CERTIFICATE OF LIABILITY INSURANCE - RFQ 24-15 ACCORV DATE IM MID DIYYYYI
CERTIFICATE OF LIABILITY INSURANCE 11'03 2017'
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 ri_qhts to the certificate holder in lieu of such endorsement(s),
PRODUCER CONTACT
MARSH USA,INC. NAME:
'
TWO ALLIANCE CE NTE R PHONE FA
1AJC,No,Ext), X No):
3560 LENOX ROAD,SUITE 2400 E-MAIL
ATLANTA,GA 30326 ADDRESS:
INSURER�ffDING COVERAGE NAIL III
000000-Atkin-GAWUp-17-18 INSURER A:Zurich American Insurance Co•Cant 16535
INSURED iNSURER B:American Guarantee&Liabili Ins Co 26247
Atkins Nonih Annedca,Inc
4030 West Boy Scout Blvd Ste 700 iNSURERC;
Tampa.IFIL 33607-5713 INSURER D:
INSURER E;
INSURER F:
COVERAGES CERTIFICATE NUMBER: ATL-004776777-02 REVISION NUMBER: 0
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.
INSR' ADDLSUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE POLICY NUMBER IA;DWYYYYI., JMM DDIYYYYJ LIMITS,
A COMMERCIAL GENERAL LIABILITY 11011512018 EACH OCCURRENCE 2.000,000
R_
-MADE OCCUR 11A APE RENTED I
MIS T9. 1,000,D00
CLAIMS REM ESE occurrerice)
MED EXP(Any one person) i $ 50,000
PERSONAL&ADV INJURY $ 2.000.000
GEN'L AGGREGATE LIMIT APPLIES PER l GENERAL AGGREGATE 4.000.000
POLICY[:] J'E'OT-
C LOC
PRODUCTS-COMPIOP AGG 4,000,000
OTHER
A AUTOMOBILE LIA31LITY BA 2.DDO.000
COMBINED SINGLE LIMIT I
ANY AUTO 1011512017 1011512018 Ea aqgcLenD__P__rp_er_son) I.
BODILY INJURY
Ov`)NED SCHEDULED i BO D IT Y I NJ U RY(Per accident)i 3
ALITOS ONLY AUTOS i
X I HIRED x NON-OVVNED PROPERTY DAMAGE
- AUTOS ONLY — AUTOS ONLY -Leff
UMBRELLA LIAB
- XOCCUR AUC 9304209-15 1011512017 1011512018 EACH OC C U RRE NC E
5,000,00
EX C E SS LIAB 5,000,000
DED RrTEN-1'ON - AGGREGATE $
A WORKERS COMPENSATION VVC0137577-03 1011512017 1011512018 y I PER 1 1 OTH- 1
,AND EMPLOYERS'LIABILITY YiN ER
ANYPROPR I ET ORIPARTN E RIEXE C UT I VE E-L EACH ACCIDENT I $ 1,000,000
OF F I CE R?M E M BE R EXC LU 0 E D'? F_N] N/A
!(Mandatory in N III) E1 DISEASE,EA EMPLOYEEi
If yes 6 $ 1�000_000
R,.-,b-u'der
P'l IN OF OPERATIONS below E-L DISEASE-POLICY LIMIT 1.000,000
DESCRIPTION OF OPERATIONS I LOCATIONSI VEHICLES ACCRID 101,Additional Remarks Schedule,may be attached if more space is required)I
RE!City of Dearwater ContraCWat Liabifily i,w ri0.,d(,,,J m Gerieral Liabil5ty subject to policy torms and conditions. City of Clearwater is included as additionat insured with respect to General Liability and Auto
Liabi0ity where required by written contract. Thig insurance is pnma.,y and rion-contribuiory over any existing Msurance and limited to lability arising out of operawns of the named insured subject to policy terms and
conditions. 'Naiver of submgation is applicable whefe required by wTitten contract with respect to General Liability,Auto Liability and Workers'Compensation policies and subject to policy terms and conditions.
CERTIFICATE HOLDER CANCELLATION
Csty of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Engineer of Record THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
1 DO S-My roe Avenue ACCORDANCE WITH THE POLICY PROVISIONS.
Engineering-Suite 220
Cleanvater.FL 33756
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
i Manash"i Mulkherjee
C 1988-2016 ACORD CORPORATION, All rights reservi�d.
ACORD 25(20116103) The ACORD name and logo are registered marks of ACORD
«
Coverage Extension Endorsement ZU RICH
BAP-E01 37571 E5 -,_-,,Y 1 1 10/13/2018 10/1,�/21117
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ O' CAREFULLY.
This endorsement modifies insurance provided under the:
Business Auto Coverage Form
N8otorCarr|exCmverag eFarm
A. Amended Who |s An Insured
1. Thefu||owin0 is addadtu the Who Is An Insured Pruvia|on in Sao11nn || - Covered Autos Liability CmmmiraQm�
The foUovv>n0 m|m m[ao "in eu red o^:
a. Any "employee" of yours is an "insured" while using a covered "auto" you don'( ovvn, him or borrow for acts
performed within the scope of employment by you, Any "employee" of yours is also an ^inaured^ while
operating an ^mudo^ hired or rented undo, m contract or agreement in an "employee's" name, with your
permission,while performing duties related to the conduct of your business-
b. Anyone volunteering services to you is an "insured" while using a covered 'au1u^ you don't uwm, him or
borrmwto transport your clients or other persons in activities necessary io your business.
n. Anyone e\aw who furnishes on "auto" referenced in Pm/mUrmphoA.I.a. and A'1-b. in this endorsement.
d. Where and to the extent permitted by law,any peraon(s) oro0mn|znhun(u)where required byvvrit|eu contract
or written agreement with you executed prior to any "accident", including those person(s) or organization(s)
directing your work pursuant to such written contract or written agreement with you, provided the ^mooiUent^
arises out of operations governed by such contract or agreement and only up to the limits required in the
written contract or written agreement, orthe Limits of Insurance shown in the Declarations,whichever is less,
2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other
Insurance- Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form:
Coverage for any person(s) or nrUmn|zmhun(o) where required by written ounYmut or written agreement with you
executed pdmrto any ''mccidenY'. will apply onw primary and non-contributory basis and any insurance maintained
by the additional ^inaured^will apply on an excess basis, However, in no event will this coverage extend beyond
the terms and conditions of the Coverage Form,
O. Amendment- Supplementary Payments
Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section || - Cowered Autos Liability
Coverage are replaced bythefollowing:
/2\ Up to $5.000 for the ouat of bail bomdo (including bonds for related traffic law violations) required because of an
.'accident" we ouver, We du not hmvetofurnish these bonds,
W\ Ail reasonable expenses Incurred by the "insured" at our request, including actual loss of earnings up to $SOO a
day because of time off from work.
U'C4+424'pCYV04A4
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lnd"desoopyvi0xtedmdmria| of Insurance Se,mces Office,|no..pAhftmpanniusiun
C. Fellow Employee Coverage
The Fellow Employee Exclusion contained in Section 11—*covered Autos Liability Coverage does not apply-
D. Driver Safety Program Liability and Physical Damage Coverage
1. The fallowing is added to the acing Exclusion in Section 11—Covered Autos Liabl I Ity Coverage'.
This exclusion does not apply to covered "autos" participating in a driver safety program event, suct'i as, but not
lirn ted to auto or truck rodeos and other auto or truck agility demonstrations,
2, The following is added to Paragraph 2. in the Exclusions of Section III — Physical Damage Coverage of the
Business Auto Coverage Form and Paragraph 2.b. in the Exclusions of Section IV — Physical Damage
Coverage of the Motor Carrier Coverage Form:
This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not
limited to auto or truck rodeos and other auto or truck agility demonstrations,
E. Lease or Loan Gap Coverage
The following is added to the Coverage Provision of the Physical Damage Coverage Section.-
Lease Cr Loan Gap Coverage
In the event of a total "loss"to a covered"auto'", we will pay any unpaid amount due on the lease or loan for a covered
"auto", less:
a. Any amount paid under the Physical Damage Coverage Section of the Coverage Form', and
b. Any:
(1) Overdue lease or loan payments at the time of the"loss";
(2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage;
(3) Security deposits not returned by the lessor;
(4) Costs for extended warranties, credit life insurance, health, accident or disability insurance purchased with the
loan or lease: and
(5) Carry-over balances from previous leases or loans.
F. Towing and Labor
Paragraph A.2.of the Physical Damage Coverage Section is replaced by the following:
We will pay up to $75 for towing and labor costs incurred each time a covered "auto" of the private passenger type is
disabled. However, the labor must be performed at the place of disablement.
G. Extended Glass Coverage
The following is added to Paragraph A.3.a.of the Physical Damage Coverage Section:
If glass must be replaced, the deductible shown in the Declarations will apply. However, if glass can be repaired and
is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass
repaired rather than replaced
H. Hired Auto Physical Damage—Increased Loss of Use Expenses
The Coverage Extension for Loss Of Use Expenses in the Physical Damage Coverage Section is replaced by the
following:
Loss Of Use Expenses
For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for
loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We
will pay for loss of use expenses if caused by
U-CA-424-F CW(04114)
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Includes copyrighted material of Insurance Services Office, Inc-,with its permission.
(1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered
"`auto'":.
(2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided
for any covered 'auto"; or
(3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto",
However. the most we will pay for any expenses for loss of use is $100 per day, to a maximum of$3000.
Personal Effects Coverage
The following is added to the Coverage Provision of the Physical Damage Coverage Section:
Personal Effects Coverage
a. We will pay up to$750 for"loss"to personal effects which are.
(1) Personal property owned by an 'insured'% and
(2) In or on a covered "auto".
b. Subject to Paragraph a.above, the amount to be paid for"loss"to personal effects will be based on the lesser of:
(1) The reasonable cost to replace; or
(2) The actual cash value.
c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered
"auto". No deductible applies to this coverage. However, we will not pay for "loss"to personal effects of any of
the following:
(1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other
documents of value.
(2) Bullion, gold, silver: platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches,
precious or semi-precious stones.
(3) Paintings, statuary and other works of art.
(4) Contraband or property in the course of illegal transportation or trade.
(6) Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment.
Any coverage provided by this Provision is excess over any other insurance coverage available for the same "loss",
J. Tapes, Records and Discs Coverage
1. The Exclusion in Paragraph B.4.a. of Section III — Physical Damage Coverage in the Business Auto Coverage
Form and the Exclusion in Paragraph B.2.c. of Section IV— Physical Damage Coverage in the Motor Carrier
Coverage Form does not apply-
2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the
Physical Damage Coverage Section:
We will pay for "loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic
equipment, We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices.
(a) Are the property of an"insured"i and
(b) Are in a covered"auto"at the time of"loss".
The most we will pay for such "loss" to tapes, records, discs or other similar devices is $500. The Physical
Damage Coverage Deductible Provision does not apply to such"loss",
U-CA-424-F CW(04/14)
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Includes copyrighted material of Insurance Services Office, Inc-wrath its permission.
K. Airbag Coverage
The Exclusion in Paragraph 13.3.a. of Section III—Physical Damage Coverage in the Business Auto Coverage Form
and the Exclusion in Paragraph 13.4.a. of Section IV — Physical Damage Coverage in the Motor Carrier Coverage
Form does not apply to the accidental discharge of an airbag.
L. Two or More Deductibles
The following is added to the Deductible Provision of the Physical Damage Coverage Section:
If an accident is covered both by this policy or Coverage Form and by another policy or Coverage Form issued to you
by us, the following applies for each covered"auto"an a per vehicle basis:
1. If the deductible on this policy or Coverage Form is the smaller(or smallest) deductible, it will be waived; or
2. If the deductible on this policy or Coverage Form is not the smaller (or smallest) deductible, it will be reduced by
the amount of the smaller(or smallest) deductible.
M. Physical Damage—Comprehensive Coverage—Deductible
The following is added to the Deductible Provision of the Physical Damage Coverage Section
Regardless of the number of covered "autos" damaged or stolen, the maximum deductible that will be applied to
Comprehensive Coverage for all "loss"from any one cause is $5,000 or the deductible shown in the Declarations,
whichever is greater,
N. Temporary Substitute Autos—Physical Damage
1. The following is added to Section 11—Covered Autos:
Temporary Substitute Autos—Physical Damage
If Physical Damage Coverage is provided by this Coverage Form on your owned covered "autos", the following
types of vehicles are also covered "autos"for Physical Damage Coverage:
Any "auto"you do not own when used with the permission of its owner as a temporary substitute for a covered
"auto'"you do own but is out of service because of Its
1. Breakdown:
2. Repair,
3. Servicing,
4. "Loss"; or
6. Destruction.
2. The following is added to the Paragraph A.Coverage Provision of the Physical Damage Coverage Section:
Temporary Substitute Autos—Physical Damage
We will pay the owner for"loss"to the temporary substitute "auto" unless the "loss" results from fraudulent acts or
omissions on your part. If we make any payment to the owner, we will obtain the owners rights against any other
pa rty.
The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it
replaces.
A. Amended Duties In The Event Of Accident,Claim, Suit Or Loss
Paragraph a. of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is replaced by 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", claim, "suit" or "loss"- However, these duties only apply when the "accident". clwm, "suit" or
"loss"is known to you (if you are an individual), a partner (if you are a partnership), a member(if you are a limited
liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any
U-CA-424-F CW(04114)
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Includes copyrighted material of Insurance services Office, Inc,,vAth its permission.
agent, servant or employee of the "insured"to notify um of any "accident", o|ainn. 'suit"or"loss"ahmU not invalidate
the insurance afforded bV this policy.
Include, as soon mspracticable:
(1) How( when and where the "accident" or "losa^ occurred and if claim is nlmdm or ''auK'' is brought, written
notice of'We claim or'`eu\Y' |no\uding, but not limited to, the date and details of such c|oinn or ^muit'^�
(2) The'Ynsumad's' name and address; and
(3) To the extent possible, the names and addresses ofany injured persons and witnesses,
If you report an '�mcoident'', claim, "suit" or '1oss" to another insurer when you should have reported to ma, your
failure toreport to us will not be seen as a violation of these amended duties provided you give us notice as soon
as practicable after the fact of the delay becomes known toyou-
P' Waiver of Transfer OfRights Of Recovery Against Others To Us
The following is added io the Transfer OfRights Of Recovery Against Others TnUsCondition,
This Condition does not apply to the extent required of you by a written nontnuot, executed prior to any "accident' or
"|osm", provided that the "accident"or"loss"arises out of operations contemplated by such contract, This waiver only
applies to the person or organization designated inthmcontrmct.
Q. Employee Hired Autos—Physical Damage
Paragraph b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph f. of the Other
Insurance—Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced
by the following:
For Hired Auto Physical Damage Coverage, the following are deemed to ba covered '\autna you own.
(1) Any covered"auto"you lease, h/rm, rent or borrow; and
(2) Any covered "auto" hired or rented under a written contract or written agreement entered into by an ^ennployee''or
elected or appointed official with your permission while being operated within the course and scope of that
'emp|oyae's" employment by you or that elected or appointed official's duties as respect their obligations to you
However, any 'autq''that |sleased, hired, rented or borrowed with m driver |a not a covered "auto°
R. Unintentional Failure to Disclose Hazards
The following is added to the Concealment, Misrepresentation Or Fraud Condition:
However, we will not deny coverage under this Coverage Form If you unintentionally�
M\ Fail to disclose any hazards existing at the inception date of this Coverage Form, or
k2\ KAmkeanernor, omiasiun. improperdescripL\onof^auhos'orotherm/astatmmen¢uf|nfornnaUnn-
You must notify um as soon as possible after the discovery of any hazards or any other inhmrnnmt|on that was not
provided toua prior bo the acceptance of this policy.
S. Hired Auto—V%orid Wide Coverage
Paragraph 7a.(5) of the Policy Period, Coverage Territory Condition |Sreplaced bV the following'
(5) Anywhere in the world if a covered 'auto''is leased, h)nmd, rented or borrowed for a period of 80 days or less,
T. Bod1|y|n'ury Redefined
The definition of"bodily injury" in the Definitions Section is replaced bV the following:
"Bodily injun/" means bodily injury, sickness or disease, sustained by a person including death or mental anguish,
resulting from any cf these mt any time. [Nertm| anguish means any type of mental or emotional illness ordisease.
u-o/+*24-Fcxw(0*14)
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Includes copyrighted material of Insurance Services Office, Inc.,with its permission.
U. Expected Or Intended Injury
The Expected Or Intended Injury Exclusion in Paragraph B. Exclusions under Section 11 —Covered Auto Liability
Coverage is replaced by the following
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.
V. Physical Damage—Additional Temporary Transportation Expense Coverage
Paragraph AA a. of Section III—Physical Damage Coverage is replaced by the following:
4. Coverage Extensions
a. Transportation Expenses
We will pay up to $50 per day to a maximum of $1,000 for temporary transportation expense incurred by you
because of the total theft of a covered "auto" of the private passenger type. We will pay only for those
covered 'autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will
pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and
ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for Its
"loss".
W. Replacement of a Private Passenger Auto With a Hybrid or Alternative Fuel Source Auto
The following is added to Paragraph A. Coverage of the Physical Damage Coverage Section:
In the event of a total "loss"to a covered "auto" of the private passenger type that is replaced with a hybrid "auto" or
"auto" powered by an alternative fuel source of the private passenger type, we will pay an additional 10% of the cost
of the replacement "auto", excluding tax, title, license, other fees and any aftermarket vehicle upgrades, up to a
maximum of$2500. The covered "auto" must be replaced by a hybrid "auto" or an "auto" powered by an alternative
fuel source within 60 calendar days of the payment of the "loss" and evidenced by a bill of sale or new vehicle lease
agreement.
To qualify as a hybrid "auto", the "auto" must be powered by a conventional gasoline engine and another source of
propulsion power. The other source of propulsion power must be electric, hydrogen, propane, solar or natural gas,
either compressed or liquefied. To qualify as an "auto" powered by an alternative fuel source, the "auto" must be
powered by a source of propulsion power other than a conventional gasoline engine, An "auto" solely propelled by
biofuel, gasoline or diesel fuel or any blend thereof is not an"auto" powered by an alternative fuel source.
X. Return of Stolen Automobile
The following is added to the Coverage Extension Provision of the Physical Damage Coverage Section:
If a covered "auto" is stolen and recovered, we will pay the cost of transport to return the "auto" to you- We will pay
only for those covered "autos"for which you carry either Comprehensive or Specified Causes of Loss Coverage,
All other terms, conditions, provisions and exclusions of this policy remain the same.
U-CA-424-F CW(04/14)
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Includes copyrighted material of Insurance Senices Office, Inc.,with its permission.
49
v
Additional Insured Automatic�i� �-��, Lessees ��r
�����u���� ������� �� �����0���� — ��vv ����» �������� �� ZU RICH
Contractors
M_ 5137576-03 Oil 5QOl 7 1'W 1'5Q 018 1,101 5f201
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Nmnnwd Insured: SNC'Lmvo|in Engineers 8`Conetruciora Inc,
Address (including ZIP CmdmA:
819 Mi|am St, Ste, 1000
Houston,TX77OO2
This ondoraemendmodifieu insurance yrovided under the:
Commercial General Liability Coverage Part
A. Section U —Who |sAn his tired is a mended to include as an ad dition al insured an y pe rson o r o rganizatio n who m you
are required to *dd a on odditiona|insure on this policy unde r m written contract or written mUmement. Sunh pereon
or organization 1a an additional insured only with respect to |iabdhyfor "bodily injury", 'property dmme8a" or "personal
and odvehiaing i'ury^unusad^ in whole or|n pmd.by�
1. Your acts or ominsiona� or
.
2. The acts oromi ssioneofthoaeactinOon your bohalf.
in the performance of your ongoing operations or "your work" as included in the "products-completed operations
hazard",which is the subject ofthe written contract or written agreement.
Hmwevor, the insurance afforded to such additional insured:
1. Only ap9|iomto the extent permitted by |mw� and
2. Will not be broader than that which you are required by the written ounhwot or wo/8eu agreement to provide for
such additional |naurod-
B. With respect to the insurance afforded to these additional [nsureds,the following additional exclusion applies:
This insurance does not mpplytn!
"Bodily injury", "property damage"or 1momona| and advertising injury^ arising out of the rendering of, urfmUuve to
mnder, any professional avohitoctura[ enOineahnU or surveying eorviu*a including:
a. The preparing, approving or Ya|Umy hn prepare or approve mapa, ohny drax|nQa, opinione, reports, oun/oya.
��dordens. obmn8aordarnurdrmwi oandapecificohona. ur
h. Supervisory,inspection, arohkocturm| ur engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the
supe ry i io n, h iring, emp loyment, tra ining or monbohno of others b y lha t in sure d. if the ^000unonue^ which ca used iha
"bo dily i or Qo^, or the offonae which oaooed the ^owsonn| wnd mdvortiamg irUury". involyed Uhe
mndohuQ of or the teduna to rendar eny prof easinna| arohbodum| on8moering or aurve yin g aewices.
U^GL-1 1 75-P CYY(04M 3)
Pagel of
|ndudayuo»yrig Nedmet er ial o"|nsurame Se cwm Off nm.|nc.vAhKmpennkssion.
C. The following Paragraph 2. Duties In The Event Of Occurranoe, Offemse, Claim Or Suit of Section K/ —
Commercial General Liability Conditions.
The additional insured must see bmdthat:
1. VVe are notified as soon am practicable nfan"oocurrmnue''oroffense that may result/nac|aim�
2. VVemaoe|vew/rittmn notice ofau|a1nnor''uuit''amsoonaapracUomLde, and
3. A request for defense and indemnity mfthe u|a\nn or "suit" will promptly be brought against any policy Issued by
another Insurer under which the additional insured may be on insured in any capacity. This provision does not
apply to insurance on which the additional insured is a Named insured if the written contract or written agreement
requires that this coverage be primary and non-contributory-
D. For the purposes of the coverage provided bythis endorsement:
1. The fu|lovvio0 is added to the Other Insurance Condition of Section |V — Commercial General Liability
Conditions:
Primary and Noncontributory insurance
This insurance is primary to and will not seek contribution from any other Insurance available to an additional
insured provided that:
a. The additional insured |ea Named Insured under such other insurance and
b. You are required by written contract or written agreement that this insurance be primary and not meek
contribution from any other insurance available to the additional insured-
2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV— Commercial
General Liability Conditions:
This insurance |m excess over:
Any of the other mmuranoe, whether primary, excesa, contingent or un any other basis available to an additional
insured, in which the additional insured on our Dohuv is also covered as on additional insured on another policy
providing coverage for the same ''occurranoe''. offense, claim or''uu/t" This proviaion does not apply to any policy
in which the additional insured is a Named Insured on such other policy and where our policy is required by a
written contract or written agreement to provide coverage 10 the additional insured on a primary and non-
contributory basis.
E. This endorsement does not apply to an additional insured which has been added 10 this policy by an endorsement
shovv|mQ the mdd|i|onm| insured in a Schedule of additional imeurede, and which endorsement applies specifically to
that identified additional insured.
F. With respect bothe insurance afforded to the additional insureds under this endon*enlent, the following is added to
Section U|—L|mmits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance�
1. Required by the written contract or written agreement referenced in Paragraph A. of this endorsement-, or
2- Available under the applicable Limits of Insurance shown in the Declarations,
whichever |oless,
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
All other terms and conditions of this policy remain unchanged.
u'oL'1175-row(04/13)
Page 2of2
Includes copyrighted material of Insurance Services Office, Inc.,vAth its permission.
POLICY NUMBER: GLO 0137576-03 COMMERCIAL GENERAL LIABILITY
CG 20 10 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Cr Organization(s) Location(s)Of Covered Operations
Any person or organization, other than an architect, Any Location or project, other than a wrap-up or other
engineer or surveyor,to whom you are required to consolidated insurance program location or project for
add as an additional insured under this policy under which insurance is otherwise separately provided to
a written contract or written agreement executed you by a wrap-up or other consolidated insurance
prior to loss, except where such requirement is program
prohibited by law.
I
Information requi red to comelete this Schedule. if not shown above, will be shown in the Declarations.
A. Section 11 — Who Is An Insured is amended to B. With respect to the insurance afforded to these
include as an additional insured the person(s) or additional insureds, the following additional
organization(s) shown in the Schedule, but only exclusions apply.-
with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or
damage" or "personal and advertising injury" "property damage"occurring after:
caused, in whole or in part, by: 1. All work, including materials, parts or
1. Your acts or omissions; or equipment furnished in connection with such
2. The acts or omissions of those acting on your work, on the project (other than service,
behalf; maintenance or repairs) to be performed by or
in the performance of your ongoing operations for on behalf of the additional insured(s) at the
the additional insured(s) at the location(s) location of the covered operations has been
or
designated above, completed;
However 2. That portion of "your work" out of wh0"i the
injury or damage arises has been put to its
1. The insurance afforded to such additional intended use by any person or organization
insured only applies to the extent permitted by other than another contractor or subcontractor
law; and engaged in performing operations for a
2. If coverage provided to the additional insured is principal as a part of the same project.
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
CG 2010 0413 0 Insurance Services Office, Inc-, 2012 Page 1 of 2
Wolters Kuwer Financial Services I Uniform Fcms T41
C. With respect to the insurance afforded to these 2. Available under the applicable Limits of
additional insureds, the following is added to Insurance show n in the Declarations;
Section III—Limits Of Insurance: whichever is less.
If coverage provided to the additional insured is This endorsement shall not increase the
required by a contract or agreement, the most we applicable Limits of Insurance shown in the
will pay on behalf of the additional insured is the Declarations,
amount of insurance:
1. Required by the contract or agreement-, or
Page 2 of 2 Q Insurance Services Office, Inc,, 2012 CG 20 10 0413
POLICY NUMBER: GLO 0137576-03 COMMERCIAL GENERAL LIABILITY
CG 24 04 05 09
WAIVER OF' TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COViE:RAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Cr Organization:
Any Person or Organization that requires You to waive your Rights of Recovery, in a written contract or agree-
ment with the Named Insured that is executed prior to the accident or loss.
j Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV—Conditions:
We waive any right of recovery we may have against
the 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.
CG 24 04 05 09 0 Insurance Services Office, Inc-, 2008 Page I of I
Wolters Kluwer Financial Services I Uniform Forms Tk"
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313
(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
ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR
AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT VVAIVER OF
SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT
PERSON AND/OR ORGANIZATION OR SCHEDULED AND PREMIUM CHARGE.
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: 1 011 5/201 7 Policy No,WC 0137577-03 Endorsement No, -
Insured: SNC Lavalin Engieers&Constructors, Inc- Premium$ -
Insurance Company :Zurich American Insurance Company Countersigned by
WC 124(4-84) Page I of 1
WC 00 03 13 Copyright 1983 National council on Compensation Insurance, Inc. uniform Forms TM