ave, Ste 100
Phoenix, AZ 85016
312306783
A
5,000,000
X
X
X
7014861826
6/1/2025
6/1/2026
A
Automobile Physical Damage
7014861826
6/1/2025
6/1/2026
Comprehensive Ded.
Collision Deductible
$1,000
$1,000
6947B - SW Justice Center Construction
Certificate Holder and all other parties required by the contract are included as Additional Insured on the Automobile Liability Policy, if required by written
contract or agreement, subject to the policy terms and conditions. This Insurance is Primary and Non-Contributory on the Automobile Liability Policy, if required
by written contract or agreement, subject to the policy terms and conditions. A Waiver of Subrogation is provided in favor of Certificate Holder and all other
parties required by the contract on the Automobile Liability Policy, if required by written contract or agreement, subject to the policy terms and conditions.
Automobile Liability Coverage includes 30 day notice of cancellation, subject to the terms and conditions of the policy.
Certificate Holder and all other parties required by the contract are included as Loss Payee on the Automobile Physical Damage Coverage, if required by written
contract or agreement, subject to the policy terms and conditions.
Maricopa County
401 W Jefferson St
Phoenix AZ 85003

Business Auto Policy
Policy Endorsement
ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY
It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows:
SCHEDULE
Name of Additional Insured Person Or Organization
ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED BY WRITTEN CONTRACT OR WRITTEN 
AGREEMENT TO NAME AS AN ADDITIONAL INSURED
1.
In conformance with paragraph A.1.c. of Who Is An Insured of Section II - LIABILITY COVERAGE, the 
person or organization scheduled above is an insured under this policy.
2.
The insurance afforded to the additional insured under this policy will apply on a primary and 
non-contributory basis if you have committed it to be so in a written contract or written agreement 
executed prior to the date of the “accident” for which the additional insured seeks coverage under this 
policy.
All other terms and conditions of the policy remain unchanged
This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, 
takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective 
date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy.
 
Endorsement No: 43; Page: 1 of 1
 
Underwriting Company:  National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 
60606
Form No: CNA71527XX (10-2012)
Endorsement Expiration Date:
Endorsement Effective Date:
© Copyright CNA All Rights Reserved.
 
 
 
 
 
 
 
Policy No:
 
7014861826Policy 
Effective Date:
 
06/01/2025Policy
Page:
 
188
 
of
 
197

Business Auto Policy
Policy Endorsement
CONTRACTORS EXTENDED COVERAGE ENDORSEMENT - BUSINESS AUTO PLUS
I.
A.
1.
2.
a.
b.
(1)
(2)
3.
4.
1.
2.
B.
1.
2.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
LIABILITY COVERAGE
Who Is An Insured
The following is added to Section II, Paragraph A.1., Who Is An Insured:
a. Any incorporated entity of which the Named Insured owns a majority of the voting stock on the
date of inception of this Coverage Form; provided that,
b. The insurance afforded by this provision A.1. does not apply to any such entity that is an 
insured under any other liability "policy" providing auto coverage.
Any organization you newly acquire or form, other than a limited liability company, partnership or 
joint venture, and over which you maintain majority ownership interest.
The insurance afforded by this provision A.2.:
Is effective on the acquisition or formation date, and is afforded only until the end of the policy 
period of this Coverage Form, or the next anniversary of its inception date, whichever is earlier.
Does not apply to:
Bodily injury or property damage caused by an accident that occurred before you acquired or 
formed the organization; or
Any such organization that is an insured under any other liability "policy" providing auto
coverage.
Any person or organization that you are required by a written contract to name as an additional 
insured is an insured but only with respect to their legal liability for acts or omissions of a person, 
who qualifies as an insured under SECTION II – WHO IS AN INSURED and for whom Liability 
Coverage is afforded under this policy. If required by written contract, this insurance will be primary 
and non-contributory to insurance on which the additional insured is a Named Insured.
An employee of yours is an insured while operating an auto hired or rented under a contract or 
agreement in that employee's name, with your permission, while performing duties related to the 
conduct of your business.
"Policy", as used in this provision A. Who Is An Insured, includes those policies that were in force on 
the inception date of this Coverage Form but:
Which are no longer in force; or
Whose limits have been exhausted.
Bail Bonds and Loss of Earnings
Section II, Paragraphs A.2. (2) and A.2. (4) are revised as follows:
In a.(2), the limit for the cost of bail bonds is changed from $2,000 to $5,000; and
In a.(4), the limit for the loss of earnings is changed from $250 to $500 a day.
 
Endorsement No: 41; Page: 1 of 4
 
Underwriting Company:  National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 
60606
Form No: CNA63359XX (04-2012)
Endorsement Expiration Date:
Endorsement Effective Date:
© Copyright CNA All Rights Reserved. Includes copyrighted material of the 
Insurance Services Office, Inc., used with its permission.
 
 
 
 
 
 
 
 
Policy No:
 
7014861826Policy
Effective Date:
 
06/01/2025 
Policy Page:
 
183
 
of
 
197

Business Auto Policy
Policy Endorsement
C.
II.
A.
B.
a.
b.
C.
a.
D.
a.
b.
c.
d.
e.
(1)
(2)
E.
Fellow Employee
Section II, Paragraph B.5 does not apply.
Such coverage as is afforded by this provision C. is excess over any other collectible insurance.
PHYSICAL DAMAGE COVERAGE
Glass Breakage – Hitting A Bird Or Animal – Falling Objects Or Missiles
The following is added to Section III, Paragraph A.3.:
With respect to any covered auto, any deductible shown in the Declarations will not apply to glass 
breakage if such glass is repaired, in a manner acceptable to us, rather than replaced.
Transportation Expenses
Section III, Paragraph A.4.a. is revised, with respect to transportation expense incurred by you, to 
provide:
$60 per day, in lieu of $20; subject to
$1,800 maximum, in lieu of $600.
Loss of Use Expenses
Section III, Paragraph A.4.b. is revised, with respect to loss of use expenses incurred by you, to 
provide:
$1,000 maximum, in lieu of $600.
Hired "Autos"
The following is added to Section III. Paragraph A.:
5. Hired "Autos"
If Physical Damage coverage is provided under this policy, and such coverage does not extend to Hired 
Autos, then Physical Damage coverage is extended to:
Any covered auto you lease, hire, rent or borrow without a driver; and
Any covered auto hired or rented by your employee without a driver, under a contract in that 
individual employee's name, with your permission, while performing duties related to the 
conduct of your business.
The most we will pay for any one accident or loss is the actual cash value, cost of repair, cost 
of replacement or $75,000, whichever is less, minus a $500 deductible for each covered auto. 
No deductible applies to loss caused by fire or lightning.
The physical damage coverage as is provided by this provision is equal to the physical damage 
coverage(s) provided on your owned autos.
Such physical damage coverage for hired autos will:
Include loss of use, provided it is the consequence of an accident for which the Named 
Insured is legally liable, and as a result of which a monetary loss is sustained by the leasing 
or rental concern.
Such coverage as is provided by this provision will be subject to a limit of $750 per 
accident.
Airbag Coverage
The following is added to Section III, Paragraph B.3.:
The accidental discharge of an airbag shall not be considered mechanical breakdown.
 
Endorsement No: 41; Page: 2 of 4
 
Underwriting Company:  National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 
60606
Form No: CNA63359XX (04-2012)
Endorsement Expiration Date:
Endorsement Effective Date:
© Copyright CNA All Rights Reserved. Includes copyrighted material of the 
Insurance Services Office, Inc., used with its permission.
 
 
 
 
 
 
 
 
Policy No:
 
7014861826Policy
Effective Date:
 
06/01/2025 
Policy Page:
 
184
 
of
 
197

Business Auto Policy
Policy Endorsement
F.
c.
d.
G.
a.
b.
c.
d.
(1)
(2)
III.
1.
a.
b.
(1)
(2)
2.
IV.
A.
Electronic Equipment
Section III, Paragraphs B.4.c and B.4.d. are deleted and replaced by the following:
Physical Damage Coverage on a covered auto also applies to loss to any permanently installed 
electronic equipment including its antennas and other accessories
A $100 per occurrence deductible applies to the coverage provided by this provision.
Diminution In Value
The following is added to Section III, Paragraph B.6.:
Subject to the following, the diminution in value exclusion does not apply to:
Any covered auto of the private passenger type you lease, hire, rent or borrow, without a driver 
for a period of 30 days or less, while performing duties related to the conduct of your business; 
and
Any covered auto of the private passenger type hired or rented by your employee without a 
driver for a period of 30 days or less, under a contract in that individual employee's name, with 
your permission, while performing duties related to the conduct of your business.
Such coverage as is provided by this provision is limited to a diminution in value loss arising 
directly out of accidental damage and not as a result of the failure to make repairs; faulty or 
incomplete maintenance or repairs; or the installation of substandard parts.
The most we will pay for loss to a covered auto in any one accident is the lesser of:
$5,000; or
20% of the auto's actual cash value (ACV).
Drive Other Car Coverage – Executive Officers
The following is added to Sections II and III:
Any auto you don't own, hire or borrow is a covered auto for Liability Coverage while being used by, 
and for Physical Damage Coverage while in the care, custody or control of, any of your "executive 
officers", except:
An auto owned by that "executive officer" or a member of that person's household; or
An auto used by that "executive officer" while working in a business of selling, servicing, repairing 
or parking autos.
Such Liability and/or Physical Damage Coverage as is afforded by this provision.
Equal to the greatest of those coverages afforded any covered auto; and
Excess over any other collectible insurance.
For purposes of this provision, "executive officer" means a person holding any of the officer positions 
created by your charter, constitution, by-laws or any other similar governing document, and, while a 
resident of the same household, includes that person's spouse.
Such "executive officers" are insureds while using a covered auto described in this provision.
BUSINESS AUTO CONDITIONS
Duties In The Event Of Accident, Claim, Suit Or Loss
The following is added to Section IV, Paragraph A.2.a.:
 
Endorsement No: 41; Page: 3 of 4
 
Underwriting Company:  National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 
60606
Form No: CNA63359XX (04-2012)
Endorsement Expiration Date:
Endorsement Effective Date:
© Copyright CNA All Rights Reserved. Includes copyrighted material of the 
Insurance Services Office, Inc., used with its permission.
 
 
 
 
 
 
 
Policy No:
 
7014861826Policy 
Effective Date:
 
06/01/2025Policy
Page:
 
185
 
of
 
197

Business Auto Policy
Policy Endorsement
(4)
(6)
B.
C.
D.
E.
a.
V.
Your employees may know of an accident or loss. This will not mean that you have such 
knowledge, unless such accident or loss is known to you or if you are not an individual, to any 
of your executive officers or partners or your insurance manager.
The following is added to Section IV, Paragraph A.2.b.:
Your employees may know of documents received concerning a claim or suit. This will not mean 
that you have such knowledge, unless receipt of such documents is known to you or if you are 
not an individual, to any of your executive officers or partners or your insurance manager.
Transfer Of Rights Of Recovery Against Others To Us
The following is added to Section IV, Paragraph A.5. Transfer Of Rights Of Recovery Against Others To 
Us:
We waive any right of recovery we may have, because of payments we make for injury or damage, 
against any person or organization for whom or which you are required by written contract or 
agreement to obtain this waiver from us.
This injury or damage must arise out of your activities under a contract with that person or 
organization.
You must agree to that requirement prior to an accident or loss.
Concealment, Misrepresentation or Fraud
The following is added to Section IV, Paragraph B.2.:
Your failure to disclose all hazards existing on the date of inception of this Coverage Form shall not 
prejudice you with respect to the coverage afforded provided such failure or omission is not intentional.
Other Insurance
The following is added to Section IV, Paragraph B.5.:
Regardless of the provisions of Paragraphs 5.a. and 5.d. above, the coverage provided by this policy 
shall be on a primary non-contributory basis. This provision is applicable only when required by a 
written contract.
That written contract must have been entered into prior to Accident or Loss.
Policy Period, Coverage Territory
Section IV, Paragraph B. 7.(5).(a). is revised to provide:
45 days of coverage in lieu of 30 days.
DEFINITIONS
Section V. paragraph C. is deleted and replaced by the following:
Bodily injury means bodily injury, sickness or disease sustained by a person, including mental anguish, 
mental injury or death resulting from any of these. 
 
Endorsement No: 41; Page: 4 of 4
 
Underwriting Company:  National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 
60606
Form No: CNA63359XX (04-2012)
Endorsement Expiration Date:
Endorsement Effective Date:
© Copyright CNA All Rights Reserved. Includes copyrighted material of the 
Insurance Services Office, Inc., used with its permission.
 
 
 
 
 
 
 
 
Policy No:
 
7014861826Policy
Effective Date:
 
06/01/2025 
Policy Page:
 
186
 
of
 
197

Business Auto Policy
Policy Endorsement
NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS
It is understood and agreed that:
If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of 
Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of 
Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to 
such Certificateholders at least 30 days in advance of the date cancellation is effective.
If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with 
the Agent of Record will be sufficient to prove notice.
Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or 
impose any liability or obligation upon us or the Agent of Record.
All other terms and conditions of the policy remain unchanged
This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, 
takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective 
date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy.
 
Endorsement No: 42; Page: 1 of 1
 
Underwriting Company:  National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 
60606
Form No: CNA68021XX (02-2013)
Endorsement Expiration Date:
Endorsement Effective Date:
© Copyright CNA All Rights Reserved.
 
 
 
 
 
 
 
 
Policy No:
 
7014861826Policy
Effective Date:
 
06/01/2025 
Policy Page:
 
187
 
of
 
197