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Saunders North, LLC - Insurance Certificate
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-MAILADDRESS: 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 EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR 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 5/30/2025 IMA,Inc.-Colorado 1705 17th Street,Suite 100 Denver CO 80202 IMA Certificate Team certificates@imacorp.com American Contractors Insurance Company Risk 12300 SAUNCON-02 The Cincinnati Insurance Company 10677SaundersNorth,LLC 1212 Riverside Ave Suite 130 Fort Collins,CO 80524 The Continental Insurance Company 35289 ACIG Insurance Company 19984 62662252 A X 10,000,000 X 100,000 5,000 10,000,000 10,000,000 X Y Y GL25A00055 6/1/2025 6/1/2026 10,000,000 B 1,000,000 X X X Y Y ENP0626885 6/1/2025 6/1/2026 C X 10,000,000 X CUE7014992559 6/1/2025 6/1/2026 10,000,000 X 0 D D X N Y WCA000014125 WCA000017225 6/1/2025 6/1/2025 6/1/2026 6/1/2026 1,000,000 1,000,000 1,000,000 *All States included in Workers Compensation: MI,MT,NE,CO Professional Liability Coverage:Policy #PCADB-5027981-0625 Effective Dates:06/01/2025-06/01/2026 Insurer:Berkley Assurance Company $15,000,000 Aggregate;$15,000,000 Each Claim;$100,000 Deductible;Claims Made Pollution Liability Coverage:Policy #PCADB-5027981-0625 Effective Dates:06/01/2025-06/01/2026 Insurer:Berkley Assurance Company $15,000,000 Limit;$100,000 Deductible;Includes Mold See Attached... City of Fort Collins 300 LaPorte Ave. Fort Collins CO 80522 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: SAUNCON-02 1 1 IMA,Inc.-Colorado Saunders North,LLC 1212 Riverside Ave Suite 130 Fort Collins,CO 80524 25 CERTIFICATE OF LIABILITY INSURANCE Builders Risk Coverage:Policy #IH4H59092706 Effective Dates:06/01/2025-06/01/2026 Insurer:The Hanover Insurance Company $7,500,000 Frame Limit;$8,500,000 Joisted Masonry Limit;$30,000,000 Non-Combustible Limit; $95,000,000 Masonry Non-Combustible or Better;$50,000 Deductible; $2,500,000 Temporary Storage Limit;$50,000 Deductible $2,500,000 Property in Transit Limit;$50,000 Deductible;$2,500,000 Flood (Zone X)Limit;$50,000 Deductible $10,000,000 Earthquake Limit;$25,000 Deductible;Replacement Cost Valuation;Special Cause of Loss; Equipment Breakdown/Testing Included;No Coinsurance;Owner and Subcontractors are included as Insured. Leased &Rented Equipment Coverage:Policy #RH4H59092605 Effective Dates:06/01/2025-06/01/2026 Insurer:The Hanover Casualty Company $1,650,000 Limit;$10,000 Deductible Crime Coverage:Policy #105607068 Effective Dates:06/01/2025-06/01/2026 Insurer:Travelers Casualty and Surety Company of America $5,000,000 Employee Theft Limit;$35,000 SIR RE:Project #25031003;Project Name:FC Schoolside Park. City of Fort Collins,its officers,agents and employees are included as Additional Insured on the General Liability and Automobile Liability Policies,if required by written contract or agreement,subject to the policy terms and conditions.This Insurance is Primary &Non-Contributory on the General Liability and Automobile Liability Policies,if required by written contract or agreement,subject to the policy terms and conditions.A Waiver of Subrogation is provided in favor of Additional Insured on the General Liability,Automobile Liability and Workers Compensation Policies,if required by written contract or agreement,subject to the policy terms and conditions. 1170 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 No.: 9 Premium $ Insurance Company: American Contractors Insurance Company Risk Retention Group ADDITIONAL INSURED – AUTOMATIC STATUS AS REQUIRED BY CONTRACT – BLANKET This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Any person or organization that you are required by written contract to include as an additional insured on this policy if th e contract is executed prior to the loss. A. Section II - Who Is An Insured is amended to include as an additional insured any person or organization shown in the above SCHEDULE (called additional insured), but only with respect to liability for “bodily injury”, “property damage” or “personal and adver tising injury” arising out of your premises or your operations for the additional insured, and only to the extent and for the minimum limits required in the written contract. B. The insurance provided to the additional insured is subject to the following limitations: 1. Unless a written contract specifically requires additional insured coverage for your completed operations, this insurance does not apply to “bodily injury” or “property damage” occurring after “your work” for the additional insured has been completed or after that portion of “your work” out of which the “bodily injury” or “property damage” arises has been put to its intended use by any person or organization, whichever occurs first. 2. Unless broader coverage is specifically required by written contract, this insurance provides additional insured coverage only for liability for “bodily injury”, “property damage” or “personal and advertising injury” to the extent caused by the named insured’s acts or omissions or the acts or omissions of those acting on the named insured’s behalf. If broader coverage is specifically required by written contract, this insurance does not apply to “bodily injury” or “property damage” or “personal and advertising injury” arising out of the sole negligence, act, or omission of the Additional Insured unless additional insured coverage for an Additional Insured’s sole ne gligence, act, or omission is specifically required by written contract. 3. This insurance does not apply to “bodily injury”, “property damage” or “personal and advertising injury” for which the additional insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement except to the extent that the additional insured would have been obligated to pay such damages in the absence of the contract or agreement. 4. This insurance does not apply to “bodily injury”, “property damage” or “personal and advertising injury” arising out of the r endering or failure to render any professional services by any insured or on any insured’s behalf, including: a) The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, drawings or specifications; or b) Supervisory, inspection, architectural, or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the “occurrence” which caused the “bodily injury” or “property damage”, or the offense which caused the “personal and advertising injury”, involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. 5. This endorsement shall not apply to a person or organization if any other additional insured endorsement attached to this policy specifically applies to that person or organization. 6. The insurance afforded herein only applies to the extent permitted by applicable state law, including statutes governing additional insured coverage in the construction industry. 7. The insurance afforded to the additional insured shall not exceed the minimum limits required in the written contract. C. In no event shall the insurance provided to the additional insured exceed the minimum coverage required by the written contract, including but not limited to minimum limits, minimum scope of coverage, or minimum duration of coverage. If a written contract or agreement requires that additional insured status be provided by the use of specified edition dates of the ISO CG2010 and/or CG2037, then the te rms of that endorsement are incorporated into this endorsement as respects such additional insured and shall supersede the coverage grant and limitations in Sections A. and B. of this endorsement. In the event that CG2010 and/or CG2037 are required but no edition dat es are specified, the 04/13 editions shall apply. D. This insurance is excess to any other insurance, whether primary, excess, contingent or on any other basis, available to the additional insured unless a written contract requires that this insurance be primary or primary and non-contributing. However, this insurance is always excess to other insurance, whether primary, excess, contingent or on any other basis, when the additional insured has been ad ded to the other insurance as an additional insured. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. Endorsement Effective: 6/1/2025 Policy Effective: 6/1/2025 Insured: Saunders Construction, Inc. Policy No.: GL25A00055 205 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 No.: 16 Premium $ Insurance Company: American Contractors Insurance Company Risk Retention Group WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name of Person(s) or Organization(s): Any person or organization for whom you have agreed by written contract to furnish this waiver. Section IV – Commercial General Liability Conditions, 14. Transfer of Rights of Recovery Against Others to Us is amended by the addition of the following: We waive any right of recovery we may have against any person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or “your work” done under a contract with that person or organization and included in the “products -completed operations hazard”. This waiver applies only to the person or organization shown in the Schedule above. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. Policy No.: GL25A00055Endorsement Effective: 6/1/2025 Policy Effective: 6/1/2025 Insured: Saunders Construction, Inc. 336 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 No.: 23 Premium $ Insurance Company: American Contractors Insurance Company Risk Retention Group NOTICE OF CANCELLATION, NONRENEWAL OR MATERIAL CHANGE – CERTIFICATE HOLDERS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM The certificate of insurance holders shown in the schedule below have requested that they receive written notice of cancellation, nonrenewal or material change with respect to this policy. If we decide to cancel, nonrenew or make a material change to this policy, we agree to mail or deliver sixty (60) days advance written notice to the certificate of insurance holders shown in the schedule below. However, if we are cancelling or nonrenewing due to nonpayment of premium, we will only provide the certificate of insurance holders shown in the schedule below with ten (10) days advance written notice. The notice of cancellation, nonrenewal or material change will be mailed to the addresses provided to us by the certificate of insurance issuer. Proof of mailing will be considered sufficient proof of our good faith attempt to provide notice of cancellation, nonrenewal or material change to the certificate of insurance holders shown in the schedule below. SCHEDULE All certificate of insurance holders where written notice of cancellation, nonrenewal or material change to this policy is required by written contract, permit or agreement with the Named Insured. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. Policy No.: GL25A00055Endorsement Effective: 6/1/2025 Policy Effective: 6/1/2025 Insured: Saunders Construction, Inc. 9 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 No.: 5 Premium $ Insurance Company: American Contractors Insurance Company Risk Retention Group AGGREGATE LIMITS OF INSURANCE (PER PROJECT) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM It is hereby understood and agreed the General Aggregate Limit under Section III - Limits of Insurance of the Coverage Form applies separately to each of your projects away from premises owned by or rented to you. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. Endorsement Effective: 6/1/2025 Policy Effective: 6/1/2025 Insured: Saunders Construction, Inc. Policy No.: GL25A00055 Includes copyrighted material of ISO AA 288 06 20 Properties, Inc., with its permission.Page 1 of 4 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CinciPlus® BUSINESS AUTO XC+® (EXPANDED COVERAGE PLUS) ENDORSEMENT This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. A.Blanket Waiver of Subrogation SECTION IV -BUSINESS AUTO CONDI- TIONS, A. Loss Conditions, 5. Transfer of Rights of Recovery Against Others to Us is amended by the addition of the following: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury"or "property damage"arising out of the operation of a covered "auto"when you have assumed liability for such "bodily injury"or "property damage"under an "insured contract", provid- ed the "bodily injury"or "property damage"oc- curs subsequent to the execution or the "in- sured contract". B.Noncontributory Insurance SECTION IV -BUSINESS AUTO CONDI- TIONS, B. General Conditions, 5. Other In- surance c.is deleted in its entirety and re- placed by the following: c.Regardless of the provisions of Par- agraph a.above,this Coverage Form's Liability Coverage is primary and we will not seek contribution from any other insurance for any lia- bility assumed under an "insured contract"that requires liability to be assumed on a primary noncontributo- ry basis. C.Additional Insured by Contract SECTION II -LIABILITY COVERAGE,A. Coverage, 1. Who is an Insured is amended to include as an insured any person or organi- zation for whom you have agreed in a valid written contract to provide insurance as af- forded by this policy. This provision is limited to the scope of the valid written contract. This provision does not apply unless the valid written contract has been: 1.Executed prior to the accident causing "bodily injury"or "property damage"; and 2.Is still in force at the time of the "accident" causing "bodily injury"or "property dam- age". D.Employee Hired Auto 1.Changes in Liability Coverage The following is added to the SECTION II -LIABILITY COVERAGE, A. Coverage, 1. Who is an Insured: An "employee"of yours is an "insured" while operating an "auto"hired or rented under a contract or agreement in that "employee's"name, with your permission, while performing duties related to the conduct of your business. 2.Changes in General Conditions SECTION IV -BUSINESS AUTO CON- DITIONS, B. General Conditions, 5. Other Insurance is deleted in its entirety and replaced by the following: b.For Hired Auto Physical Damage Coverage the following are deemed to be covered "autos"you own: (1)Any covered "auto"you lease, hire, rent or borrow; and (2)Any covered "auto"hired or rented by your "employee"under a contract in that individual "em- ployee's"name, with your per- mission,while performing duties related to the conduct of your business. Includes copyrighted material of ISO AA 288 06 20 Properties, Inc., with its permission.Page 2 of 4 However, any "auto"that is leased, hired,rented or borrowed with a driver is not a covered "auto". E.Audio, Visual and Data Electronic Equip- ment SECTION III -PHYSICAL DAMAGE COV- ERAGE, C. Limit of Insurance is amended by adding the following: 4.The most we will pay for all "loss"to au- dio, visual or data electronic equipment and any accessories used with this equipment as a result of any one "acci- dent"is the lesser of: a.The actual cash value of the dam- aged or stolen property as of the time of the "accident"; b.The cost of repairing or replacing the damaged or stolen property with oth- er property of like kind and quality; or c.$2,500. Provided the equipment, at the time of the "loss"is: a.Permanently installed in or upon the covered "auto"in a housing, opening or other location that is not normally used by the "auto"manufacturer for the installation of such equipment; b.Removable from a permanently in- stalled housing unit as described in Paragraph 2.a.above; or c.An integral part of such equipment. F.Who is an Insured -Amended SECTION II -LIABILITY COVERAGE,A. Coverage, 1. Who is an Insured is amended by adding the following: The following are "insureds": 1.Any subsidiary which is a legally incorpo- rated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this cover- age form. However, the insurance afforded by this provision does not apply to any subsidiary that is an "insured"under any other au- tomobile liability policy or would be an "in- sured"under such policy but for termina- tion of such policy or the exhaustion of such policy's limits of insurance. 2.Any organization that is newly acquired or formed by you and over which you main- tain majority ownership.The insurance provided by this provision: a.Is effective on the date of acquisition or formation, and is afforded for 180 days after such date; b.Does not apply to "bodily injury"or "property damage"resulting from an "accident"that occurred before you acquired or formed the organization; c.Does not apply to any newly acquired or formed organization that is a joint venture or partnership; and d.Does not apply to an insured under any other automobile liability policy or would be an insured under such a policy but for the termination of such policy or the exhaustion of such poli- cy's limits of insurance. 3.Any of your "employees"while using a covered "auto"in your business or your personal affairs, provided you do not own, hire or borrow that "auto". G.Liability Coverage Extensions -Supple- mentary Payments -Higher Limits SECTION II -LIABILITY COVERAGE,A. Coverage, 2. Coverage Extensions,a. Sup- plementary Payments is amended by: 1.Replacing the $2,000 Limit of Insurance for bail bonds with $4,000 in (2); and 2.Replacing the $250 Limit of Insurance for reasonable expenses with $500 in (4). H.Amended Fellow Employee Exclusion SECTION II -LIABILITY COVERAGE,B. Ex- clusions,5. Fellow Employee is modified as follows: Exclusion 5. Fellow Employee is deleted. I.Hired Auto -Physical Damage If hired "autos"are covered "autos"for Liability Coverage, then Comprehensive and Collision Physical Damage Coverages as provided un- der SECTION III -PHYSICAL DAMAGE COVERAGE of this Coverage Part are ex- tended to "autos"you hire, subject to the fol- lowing: 1.The most we will pay for "loss"to any hired "auto"is $50,000 or the actual cash value or cost to repair or replace, which- ever is the least, minus a deductible. 2.The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage, or $1,000, whichever is less. 3.Hired Auto -Physical Damage coverage is excess over any other collectible insur- ance. Includes copyrighted material of ISO AA 288 06 20 Properties, Inc., with its permission.Page 3 of 4 4.Subject to the above limit, deductible, and excess provisions we will provide cover- age equal to the broadest coverage appli- cable to any covered "auto"you own in- sured under this policy. Coverage includes loss of use of that hired au- to, provided it results from an "accident"for which you are legally liable and as a result of which a monetary loss is sustained by the leasing or rental concern.The most we will pay for any one "accident"is $3,000. If a limit for Hired Auto -Physical Damage is shown in the Schedule, then that limit replac- es, and is not added to, the $50,000 limit indi- cated above and the deductibles shown in the Schedule are applicable. J.Rental Reimbursement SECTION III -PHYSICAL DAMAGE COV- ERAGE is amended by adding the following: 1.We will pay for rental reimbursement ex- penses incurred by you for the rental of an "auto"because of a "loss"to a covered "auto". Payment applies in addition to the otherwise applicable amount of each cov- erage you have on a covered "auto". No deductible applies to this coverage. 2.We will pay only for those expenses in- curred during the policy period beginning 24 hours after the "loss"and ending, re- gardless of the policy's expiration, with the lesser of the following number of days: a.The number of days reasonably re- quired to repair the covered "auto". If "loss"is caused by theft,this number of days is added to the number of days it takes to locate the covered "auto"and return it to you; or b.30 days. 3.Our payment is limited to the lesser of the following amounts: a.Necessary and actual expenses in- curred; or b.$50 per day. 4.This coverage does not apply while there are spare or reserve "autos"available to you for your operations. 5.We will pay under this coverage only that amount of your rental reimbursement ex- penses which is not already provided for under SECTION III -PHYSICAL DAM- AGE COVERAGE,A. Coverage, 4. Coverage Extensions. K.Transportation Expense -Higher Limits SECTION III -PHYSICAL DAMAGE COV- ERAGE, A.Coverage,4.Coverage Exten- sions is amended by replacing $20 per day with $50 per day, and $600 maximum with $1,500 maximum in Extension a. Transpor- tation Expenses. L.Airbag Coverage SECTION III -PHYSICAL DAMAGE COV- ERAGE, B. Exclusions, 3.a.is amended by adding the following: However, the mechanical and electrical breakdown portion of this exclusion does not apply to the accidental discharge of an airbag. This coverage for airbags is excess over any other collectible insurance or warranty. M.Loan or Lease Gap Coverage 1.SECTION III -PHYSICAL DAMAGE COVERAGE, C.Limit of Insurance is deleted in its entirety and replaced by the following, but only for private passenger type "autos"with an original loan or lease, and only in the event of a "total loss"to such a private passenger type "auto": a.The most we will pay for "loss"in any one "accident"is the greater of: (1)The amount due under the terms of the lease or loan to which your covered private passenger type "auto"is subject, but will not include: (a)Overdue lease or loan pay- ments; (b)Financial penalties imposed under the lease due to high mileage,excessive use or abnormal wear and tear; (c)Security deposits not re- funded by the lessor; (d)Costs for extended warran- ties, Credit Life Insurance, Health, Accident or Disabil- ity Insurance purchased with the loan or lease; and (e)Carry-over balances from previous loans or leases, or (2)Actual cash value of the stolen or damaged property. b.An adjustment for depreciation and physical condition will be made in de- termining actual cash value at the time of "loss". Includes copyrighted material of ISO AA 288 06 20 Properties, Inc., with its permission.Page 4 of 4 2.SECTION V -DEFINITIONS is amended by adding the following, but only for the purposes of this Loan or Lease Gap Coverage: "Total loss"means a "loss"in which the cost of repairs plus the salvage value ex- ceeds the actual cash value. N.Glass Repair -Waiver of Deductible SECTION III -PHYSICAL DAMAGE COV- ERAGE, D. Deductible is amended by adding the following: No deductible applies to glass damage if the glass is repaired in a manner acceptable to us rather than replaced. O.Duties in the Event of an Accident, Claim, Suit or Loss -Amended SECTION IV -BUSINESS AUTO CONDI- TIONS, A. Loss Conditions, 2. Duties in the Event of Accident, Claim, Suit or Loss, a.is amended by adding the following: This condition applies only when the "acci- dent"or "loss"is known to: 1.You, if you are an individual; 2.A partner, if you are a partnership; 3.An executive officer or insurance manag- er, if you are a corporation; or 4.A member or manager,if you are a lim- ited liability company. P.Unintentional Failure to Disclose Hazards SECTION IV -BUSINESS AUTO CONDI- TIONS, B.General Conditions, 2. Conceal- ment, Misrepresentation or Fraud is amended by adding the following: However, if you unintentionally fail to disclose any hazards existing on the effective date of this Coverage Form,we will not deny cover- age under this Coverage Form because of such failure. Q.Mental Anguish Resulting from Bodily Inju- ry SECTION V -DEFINITIONS, C. "Bodily inju- ry"is deleted in its entirety and replaced by the following: "Bodily injury"means bodily injury, sickness or disease sustained by a person, including men- tal anguish and death sustained by the same person that results from such bodily injury, sickness or disease. "Bodily injury"does not include mental anguish or death that does not result from bodily injury, sickness or disease. R.Coverage for Certain Operations in Con- nection with Railroads With respect to the use of a covered "auto"in operations for or affecting a railroad: 1.SECTION V -DEFINITIONS, H. "Insured contract", 1.c.is deleted in its entirety and replaced by the following: c.An easement or license agreement; 2.SECTION V -DEFINITIONS, H. "Insured contract",2.a.is deleted. Schedule WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) (Ed. 4-84)Copyright 1983 National Council on Compensation Insurance. WC 00 03 13 Page 1 of 1 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. 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 No. Premium $ Countersigned by ________________________________________________ Whomever the named insured is required by written contract executed prior to loss to waive rights of recovery against. Endorsement Effective 06/01/2025 Insured Saunders Construction, Inc. Insurance Company ACIG Insurance Company Policy No. WCA 0000172 25 WCA 0000141 25 WC 99 06 01 (Ed. 03-13) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 01 (Ed. 03-13) Schedule 1.Number of days advance notice: 2.Notice will be mailed to: Page 1 of 1 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 No. Premium $ Insurance Company Countersigned by ______________________________________ NOTICE OF CANCELLATION, NONRENEWAL OR MATERIAL CHANGE ENDORSEMENT In the event of cancellation, nonrenewal or other material change of the policy, we will mail advance notice to the person or organization named in the Schedule. The number of days advance notice is shown in the Schedule. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Endorsement Effective 06/01/2025 Insured Saunders Construction, Inc. ACIG Insurance Company 60 days. However, in the case of cancellation or nonrenewal due to nonpayment of premium, only 10 days advance notice will be provided. All certificate holders where written notice of cancellation, nonrenewal or material change to this policy is required by written contract, permit or agreement with the Named Insured. The notice will be mailed to the addresses provided to us by the certificate of insurance issuer. Proof of mailing will be considered sufficient proof of our good faith attempt to provide written notice. Policy No. WCA 0000172 25 WCA 0000141 25